DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides calories for metabolic processes, restoring blood glucose levels and reducing protein and fat catabolism. Sodium chloride maintains osmolarity and replaces sodium and chloride losses.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle; insulin-dependent uptake. Sodium chloride is not metabolized; excreted renally. |
| Excretion | Renal: >99% of administered glucose is metabolized or excreted; sodium and chloride are excreted renally. In dextrose 5% and sodium chloride 0.2%, glucose undergoes metabolism to CO2 and water; excess is excreted renally. Sodium and chloride are almost entirely excreted renally with >90% reabsorption under normal conditions. |
| Half-life | Glucose half-life is approximately 1.5-2 hours in normal individuals, prolonged in renal impairment or diabetes. Sodium and chloride have no defined half-life as they are electrolytes; their elimination depends on renal function and hydration status. |
| Protein binding | Glucose: negligible (<1%). Sodium and chloride: not protein bound. |
| Volume of Distribution | Glucose: approximately 0.2-0.25 L/kg; distributes primarily in extracellular fluid. Sodium: 0.6-0.7 L/kg (total body water); chloride: similar. Clinical meaning: initial distribution reflects ECF volume; changes indicate fluid shifts. |
| Bioavailability | Intravenous: 100% for all components. Not applicable for oral or other routes as this formulation is for IV use only. |
| Onset of Action | Intravenous: immediate (within seconds to minutes) for volume expansion and plasma osmolality effects. Glucose metabolism begins rapidly upon infusion. |
| Duration of Action | Intravenous: Duration is infusion-dependent; after cessation, effects on plasma volume and osmolality persist for 2-4 hours in euvolemic patients. Glucose effects on blood glucose last approximately 1-2 hours post-infusion. |
Intravenous infusion. Adult: 500-1000 mL per dose at a rate of 2-6 mL/min, frequency dependent on fluid and electrolyte needs. Maximum 40 mL/kg/day.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR 30-50 mL/min: close monitoring of electrolytes; GFR <30 mL/min: use with caution, monitor for hypernatremia and fluid overload, reduce infusion rate by 50%. |
| Liver impairment | No specific adjustment required for Child-Pugh class A or B; use with caution in class C due to risk of fluid overload. |
| Pediatric use | Intravenous infusion. 5-10 mL/kg per dose as needed; rate not to exceed 0.5-1 g/kg/hour of dextrose. For neonates, avoid unless specific indication due to high sodium load. |
| Geriatric use | Reduce initial infusion rate to 1-2 mL/min due to decreased renal function and higher risk of fluid overload; monitor serum sodium and osmolality closely. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Breastfeeding | Dextrose and sodium chloride are normal blood constituents; transfer into breast milk is not clinically significant. No M/P ratio available; considered safe during breastfeeding. |
| Teratogenic Risk | Dextrose and sodium chloride are physiologic substances. No teratogenic risk is reported; however, hyperglycemia or electrolyte imbalances in the mother may affect the fetus. Use standard precautions. |
■ FDA Black Box Warning
Solutions containing dextrose may be contraindicated in patients with known allergies to corn or corn products. Intrathecal administration is contraindicated.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperglycemia and hyperosmolar coma","Hypersensitivity to corn or corn products","Intrathecal administration","Severe dehydration with hypernatremia","Addison's disease without adequate corticosteroid therapy"]
| Precautions | ["Risk of hyperglycemia and hyperosmolar syndrome, especially in patients with diabetes mellitus","May cause fluid and solute overload leading to dilution of serum electrolytes, overhydration, congested states, or pulmonary edema","Use with caution in patients with heart failure, renal impairment, or severe dehydration","Not for use in patients with intracranial or intraspinal hemorrhage","Air embolism risk if administered via pressurized IV lines"] |
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| Fetal Monitoring | Monitor maternal blood glucose, serum electrolytes, fluid balance, and urine output. Fetal assessment via ultrasound if maternal glucose intolerance develops. |
| Fertility Effects | No known adverse effects on fertility with standard use. Uncontrolled maternal hyperglycemia may impair fertility or increase pregnancy complications. |
| Food/Dietary |
| No specific food interactions. Monitor fluid and electrolyte balance especially if patient is on a low-sodium diet. Dextrose may affect blood glucose; adjust meal timing or insulin accordingly. |
| Clinical Pearls | This isotonic solution provides 170 kcal/L from dextrose and is used for maintenance hydration and electrolyte replacement. Monitor serum glucose in diabetics; may cause hyperglycemia. Contains 34 mEq/L sodium and 34 mEq/L chloride. Avoid in patients with hypernatremia, fluid overload, or significant renal impairment. Use with caution in pediatric and elderly patients due to risk of hyponatremia. |
| Patient Advice | This solution provides sugar and salt to help maintain body fluids and energy. · Tell your healthcare provider if you have diabetes, heart failure, kidney disease, or are on a low-salt diet. · Report any swelling, shortness of breath, headache, nausea, or changes in urination. · Do not drink this solution; it is given intravenously. |