DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 20MEQ (K)
Clinical safety rating: safe
No 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. |
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 | 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 | Compatible with breastfeeding. Dextrose and electrolytes are normal constituents of human milk. Potassium levels in milk are tightly regulated; M/P ratio not applicable. No adverse effects reported. |
| 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. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
Hyperkalemia, severe renal insufficiency (oliguria or anuria), hypernatremia, fluid overload states (e.g., pulmonary edema, decompensated heart failure), severe hypokalemia (until corrected), and known hypersensitivity to any component.
| 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. |
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| 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. |