DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 5MEQ
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides glucose for cellular energy metabolism; sodium chloride and potassium chloride restore electrolyte balance and maintain osmotic gradients. Potassium is essential for neuronal conduction, muscle contraction, and acid-base regulation.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water; potassium and sodium are excreted primarily by the kidneys with minimal metabolism. |
| Excretion | Renal: >95% as free ions (K+, Na+, Cl-) and glucose metabolism products; biliary/fecal: <5% |
| Half-life | Glucose: 2-3 hours (increased in renal impairment, diabetes); potassium: 12-24 hours (tissue redistribution); sodium/chloride: 20-30 minutes (rapid renal adjustment) |
| Protein binding | Glucose: negligible (<5%); potassium, sodium, chloride: none (free ions) |
| Volume of Distribution | Glucose: 0.15-0.25 L/kg (primarily extracellular fluid); potassium: 0.4-0.6 L/kg (intracellular distribution); sodium/chloride: 0.2-0.3 L/kg (extracellular fluid) |
| Bioavailability | Intravenous: 100% (not applicable for oral due to different formulation) |
| Onset of Action | Intravenous: immediate (seconds to minutes) for electrolyte and glucose effects |
| Duration of Action | Intravenous: 1-2 hours for glucose effect; electrolyte effects persist while infusion continues (tissue redistribution prolongs potassium effect) |
Intravenous infusion; rate determined by fluid and electrolyte requirements. Typical adult dose: 1000-2000 mL over 24 hours, providing 5 g dextrose, 0.2 g sodium chloride, and 5 mEq potassium chloride per 100 mL. Infusion rate not to exceed 25 mL/hr to avoid hyperkalemia.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR < 30 mL/min) due to risk of potassium accumulation. For mild-moderate impairment (GFR 30-60 mL/min): reduce infusion rate by 50% and monitor serum potassium closely. |
| Liver impairment | No specific adjustment for Child-Pugh class A or B; monitor for fluid overload and electrolyte disturbances. In Child-Pugh class C (decompensated cirrhosis), avoid use due to risk of hyperkalemia and volume overload; consider alternative solutions. |
| Pediatric use | Intravenous infusion; dose individualized based on weight, fluid, and electrolyte needs. Typical range: 2-6 mL/kg/hr, providing up to 0.5 mEq/kg/day potassium, with maximum infusion rate 0.25 mEq/kg/hr. Monitor serum potassium and glucose. |
| Geriatric use | Use with caution due to reduced renal function; lower initial infusion rates (e.g., 50-100 mL/hr) and monitor serum potassium, electrolytes, and volume status. Adjust based on creatinine clearance and avoid rapid infusion. |
| 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, and potassium are normal constituents of breast milk. Administration of these electrolytes at physiologic doses does not pose risk to the nursing infant. No M/P ratio is applicable as these are endogenous substances. The product is compatible with breastfeeding. |
| Teratogenic Risk | Dextrose, sodium chloride, and potassium chloride at standard replacement doses are not associated with teratogenic risk. Dextrose provides caloric support; sodium and potassium are physiologic electrolytes. No evidence of teratogenicity in any trimester. However, maternal hyperglycemia from excessive dextrose may contribute to fetal macrosomia and neonatal hypoglycemia, particularly in the third trimester. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Hypernatremia","Hyperglycemia with ketoacidosis","Severe renal impairment with oliguria or anuria","Addison's disease (relative)","Concomitant use of potassium-sparing diuretics or ACE inhibitors (relative)"]
| Precautions | ["Risk of hyperglycemia in impaired glucose tolerance or diabetes mellitus","Risk of hyperkalemia in renal impairment or excessive administration","Monitor serum electrolytes, blood glucose, and fluid balance during therapy","Use with caution in patients with heart failure, edema, or conditions predisposing to fluid overload","May cause phlebitis or extravasation at infusion site"] |
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| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, potassium, glucose) and fluid balance, especially in prolonged therapy. Assess for signs of fluid overload (edema, hypertension) or electrolyte disturbances. Fetal heart rate monitoring is not routinely required unless maternal condition warrants. In gestational diabetes, monitor maternal blood glucose. |
| Fertility Effects | No adverse effects on fertility are known. Dextrose, sodium chloride, and potassium chloride are basic nutrients and electrolytes; they do not impair reproductive function. |