DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that serves as a source of calories and energy, replenishing blood glucose levels. Sodium chloride provides electrolytes for fluid and electrolyte balance.
| Metabolism | Dextrose is metabolized via glycolysis and the tricarboxylic acid cycle. Sodium chloride is not metabolized. |
| Excretion | Renal: Dextrose is metabolized to carbon dioxide and water, with negligible renal excretion of unchanged dextrose. Sodium and chloride are primarily excreted renally with >90% of filtered load reabsorbed; excess is excreted in urine. Biliary/fecal: Negligible. |
| Half-life | Dextrose: Not applicable as it is rapidly metabolized. Sodium: Not applicable (homeostatically regulated). Chloride: Not applicable (follows sodium). Clinical context: Half-life concepts do not apply; steady state for electrolytes depends on infusion rate and renal function. |
| Protein binding | Dextrose: Not bound. Sodium: Not bound. Chloride: Not bound. |
| Volume of Distribution | Dextrose: 0.2–0.3 L/kg (total body water). Sodium and chloride: 0.2–0.3 L/kg (extracellular fluid). Clinical meaning: Distributes predominantly in extracellular fluid; expands plasma and interstitial volume. |
| Bioavailability | IV: 100% (by definition). |
| Onset of Action | IV infusion: Caloric effect immediate upon metabolism; plasma volume expansion immediate; electrolyte effects within minutes based on infusion rate. |
| Duration of Action | IV infusion: Duration depends on infusion rate and metabolic/renal clearance; caloric effect persists as long as infusion continues; plasma volume expansion persists for hours post-infusion; electrolyte effects follow infusion duration. |
| Molecular Weight | Dextrose: 180.16 Da; Sodium chloride: 58.44 Da |
Intravenous infusion; dosing depends on patient's fluid and electrolyte needs. Typical adult dose: 0.9% sodium chloride equivalent at 100-200 mL/hour, but adjust based on serum sodium, glucose, and volume status.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR 30-60 mL/min: no specific adjustment; monitor volume status and serum electrolytes. For GFR <30 mL/min: use with caution; may require volume restriction and monitoring for hyperchloremic metabolic acidosis. |
| Liver impairment | No specific Child-Pugh based adjustments; use with caution in patients with cirrhosis due to risk of fluid overload and hyponatremia. |
| Pediatric use | Weight-based infusion: 0.9% sodium chloride equivalent at 4-8 mL/kg/hour; adjust based on serum sodium and glucose levels. For maintenance: 100 mL/kg/day for first 10 kg, 50 mL/kg/day for next 10 kg, 20 mL/kg/day for additional weight. |
| Geriatric use | Use with caution; lower initial infusion rates (e.g., 50-100 mL/hour) due to increased risk of fluid overload and electrolyte disturbances. Monitor serum sodium and glucose frequently. |
| 1st trimester | Generally considered safe; dextrose and sodium chloride are physiological components. Use only when clearly needed. |
| 2nd trimester | Generally considered safe; monitor maternal serum glucose and electrolytes if prolonged use. |
| 3rd trimester | Generally considered safe; avoid excessive fluid administration to prevent neonatal hypoglycemia due to maternal hyperglycemia. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Dextrose and sodium chloride readily cross the placenta by passive diffusion and active transport; physiological concentrations maintained. |
| Breastfeeding | Compatible with breastfeeding; dextrose and sodium chloride are endogenous substances. Excretion into breast milk is minimal and not clinically relevant. |
| Lactation Rating | L1 – Safe |
| Teratogenic Risk | Dextrose and sodium chloride are physiologic components that are not known to be teratogenic; no increased risk of congenital anomalies has been reported. |
| Fetal Monitoring | Monitor serum electrolytes (sodium, chloride, glucose), fluid balance, urine output, and signs of fluid overload (edema, hypertension) or hyperglycemia. |
| Fertility Effects | No known adverse effects on fertility; reproductive studies are not available. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperglycemia (severe, uncontrolled)HypernatremiaFluid overload states (e.g., congestive heart failure, renal impairment with oliguria)Sensitivity to any component
| Precautions | Risk of hyperglycemia and hyperosmolar syndrome in patients with diabetes mellitus or impaired glucose tolerance., Risk of fluid overload, especially in patients with renal impairment or cardiac disease., Risk of dilutional hyponatremia, particularly in patients with increased ADH production. |
| Food/Dietary | No direct food interactions. However, sodium content (0.225% = 34.5 mEq/L) should be considered in patients on sodium-restricted diets. Dextrose may affect glucose tolerance; monitor intake in diabetic patients. |
| Clinical Pearls | This hypotonic solution (225 mOsm/L) is suitable for maintenance hydration in normonatremic patients. Monitor serum sodium to avoid hyponatremia, especially in children, elderly, or those with impaired renal function. Do not use for resuscitation or in patients with hyponatremia. Contains 5% dextrose providing 170 kcal/L; consider in catabolic states. |
| Patient Advice | This solution provides water, sugar, and salt to maintain hydration and energy. · Tell your doctor if you have swelling (edema), heart failure, or kidney problems. · Inform your doctor if you are on a low-sodium diet. · You may experience weight gain or swelling if too much fluid is given. · Do not self-adjust the infusion rate. |
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