DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides caloric support and is metabolized to carbon dioxide and water, yielding energy. Sodium chloride provides electrolyte replacement and maintains osmotic pressure.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water, producing ATP. Sodium chloride is not metabolized; it distributes in extracellular fluid and is excreted renally. |
| Excretion | The dextrose is metabolized to carbon dioxide and water, with negligible renal excretion of unchanged dextrose. Sodium and chloride are excreted renally, with >90% of an administered sodium load eliminated via kidneys within 24-48 hours in patients with normal renal function. |
| Half-life | Dextrose has an effective half-life of approximately 1.5-2 hours for equilibration with total body water; however, the terminal elimination half-life is not applicable as it is rapidly metabolized. Sodium has a elimination half-life of about 24-48 hours depending on renal function. |
| Protein binding | Dextrose: not bound to plasma proteins. Sodium and chloride: not protein bound. |
| Volume of Distribution | Dextrose distributes in total body water, approximately 0.55 L/kg (range 0.4-0.6 L/kg). Sodium distributes in extracellular fluid, approximately 0.2 L/kg. |
| Bioavailability | Intravenous: 100% bioavailability. |
| Onset of Action | Intravenous administration: Onset of action for volume expansion occurs within minutes; for glucose elevation, within seconds to minutes following infusion. |
| Duration of Action | Intravenous: Duration of volume expansion is 30-90 minutes depending on infusion rate and patient status; glucose elevation is maintained only during infusion, with return to baseline within minutes after cessation. |
Intravenous infusion. Adult dose is typically 100-200 mL/hour, adjusted based on fluid and electrolyte needs, serum glucose, and clinical status.
| Dosage form | INJECTABLE |
| Renal impairment | In patients with impaired renal function, dose and rate must be individualized based on fluid and electrolyte balance, renal function, and serum glucose. For GFR < 30 mL/min, reduce infusion rate and monitor closely for hypervolemia and electrolyte disturbances. |
| Liver impairment | No specific dose adjustments based on Child-Pugh classification. Use with caution in patients with hepatic impairment due to risk of fluid overload and hyperglycemia; monitor serum glucose and electrolytes. |
| Pediatric use | Weight-based dosing: 5-10 mL/kg/hour as maintenance fluid, adjust based on age, weight, clinical condition, and serum glucose. For neonates and children, consider body surface area and avoid excessive glucose load. |
| Geriatric use | Elderly patients: Use lower initial infusion rates and titrate slowly due to decreased renal function and higher risk of fluid overload, hyperglycemia, and electrolyte abnormalities. Monitor serum glucose, renal function, and volume status 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 components of breast milk. No significant excretion; M/P ratio not applicable. Considered compatible with breastfeeding. |
| Teratogenic Risk | No known teratogenic risk. Dextrose and sodium chloride are normal physiological constituents. No evidence of fetal harm from IV administration at standard doses. Correct electrolyte and glucose abnormalities to prevent fetal acidosis or hyperglycemia. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperglycemia (severe, uncontrolled)","Hypersensitivity to any component","Intracranial hemorrhage (if dextrose-containing solutions may be harmful)","Severe renal impairment (oliguria, anuria) without appropriate monitoring"]
| Precautions | ["Risk of hyperglycemia in diabetic patients or those with glucose intolerance","Risk of fluid overload in patients with heart failure, renal impairment, or pulmonary edema","Electrolyte imbalances (e.g., hypernatremia, hyponatremia) with administration","Use with caution in patients with increased intracranial pressure (dextrose may exacerbate)","Avoid in patients with known allergy to corn or corn products (dextrose derived from corn)"] |
| Food/Dietary |
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| Fetal Monitoring | Monitor maternal serum electrolytes, blood glucose, fluid balance, urine output, and signs of fluid overload. Fetal monitoring as per gestational age and maternal condition. |
| Fertility Effects | No known effects on fertility. Not a reproductive toxicant. |
| No specific food interactions. However, patients on fluid or sodium restriction should be monitored. Diabetic patients should monitor blood glucose levels and adjust diet accordingly. |
| Clinical Pearls | This solution provides 50g dextrose and 34 mEq sodium per liter. It is isotonic with serum; used for maintenance hydration and mild sodium depletion. Monitor serum glucose in diabetic patients. Avoid in patients with hypernatremia or severe renal impairment. Incompatible with certain drugs; check compatibility before IV co-administration. |
| Patient Advice | This solution is used to provide fluids and sugar to your body. · Tell your doctor if you have diabetes, high blood pressure, or kidney problems. · Report any signs of allergic reaction like rash, itching, or trouble breathing. · Inform your healthcare provider if you are pregnant or breastfeeding. · Do not use if the solution is cloudy, discolored, or contains particles. |