DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 15MEQ (K)
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides a source of calories and energy; sodium chloride and potassium chloride replenish electrolytes and maintain fluid balance.
| Metabolism | Dextrose is metabolized via glycolysis and oxidative phosphorylation; potassium is excreted renally; sodium is excreted renally. |
| Excretion | Renal: glucose is completely reabsorbed under normal conditions; excess is excreted unchanged in urine. Sodium, chloride, and potassium are primarily excreted renally, with >90% of infused loads eliminated by kidneys. Fecal and biliary excretion are negligible. |
| Half-life | Not applicable as terminal half-life for dextrose is not defined due to rapid metabolism; for potassium, distribution half-life ~1-1.5 h, terminal half-life ~12-24 h reflecting renal elimination. |
| Protein binding | Not determined; glucose and electrolytes are not protein-bound. |
| Volume of Distribution | Glucose distributes into total body water ~0.55 L/kg; sodium and chloride distribute into extracellular fluid ~0.2 L/kg; potassium distributes into total body water ~0.55 L/kg with preferential intracellular distribution (98% in cells). |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: Immediate (seconds to minutes) for expansion of extracellular fluid volume and correction of electrolyte deficits. |
| Duration of Action | Intravenous: 1-2 hours for volume expansion; electrolyte effects persist as determined by renal elimination and ongoing losses. |
| Molecular Weight | Dextrose: 180.16 Da; Sodium chloride: 58.44 Da; Potassium chloride: 74.55 Da |
Intravenous infusion at a rate of 100-200 mL/hour (2-4 mL/kg/hour) based on fluid and electrolyte requirements. Maximum infusion rate: 1000 mL/hour. Adjust according to serum potassium levels.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: No dose adjustment; monitor serum potassium. GFR 15-29 mL/min: Reduce potassium to 10-15 mEq/L or decrease infusion rate by 50%. GFR <15 mL/min: Avoid use; use potassium-free solution or adjust based on serum potassium. |
| Liver impairment | Child-Pugh A: No adjustment. Child-Pugh B: Reduce potassium to 10-15 mEq/L. Child-Pugh C: Avoid use or use with extreme caution; monitor potassium closely. |
| Pediatric use | Neonates and infants: 0.5-1.0 mEq/kg/day of potassium; adjust per serum levels. Children: Maintenance fluid with potassium 20-40 mEq/L at a rate of 100 mL/kg/day for first 10 kg, then 50 mL/kg/day for next 10 kg, then 20 mL/kg/day for additional weight. Maximum infusion rate: 0.5 mEq/kg/hour. |
| Geriatric use | Start at lower infusion rate (50-100 mL/hour) with frequent monitoring of serum potassium and renal function. Avoid if GFR <30 mL/min; use caution in patients with heart failure or hypertension. |
| 1st trimester | No known teratogenic risk; dextrose, sodium chloride, and potassium chloride are physiological components required for maternal and fetal homeostasis. Use only if clearly needed. |
| 2nd trimester | Safe for use in standard doses; monitor maternal electrolytes and fluid balance. |
| 3rd trimester | Safe for use; caution in preeclampsia or renal impairment due to sodium load. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Dextrose and electrolytes readily cross the placenta via passive diffusion and active transport; concentrations equilibrate between maternal and fetal compartments. |
| Breastfeeding | Excreted into breast milk in insignificant amounts; compatible with breastfeeding. Use only if clinically indicated. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | No teratogenic risk; dextrose, sodium chloride, and potassium chloride are physiological substances. No fetal harm reported in any trimester when used as indicated. |
| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, potassium, glucose), fluid balance, and renal function. Fetal monitoring only if maternal electrolyte disturbances occur. |
| Fertility Effects | No known adverse effects on fertility; components are physiological and essential for normal reproductive function. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaHypernatremiaHyperglycemia with significant ketoacidosisSevere renal impairment with oliguriaFluid overload states (e.g., pulmonary edema, congestive heart failure)
| Precautions | Risk of fluid overload in patients with cardiac or renal impairment, Hyperkalemia risk with rapid potassium infusion, Phlebitis at infusion site, Monitor serum electrolytes and glucose levels |
| Food/Dietary | Avoid excessive intake of potassium-rich foods (e.g., bananas, oranges, potatoes, spinach, avocados, tomatoes) and salt substitutes containing potassium chloride. No alcohol restriction is typically required. |
| Clinical Pearls | This combination (D5 0.2% NaCl with 15 mEq KCl) is a maintenance fluid for patients with ongoing potassium losses and normal renal function. Monitor serum potassium levels and urine output; avoid in hyperkalemia, renal impairment, or Addison's disease. Infusion rate should not exceed 10-20 mEq/hour of potassium. Use with caution in patients on potassium-sparing diuretics or ACE inhibitors. Check compatibility with other IV medications. |
| Patient Advice | This fluid contains potassium; do not consume additional potassium supplements or salt substitutes without consulting your doctor. · Report symptoms of high potassium such as muscle weakness, irregular heartbeat, or tingling sensations immediately. · Tell your healthcare provider if you have kidney problems, heart disease, or are taking certain medications like ACE inhibitors or diuretics. · The infusion rate is carefully controlled; do not adjust the IV drip yourself. |
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