DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 20MEQ
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose 5% provides calories and fluid for hydration; sodium chloride 0.2% replaces sodium and chloride ions to maintain electrolyte balance; potassium chloride 20 mEq replaces potassium to maintain intracellular ion concentrations and nerve/muscle function.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle; sodium and potassium are excreted primarily by the kidneys. |
| Excretion | Renal: Dextrose is metabolized to CO2 and water, not excreted unchanged. Sodium and chloride are excreted renally; potassium is excreted renally (90%) and fecally (10%). |
| Half-life | Dextrose: ~2 hours for glucose; Sodium and chloride: not applicable; Potassium: ~12 hours (terminal) in normokalemia, prolonged in renal impairment. |
| Protein binding | Dextrose: 0%; Sodium: 0%; Chloride: 0%; Potassium: 0%. |
| Volume of Distribution | Dextrose: 0.2 L/kg (total body water); Sodium: 0.15-0.2 L/kg; Chloride: 0.2 L/kg; Potassium: 0.4-0.6 L/kg (distributes into intracellular space). |
| Bioavailability | Intravenous: 100% for all components. |
| Onset of Action | Intravenous: Immediate for dextrose and electrolytes; clinical effects (e.g., volume expansion, kalemia) within minutes. |
| Duration of Action | Intravenous: Glucose effect lasts 1-2 hours; electrolyte effects persist for hours; potassium repletion may require hours to days depending on deficit. |
Intravenous infusion at a rate of 100-125 mL/hour, providing 5 g dextrose, 0.2 g sodium chloride, and 20 mEq potassium chloride per liter. Typical adult dose is 1 L every 8-12 hours, adjusted for electrolyte needs and fluid status.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) due to risk of hyperkalemia. For GFR 30-50 mL/min, reduce dose by 50% and monitor serum potassium closely. For GFR >50 mL/min, no adjustment needed but monitor electrolytes. |
| Liver impairment | No specific dose adjustment for Child-Pugh class A or B; use with caution in severe hepatic impairment (Child-Pugh class C) due to risk of fluid overload and electrolyte disturbances. Monitor serum potassium and glucose levels. |
| Pediatric use | Weight-based dosing: Infuse at 2-4 mL/kg/hour, providing 0.1-0.2 g/kg/hour dextrose, 0.004-0.008 g/kg/hour sodium chloride, and 0.4-0.8 mEq/kg/hour potassium chloride. Adjust based on serum electrolytes and glucose monitoring. |
| Geriatric use | Reduce initial infusion rate to 50-75 mL/hour due to decreased renal function and risk of hyperkalemia. Monitor serum potassium, glucose, and fluid status closely. Avoid in patients with significant renal impairment (eGFR <30 mL/min). |
| 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 | Dextrose, sodium, chloride, and potassium are normal constituents of breast milk. Intravenous administration of this solution is considered compatible with breastfeeding. M/P ratio not applicable as these are endogenous substances. |
| Teratogenic Risk | Dextrose, sodium chloride, and potassium chloride are essential nutrients and electrolytes. No teratogenic risk is expected at physiological concentrations. However, intravenous administration during pregnancy is generally considered safe when clinically indicated. No trimester-specific risks have been identified. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia (serum potassium >5.5 mEq/L)","Severe renal impairment (oliguria or anuria) with potassium accumulation","Addison's disease (untreated)","Adynamia episodica hereditaria","Acute dehydration (with shock)"]
| Precautions | ["Risk of hyperkalemia in patients with impaired renal function or potassium-retaining conditions","Risk of fluid overload in patients with cardiac or renal impairment","Monitor serum electrolytes and fluid status","Use with caution in patients with diabetes mellitus or glucose intolerance"] |
| Food/Dietary | No known direct food interactions. However, avoid concurrent excessive intake of potassium-rich foods (e.g., bananas, oranges, spinach, potatoes, tomatoes, salt substitutes) to prevent hyperkalemia. Patients with diabetes should monitor blood glucose as dextrose may increase levels. |
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| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, potassium, chloride), glucose levels, and fluid status. In pregnant patients, monitor for signs of fluid overload or electrolyte imbalances. Fetal monitoring may include heart rate assessment if maternal condition warrants. |
| Fertility Effects | No known adverse effects on fertility at therapeutic doses. This solution is used as a maintenance fluid and does not contain hormonal or other agents that could impact reproductive function. |
| Clinical Pearls | Contains 5% dextrose (50 g/L), 0.2% sodium chloride (34 mEq/L Na+, Cl-), and 20 mEq potassium chloride per liter. Provides 170 kcal/L. Use dedicated line due to high osmolality (≈ 560 mOsm/L). Monitor serum potassium and renal function. Contraindicated in severe hyperkalemia, anuria, or hypertonic dehydration. Do not administer rapidly—risk of hyperkalemia. Use with caution in patients with heart failure or hypertension due to sodium load. |
| Patient Advice | This infusion provides sugar, salt, and potassium to maintain your body's fluid and electrolyte balance. · Tell your healthcare provider if you have a history of kidney disease, heart failure, or high potassium levels. · Report any chest pain, irregular heartbeat, muscle weakness, or shortness of breath during the infusion. · Avoid consuming potassium-rich foods (e.g., bananas, oranges, potatoes) unless advised by your clinician. · Do not adjust the infusion rate; it is set to deliver the correct amount slowly. · Notify your nurse if you experience pain, redness, or swelling at the IV site. |