DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 20MEQ (K)
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides metabolic energy via glycolysis and the Krebs cycle, replenishing extracellular fluid glucose. Sodium and chloride are major extracellular electrolytes that maintain osmotic pressure and fluid balance; chloride serves as a counterion for acid-base regulation. Potassium is the primary intracellular cation essential for membrane potential, nerve impulse transmission, and muscle contraction. The solution provides water, electrolytes, and calories to correct fluid, electrolyte, and caloric deficits.
| Metabolism | Dextrose is metabolized in all tissues via glycolysis to pyruvate, then enters the Krebs cycle; excess is stored as glycogen or converted to fat. Sodium and chloride are not metabolized but excreted renally under hormonal control (aldosterone, ADH). Potassium is actively transported into cells via Na+/K+-ATPase and excreted primarily by the kidneys. |
| Excretion | Renal: glucose <0.5% excreted unchanged; sodium and potassium >90% reabsorbed; chloride follows sodium. Biliary/fecal: negligible. |
| Half-life | Glucose: 1.5-2 h; potassium: 8-12 h; sodium: 12-24 h; clinical context: half-life affected by renal function and total body stores. |
| Protein binding | Glucose: none; sodium and chloride: none; potassium: none. |
| Volume of Distribution | Glucose: 0.2-0.3 L/kg (extracellular fluid); sodium: 0.15-0.2 L/kg (plasma and interstitial); potassium: 0.4-0.6 L/kg (total body water). |
| Bioavailability | IV: 100% for all components; oral: not applicable (IV only). |
| Onset of Action | IV: immediate for volume expansion; glucose effect within minutes; potassium effect within 1-2 h. |
| Duration of Action | Volume expansion: 1-2 h; glucose: 2-4 h; potassium repletion: 4-6 h; clinical notes: duration depends on infusion rate and patient status. |
| Molecular Weight | 180.16 |
Intravenous infusion; dose depends on fluid, electrolyte, and caloric needs. Typical adult dose: 1000-2000 mL/day, administered at 100-200 mL/hour. Potassium replacement: 20 mEq/L of solution, infused at a rate not exceeding 10 mEq/hour, with a maximum daily dose of 200 mEq.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: No adjustment. GFR 10-50 mL/min: Reduce infusion rate; monitor serum potassium; avoid if hyperkalemia risk. GFR <10 mL/min: Use with extreme caution; consider alternative potassium source; monitor ECG and serum potassium frequently. |
| Liver impairment | Child-Pugh Class A: No specific adjustment. Class B: Reduced doses due to potential for fluid retention; monitor serum potassium. Class C: Avoid due to increased risk of hyperkalemia and fluid overload. |
| Pediatric use | Intravenous infusion; dose based on weight and clinical status. Typical: 5-10 mL/kg/day of the solution, adjusted for electrolyte needs. Infusion rate: Do not exceed 0.5 mEq/kg/hour of potassium. Maximum potassium concentration: 40 mEq/L. Monitor serum electrolytes closely. |
| Geriatric use | Elderly patients may have decreased renal function; initiate at lower infusion rates (e.g., 50-100 mL/hour) and titrate based on serum potassium. Monitor renal function and electrolytes frequently; avoid overhydration. |
| 1st trimester | No known teratogenic risk; dextrose and electrolytes are essential for maternal and fetal homeostasis. Use only when clearly needed. |
| 2nd trimester | Generally safe; monitor serum electrolytes to avoid imbalances. |
| 3rd trimester | Safe; used for hydration and electrolyte maintenance during labor and delivery. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Glucose crosses the placenta via facilitated diffusion; sodium and potassium cross via active transport and passive diffusion; clinically insignificant at recommended doses. |
| Breastfeeding | Dextrose and electrolytes are normal components of breast milk; no known adverse effects on nursing infant. Compatible with breastfeeding. |
| Lactation Rating | Safe |
| Teratogenic Risk | FDA Pregnancy Category C. Dextrose and electrolytes are generally considered low risk when used at physiological doses. Potassium chloride is essential for fetal development; hyperkalemia or hypokalemia may cause fetal arrhythmias. No known teratogenicity in first trimester. Second and third trimester: risk of electrolyte imbalances affecting fetal homeostasis. Use only if clearly needed. |
| Fetal Monitoring | Monitor serum electrolytes (K+, Na+, glucose) periodically during prolonged infusion. Fetal heart rate monitoring if maternal electrolyte disturbances occur. Assess fluid balance to avoid overload, especially in preeclampsia or renal impairment. |
| Fertility Effects | No known effects on fertility. Electrolyte disturbances may affect ovulation indirectly, but no direct evidence. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaHypernatremiaHypersensitivity to any componentFluid overload states (e.g., pulmonary edema, congestive heart failure)
| Precautions | Monitor serum electrolytes, fluid balance, and renal function. Use with caution in patients with cardiac or renal impairment, hyperkalemia, hyponatremia, or conditions predisposing to fluid overload (heart failure, pulmonary edema). Rapid infusion may cause hyperglycemia, hyperosmolarity, or osmotic diuresis. Potassium-containing solutions must be administered with care in patients on potassium-sparing diuretics, ACE inhibitors, or with impaired renal function. Do not administer unless solution is clear and container undamaged. |
| Food/Dietary | No specific food interactions. However, potassium intake from diet should be considered in patients with renal impairment or hyperkalemia. Avoid salt substitutes containing potassium without medical advice. |
| Clinical Pearls | Do not administer if solution is discolored or contains precipitate. Inspect for leaks and ensure container is intact. Use strict aseptic technique when spiking bag. Monitor serum potassium levels closely in renal impairment. Rate of infusion should not exceed 0.5-1 mEq/kg/hour potassium. Do not add other medications unless compatibility verified. For peripheral administration, ensure proper vein selection to avoid phlebitis. |
| Patient Advice | Report any pain, redness, or swelling at the IV site immediately. · Inform your doctor if you have kidney problems, heart disease, or are on a low-potassium diet. · This solution contains dextrose; if you are diabetic, your blood sugar will be monitored. · Do not adjust the IV drip rate yourself. · Tell your doctor if you experience muscle weakness, tingling, or irregular heartbeat. |
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