DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 0.22% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides calories and serves as a source of glucose, which is utilized for cellular energy metabolism. Sodium chloride provides sodium and chloride ions to maintain electrolyte balance and osmotic pressure. Potassium chloride provides potassium ions essential for cellular functions, including nerve conduction and muscle contraction, and helps correct or prevent hypokalemia.
| Metabolism | Dextrose is metabolized via glycolysis to pyruvate, then enters the Krebs cycle for energy production; excess glucose is stored as glycogen in the liver and muscle. Sodium chloride is not metabolized but excreted renal. Potassium chloride is absorbed and distributed; excess potassium is excreted by the kidneys. |
| Excretion | Dextrose is metabolized to carbon dioxide and water; <1% excreted unchanged in urine. Sodium chloride and potassium chloride are excreted renally; >90% of filtered sodium and potassium is reabsorbed, with excretion balancing intake via renal regulation. Biliary/fecal excretion is negligible. |
| Half-life | Dextrose: not applicable as it is rapidly metabolized; glucose half-life is approximately 1.5-2 hours in normal individuals, prolonged in diabetes. Sodium and potassium: not defined as they are regulated by renal function. |
| Protein binding | Dextrose: negligible. Sodium and potassium: not bound to proteins. |
| Volume of Distribution | Dextrose: distributes into total body water (~0.6 L/kg). Sodium: primarily extracellular fluid (~0.2 L/kg). Potassium: primarily intracellular fluid (~4-5 L/kg total body content, but Vd for administered potassium is highly variable and influenced by cellular uptake). |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: immediate (within seconds) for correction of volume deficit and electrolyte imbalances. |
| Duration of Action | Intravenous: effects on volume status last 1-2 hours post-infusion; electrolyte effects persist as long as infusion continues; hyperglycemia may persist for 2-3 hours after stopping. |
| Molecular Weight | Dextrose: 180.16 Da, Sodium chloride: 58.44 Da, Potassium chloride: 74.55 Da. The mixture has no single molecular weight; these are the component weights. |
Intravenous infusion: 1000-2000 mL/day (25-50 mL/kg/day) titrated to fluid and electrolyte needs; maximum infusion rate 0.5 g/kg/hour dextrose.
| Dosage form | INJECTABLE |
| Renal impairment | GFR > 50 mL/min: no adjustment; GFR 10-50 mL/min: caution, reduce potassium content or monitor serum potassium; GFR < 10 mL/min: avoid unless on dialysis, use potassium-free alternative. |
| Liver impairment | Child-Pugh A: no adjustment; Child-Pugh B/C: caution due to risk of hyperkalemia, monitor potassium and glucose; no specific dose reduction. |
| Pediatric use | Neonates and children: 100-200 mL/kg/day for maintenance, adjust for deficits and ongoing losses; maximum infusion rate 0.25 g/kg/hour dextrose for neonates; monitor glucose and electrolytes. |
| Geriatric use | Elderly: use lower end of dosing range (e.g., 1000-1500 mL/day) due to reduced renal function and risk of fluid overload; monitor potassium and glucose closely. |
| 1st trimester | This solution is generally considered safe during the first trimester when used for appropriate indications such as correction of fluid and electrolyte imbalances. Dextrose and electrolytes are essential nutrients, and there is no evidence of teratogenicity at prescribed doses. However, caution is advised in conditions like gestational diabetes or preeclampsia. |
| 2nd trimester | Safe for use in the second trimester for fluid and electrolyte replacement. Monitor for fluid overload and electrolyte disturbances, especially in patients with pregnancy-induced hypertension or impaired glucose tolerance. |
| 3rd trimester | Use with caution in the third trimester due to increased risk of fluid overload and potential effects on fetal glucose levels. Avoid in patients with preeclampsia or compromised cardiac function. Continuous fetal monitoring may be considered if used during labor. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Dextrose crosses the placenta by facilitated diffusion; sodium and chloride cross via active transport; potassium crosses passively. All components appear in fetal circulation in proportion to maternal levels. No known adverse effects at therapeutic doses. |
| Breastfeeding | Dextrose and electrolytes are normal constituents of breast milk. Infusion of this solution is generally compatible with breastfeeding. However, high doses of potassium may affect milk electrolyte composition; monitor infant for signs of electrolyte imbalance if prolonged high-volume infusions are given. |
| Lactation Rating | L1: Safe |
| Teratogenic Risk | Dextrose, sodium chloride, and potassium chloride are essential nutrients and electrolytes; no teratogenic effects are expected at physiological concentrations. However, high doses of potassium chloride may cause maternal hyperkalemia, which could affect fetal cardiac function. No specific fetal risks have been reported with standard maintenance doses. Use during pregnancy should be guided by maternal electrolyte needs. |
| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, potassium, chloride, glucose), renal function, and fluid balance. Assess fetal heart rate in cases of maternal hyperkalemia or electrolyte imbalance. Observe for signs of fluid overload or electrolyte disturbances in the mother. |
| Fertility Effects | No known adverse effects on fertility. These are physiological components necessary for cellular function; therapeutic use corrects imbalances and does not impair reproductive function. |
■ FDA Black Box Warning
This combination product is not used for black box warning indication; however, potassium chloride injection concentrate is associated with a black box warning for fatal cardiac arrhythmias if administered inappropriately. This diluted product carries risk of hyperkalemia if infusion rate or concentration is excessive.
| Common Effects | fluid replacement |
| Serious Effects |
Anuria (inability to produce urine) without dialysisHyperkalemia (serum potassium >5.5 mEq/L)Hypernatremia (serum sodium >150 mEq/L)Hyperglycemia (serum glucose >250 mg/dL) not controlledHypersensitivity to any componentSevere fluid overload (e.g., pulmonary edema, congestive heart failure)
| Precautions | Risk of hyperglycemia in patients with diabetes mellitus or glucose intolerance, Risk of hyperkalemia, especially in patients with renal impairment or receiving potassium-sparing diuretics, Fluid overload in patients with heart failure or severe renal disease, Risk of phlebitis and infection at infusion site, Monitor serum electrolyte levels, blood glucose, and renal function during therapy |
| Food/Dietary | No known food interactions; however, high potassium foods should be consumed cautiously if hyperkalemia is a concern. |
| Clinical Pearls | Monitor serum potassium closely in renal impairment; check for IV site phlebitis; avoid use in patients with hyperkalemia or hypernatremia; use caution in heart failure due to sodium load. |
| Patient Advice | This solution provides fluids, sugar, and electrolytes. · Report any pain, redness, or swelling at IV site immediately. · Tell your doctor if you have kidney problems or high blood pressure. · Do not stop infusion without medical advice. |
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