DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 0.30% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides a source of calories and serves as a metabolic substrate; sodium chloride and potassium chloride replace electrolytes and maintain acid-base balance and osmotic pressure.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle; potassium is primarily excreted renally; sodium and chloride are handled by renal mechanisms. |
| Excretion | Dextrose: metabolized to CO2 and water; negligible renal excretion. Sodium and potassium: primarily renal excretion (90-95% of filtered load reabsorbed; excretion adjusts to intake and balance). Chloride: renal excretion, passively follows sodium. No biliary or fecal elimination of significance. |
| Half-life | Dextrose: not applicable (endogenous substance, rapidly cleared from blood; half-life of infused glucose is ~15-20 min due to cellular uptake and metabolism). Potassium: not applicable as a drug; serum potassium half-life depends on redistribution and renal function (typically ~8-12 h for a load). Sodium: no defined half-life; renal regulation maintains homeostasis. |
| Protein binding | Dextrose/glucose: negligible (<1% protein bound). Sodium and potassium: not protein bound. Chloride: not protein bound. |
| Volume of Distribution | Dextrose: distributes into total body water (~0.6 L/kg). Sodium: mainly extracellular fluid (~0.25-0.3 L/kg). Potassium: mainly intracellular fluid (~4-5 L/kg, but Vd for a potassium load is ~0.5-1 L/kg due to rapid cellular uptake). Chloride: extracellular fluid (~0.2-0.3 L/kg). |
| Bioavailability | Not applicable (intravenous administration only; 100% bioavailability via IV route). |
| Onset of Action | Intravenous: immediate (seconds to minutes) for volume expansion and electrolyte effects; metabolic effects (glucose utilization) begin within minutes of infusion start. |
| Duration of Action | Intravenous: duration of volume effect ~1-2 h depending on infusion rate and renal function; electrolyte effects persist as long as infusion continues and renal handling matches; glucose effect lasts minutes after infusion stops due to rapid clearance. |
Intravenous infusion; dose determined by fluid, electrolyte, and caloric requirements. Typical adult maintenance: 100-125 mL/hour; potassium not to exceed 10 mEq/hour or 200 mEq/day.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (eGFR <30 mL/min) with oliguria or anuria. Use with caution in mild-moderate impairment; monitor serum potassium and avoid hyperkalemia. |
| Liver impairment | No specific adjustment for hepatic impairment; monitor electrolyte balance, especially potassium, if severe hepatic disease. |
| Pediatric use | Intravenous infusion; dose based on weight and clinical status. Typical maintenance: 5-10 mL/kg/hour of 5% dextrose with electrolytes; potassium rate not to exceed 0.5-1 mEq/kg/hour. Maximum 3 g/kg/day dextrose. |
| Geriatric use | Use with caution due to decreased renal function; adjust rate to avoid fluid overload and hyperkalemia; monitor serum potassium and renal function. |
| 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. Components are normal milk constituents. M/P ratio not applicable (endogenous substances). |
| Teratogenic Risk | No teratogenic risk. Dextrose, sodium chloride, and potassium chloride are normal physiological constituents. At recommended doses, no fetal harm expected. |
■ FDA Black Box Warning
Not for use in patients with hyperglycemia, hyperkalemia, or fluid overload; risk of electrolyte imbalances and fluid overload in susceptible patients.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperglycemia","Hyperkalemia","Severe fluid overload","Anuria","Hypersensitivity to any component","Patients with intracerebral or intracranial hemorrhage"]
| Precautions | ["Monitor serum electrolytes, blood glucose, and fluid balance during administration","Use with caution in patients with heart failure, renal impairment, or hyperkalemia","Do not administer if solution contains visible particles or if container is damaged","Risk of air embolism if container is punctured"] |
| Food/Dietary | No specific food interactions. However, caution with potassium-containing salt substitutes or high-potassium foods if the patient is at risk of hyperkalemia. |
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| Fetal Monitoring | Monitor serum electrolytes, blood glucose, fluid balance, and renal function in mother. Fetal heart rate monitoring if indicated for maternal condition. |
| Fertility Effects | No known adverse effects on fertility. |
| Clinical Pearls | This combination is commonly used for maintenance fluid and electrolyte replacement, particularly in patients with mild hypokalemia or when potassium loss is expected, such as with diuretic use. Must be administered with caution in patients with renal impairment, hyperkalemia, or cardiac disease. Check serum potassium and renal function before and during therapy. |
| Patient Advice | This solution provides fluids, sugar, and potassium to help maintain your body's balance. · Tell your healthcare provider if you have kidney problems, heart conditions, or are on a potassium-restricted diet. · You may experience pain, redness, or swelling at the IV site; report these symptoms promptly. · Do not adjust the flow rate – the infusion should be given as prescribed. |