DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER
Clinical safety rating: safe
No 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. |
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 | 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 | Excreted in breast milk; M/P ratio not established. Dextrose and sodium chloride are normal constituents of milk; use during lactation is considered 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. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
["Hypersensitivity to any component.","Clinically significant hyperglycemia or hypernatremia.","Use in patients with intracranial or intraspinal hemorrhage, or conditions causing severe dehydration with anuria."]
| 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."] |
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| 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. |