DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 5MEQ (K)
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose 5% provides free water and calories, promoting glucose metabolism and cellular energy production; sodium chloride 0.2% provides sodium and chloride ions for maintenance of extracellular fluid volume and osmolality; potassium chloride provides potassium ions essential for nerve conduction, muscle contraction, and acid-base balance.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle; sodium and chloride are primarily renally excreted; potassium is excreted mainly by the kidneys. |
| Excretion | Renal: 100% (dextrose is metabolized to CO2 and water; sodium, chloride, and potassium are excreted renally). |
| Half-life | Dextrose: <1 min (rapid cellular uptake); potassium: 6-8 h (redistribution half-life in hyperkalemia). Clinically, potassium's elimination half-life is 12-24 h in normal renal function. |
| Protein binding | Dextrose: negligible binding; potassium: negligible binding; sodium and chloride: negligible binding. |
| Volume of Distribution | Dextrose: total body water (0.6 L/kg); potassium: 0.2-0.4 L/kg (initial distribution) up to 0.6 L/kg (total body); sodium and chloride: extracellular fluid (0.2 L/kg). |
| Bioavailability | Intravenous: 100%; oral: not applicable (D50W and electrolyte solutions are parenteral only). |
| Onset of Action | Intravenous: immediate for hemodynamic effects (dextrose) and within minutes for potassium repletion (dependent on infusion rate and clinical status). |
| Duration of Action | Dextrose: 15-30 min after infusion cessation (depends on insulin and metabolic state); potassium: few hours (distribution) to 24-48 h (full repletion); sodium/chloride: until renal excretion completes. |
Intravenous infusion, administered at a rate of 100-125 mL/hour in adults, adjusting based on fluid and electrolyte status. Typically provides 5 g dextrose, 34 mEq sodium, 34 mEq chloride, and 5 mEq potassium per liter.
| Dosage form | INJECTABLE |
| Renal impairment | GFR < 10 mL/min: Use with caution; consider reducing potassium or using potassium-free solution. Monitor potassium levels closely. No specific dose adjustment for dextrose/sodium but monitor for fluid overload. |
| Liver impairment | No specific dose adjustment. Use with caution in severe hepatic impairment due to risk of fluid and electrolyte imbalances; monitor potassium and glucose levels. |
| Pediatric use | Weight-based: 0.5-1 mL/kg/hour initially, adjust based on maintenance fluid requirements (e.g., 100 mL/kg/day for first 10 kg, 50 mL/kg/day for next 10 kg, 20 mL/kg/day for additional weight). Maximum rate not to exceed 5 mL/kg/hour. |
| Geriatric use | Use with caution due to age-related decline in renal function and increased risk of fluid overload. Consider lower infusion rates (e.g., 50-75 mL/hour) and monitor serum potassium, glucose, and volume status closely. |
| 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, sodium, and potassium are normal milk constituents. No M/P ratio available; exogenous infusion minimally alters milk composition at standard doses. |
| Teratogenic Risk | No teratogenic risk at therapeutic doses. Dextrose, sodium chloride, and potassium chloride are physiological constituents. However, severe maternal electrolyte disturbances may affect fetal homeostasis. No specific trimester risks. |
■ FDA Black Box Warning
Not for use in patients with hyperkalemia or conditions predisposing to hyperkalemia; potassium infusion must be diluted and administered via a peripheral or central line; rapid infusion may cause hyperkalemia and cardiac arrest.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperkalemia, hypernatremia, hyperchloremia, anuria, severe renal impairment with oliguria, hyperglycemic states (e.g., diabetic ketoacidosis), and known hypersensitivity to any component.
| Precautions | Use with caution in patients with renal impairment, cardiac disease, or conditions causing potassium retention; monitor serum potassium, sodium, and glucose levels; avoid extravasation; risk of hyperglycemia in diabetic patients. |
| Food/Dietary |
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| Fetal Monitoring | Monitor maternal serum electrolytes, blood glucose, fluid balance, and renal function. Fetal monitoring indicated if maternal metabolic or electrolyte derangements occur. |
| Fertility Effects | No known effects on fertility at therapeutic doses. Physiological electrolytes and glucose do not impair reproductive function. |
| No specific food interactions. However, patients may need dietary potassium or sodium adjustments based on their clinical condition. Concurrent use of potassium-rich foods or supplements can increase risk of hyperkalemia; sodium-rich foods may exacerbate fluid retention. Advise patients to follow prescribed dietary restrictions. |
| Clinical Pearls | Do not administer unless solution is clear and container is undamaged. Use strict aseptic technique for catheter insertion and care. Monitor serum potassium and renal function before and during infusion, especially in patients with renal impairment, cardiac disease, or on potassium-sparing diuretics. Potassium infusion rates generally should not exceed 10 mEq/h in adults without continuous ECG monitoring. Assess for signs of fluid overload, hyperkalemia, and hyperglycemia. For peripheral administration, maximum potassium concentration is 60 mEq/L; higher concentrations require central line. Do not add medications without verifying compatibility. Use within 24 hours after spiking the container. |
| Patient Advice | This solution provides fluids, sugar (dextrose), sodium, and potassium to correct dehydration and electrolyte imbalances. · Tell your healthcare provider if you have kidney problems, heart disease, diabetes, or if you are on a low-potassium or low-sodium diet. · Report any symptoms such as chest pain, irregular heartbeat, weakness, confusion, numbness or tingling, swelling in your legs or feet, or difficulty breathing immediately. · Do not mix other medications into this bag unless directed by a healthcare professional. · The bag is for single use only; discard any unused portion after infusion. · You may experience temporary discomfort at the injection site; notify staff if pain, redness, or swelling persists. |