DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 0.3% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides caloric support and corrects hypoglycemia by increasing blood glucose levels. Sodium chloride maintains osmotic pressure and fluid balance. Potassium chloride replaces potassium deficits and maintains electrolyte homeostasis.
| Metabolism | Dextrose is metabolized to pyruvate and lactate via glycolysis. Potassium is excreted primarily by the kidneys. Sodium is excreted mainly by the kidneys. |
| Excretion | Renal (glucose and ions are handled by the kidneys; potassium excreted via urine; sodium and chloride reabsorbed or excreted as needed; dextrose metabolized to CO2 and water; <5% unchanged glucose excreted in urine if normoglycemic) |
| Half-life | Not applicable as a combined solution; dextrose half-life ~1-2 hours (plasma glucose clearance); potassium half-life depends on distribution and renal function (approx. 1-2 hours for serum K correction); sodium and chloride have no defined half-life. |
| Protein binding | Dextrose: negligible; potassium: negligible; sodium: negligible; chloride: negligible. |
| Volume of Distribution | Dextrose volume of distribution ~0.2 L/kg (mainly extracellular); potassium initial Vd ~0.4-0.7 L/kg; sodium and chloride distribute mainly in extracellular fluid (~0.25 L/kg for Na, ~0.3 L/kg for Cl). |
| Bioavailability | Intravenous: 100% for all components; oral: not applicable for combined solution; other routes: not relevant. |
| Onset of Action | Intravenous: immediate for volume expansion and electrolyte correction; glucose effects on blood glucose within minutes. |
| Duration of Action | Intravenous: for volume expansion, 1-2 hours; for electrolyte and glucose effects, duration depends on infusion rate and patient's metabolic/renal function. |
IV infusion; rate and volume determined by fluid, electrolyte, and caloric requirements. Typical adult: 100-200 mL/hour, not to exceed 25 g dextrose/hour (500 mL/hour of D5) and 10 mEq potassium/hour. Total daily dose: 1-3 L/day.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (eGFR <30 mL/min/1.73 m²) unless hypokalemia present. For eGFR 30-60: reduce potassium infusion rate by 50% and monitor serum potassium. For eGFR <30: avoid potassium-containing solutions; consider potassium-free alternatives. |
| Liver impairment | No specific adjustment for Child-Pugh class A or B. For severe hepatic impairment (Child-Pugh C): avoid potassium loads due to risk of hyperkalemia; use with caution and monitor serum potassium and glucose closely. |
| Pediatric use | IV infusion; dose based on weight and fluid requirements. Infants and children: 2-4 mL/kg/hour of D5 0.2% NaCl with KCl 0.3% (3 mEq KCl per 100 mL). Maximum dextrose infusion rate: age-dependent: neonates: 12-15 mg/kg/min; children: 8-10 mg/kg/min. Potassium: 0.5-1 mEq/kg/day, not to exceed 0.5 mEq/kg/hour. |
| Geriatric use | Initiate at lower infusion rates (e.g., 50-100 mL/hour) due to reduced renal function. Monitor serum potassium and glucose frequently; elderly at increased risk for hyperkalemia and fluid overload. Consider renal function when determining potassium content. |
| 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 as normal constituents. No known adverse effects on infant. M/P ratio not applicable (endogenous substances). Compatible with breastfeeding. |
| Teratogenic Risk | No evidence of teratogenicity for dextrose, sodium, or potassium at physiological doses. Parenteral administration during pregnancy is safe when indicated. No known fetal risks in first trimester. In second and third trimesters, avoid hyperglycemia (dextrose) and electrolyte imbalances. Use with caution in preeclampsia or hypervolemia. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Hypernatremia","Hypersensitivity to any component","Clinically significant hyperglycemia","Addison's disease"]
| Precautions | ["Risk of fluid overload in patients with cardiac or renal impairment","Hyperkalemia risk with rapid infusion or renal dysfunction","Hyperglycemia in diabetic patients","Phlebitis and infection at infusion site"] |
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| Fetal Monitoring | Monitor maternal serum electrolytes (Na+, K+, glucose) and fluid status. Fetal heart rate monitoring if used during labor. Monitor for signs of hyperglycemia, hyperkalemia, or fluid overload. |
| Fertility Effects | No known adverse effects on fertility. Used as a vehicle for parenteral nutrition and fluid replacement. No reproductive toxicity at therapeutic doses. |