DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 10MEQ
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides calories and serves as a source of energy through cellular glucose uptake and metabolism. Sodium chloride replenishes extracellular fluid and electrolytes. Potassium chloride replaces intracellular potassium, essential for neuromuscular and cardiac function.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle; sodium and potassium are primarily excreted unchanged by the kidneys. |
| Excretion | Renal: Dextrose is metabolized to CO2 and water; sodium and potassium are excreted renally. Potassium excretion is 90% renal, 10% fecal. Sodium excretion is >95% renal. |
| Half-life | Dextrose: 1-2 hours (endogenous glucose turnover). Potassium: ~4-6 hours in healthy adults; prolonged in renal impairment. |
| Protein binding | Dextrose: negligible (<5%). Potassium: negligible (<5%). Sodium: negligible. |
| Volume of Distribution | Dextrose: ~0.2 L/kg (total body water). Sodium: ~0.6 L/kg. Potassium: ~0.4 L/kg (intracellular distribution). |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: Immediate for hemodilution and electrolyte distribution; clinical effects (e.g., glucose elevation, volume expansion) within minutes. |
| Duration of Action | Duration depends on infusion rate and patient status; effects persist while infusion continues and for ~2-4 hours after discontinuation for glucose and electrolytes. |
| Molecular Weight | Dextrose: 180.16 Da; Sodium chloride: 58.44 Da; Potassium chloride: 74.55 Da; Individual components, not combined. |
Intravenous infusion: 100-200 mL/hour, adjusting based on patient's fluid status, serum electrolytes, and clinical response. Typical administration rate for maintenance: 0.5-1.5 mL/kg/hour.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR 30-59 mL/min: monitor potassium levels closely and consider reducing potassium content. For GFR <30 mL/min: avoid use or switch to potassium-free solution; adjust fluid rate based on urine output to avoid fluid overload. |
| Liver impairment | No specific Child-Pugh based adjustments for dextrose and sodium chloride; potassium chloride may require dose reduction in severe hepatic impairment due to risk of hyperkalemia; monitor potassium levels. |
| Pediatric use | Intravenous infusion: Infants and children: 3-5 mL/kg/hour for maintenance, adjusting based on age, weight, and clinical condition. Maximum rate: 5 mL/kg/hour. Monitor serum potassium and glucose closely. |
| Geriatric use | Elderly patients: initiate at lower infusion rates (0.5-1 mL/kg/hour) due to decreased renal function and higher risk of fluid overload and hyperkalemia. Monitor electrolytes and renal function frequently. |
| 1st trimester | Dextrose, sodium chloride, and potassium chloride are generally considered safe during pregnancy when used at recommended doses. Glucose is essential for fetal growth, and electrolytes are necessary for maternal and fetal homeostasis. However, intravenous administration should be monitored to avoid fluid overload, electrolyte imbalances, and hyperglycemia. |
| 2nd trimester | Same as first trimester. Monitor serum electrolytes and glucose levels. Avoid excessive fluid administration to prevent complications. |
| 3rd trimester | Same as previous trimesters. Additional caution due to increased plasma volume and risk of gestational diabetes. Use only if clearly needed and monitor maternal blood glucose and electrolytes. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Dextrose crosses the placenta freely via facilitated diffusion. Sodium and chloride ions cross via active transport and diffusion; potassium crosses via active transport. These are physiological substances and essential for fetal development. At therapeutic doses, no adverse effects are expected. |
| Breastfeeding | Dextrose, sodium chloride, and potassium chloride are normal constituents of breast milk and body fluids. Intravenous administration does not pose a risk to the nursing infant when used at therapeutic doses. However, high doses or rapid infusion may affect maternal fluid and electrolyte balance, indirectly affecting milk composition. Monitor maternal electrolytes and hydration status. |
| Lactation Rating | L1 - Compatible |
| Teratogenic Risk | Dextrose and electrolytes are essential nutrients and are not teratogenic. No fetal risks identified in any trimester when administered as indicated. |
| Fetal Monitoring | Monitor maternal serum electrolytes (potassium, sodium, chloride, glucose) and renal function. Fetal heart rate monitoring during administration for potential fluid or electrolyte imbalances. |
| Fertility Effects | No known adverse effects on fertility. Dextrose and electrolytes are essential for normal reproductive function. |
■ FDA Black Box Warning
No FDA black box warning.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperglycemia (uncontrolled diabetes mellitus)HypernatremiaHyperchloremiaHyperkalemiaSevere fluid overload (e.g., pulmonary edema, congestive heart failure)Severe renal impairment with oliguria or anuriaHypersensitivity to any component
| Precautions | Risk of hyperglycemia in diabetic or glucose-intolerant patients, Risk of hyperkalemia in patients with renal impairment, Monitor serum potassium and glucose levels frequently, Use with caution in patients with heart failure or edema due to sodium load |
| Food/Dietary | No direct food interactions. However, potassium intake from diet (e.g., bananas, oranges, leafy greens) should be considered when monitoring total potassium load. Avoid excessive salt intake as this solution provides sodium. In diabetic patients, dextrose may affect blood glucose levels. |
| Clinical Pearls | Contains D5W, 0.2% NS, and 10 mEq KCl per liter. Used for maintenance fluid and electrolyte replacement. Monitor serum potassium regularly; adjust rate based on renal function and potassium levels. Avoid in patients with hyperkalemia, severe renal impairment, or anuria. Use with caution in heart failure or conditions that may cause fluid overload. Do not exceed infusion rate of 10-20 mEq/hr for potassium. Administer via central line if potassium concentration >10 mEq/100 mL. |
| Patient Advice | Tell your healthcare provider about all medications you are taking, especially potassium-sparing diuretics or ACE inhibitors. · Report any signs of fluid overload: difficulty breathing, swelling in ankles/legs, or rapid weight gain. · Report any symptoms of high potassium: muscle weakness, irregular heartbeat, tingling sensations. · This solution contains sugar (dextrose) and potassium; monitor blood glucose if diabetic. · Do not stop or change the infusion rate without consulting your healthcare provider. |
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