DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 15MEQ IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides caloric support and corrects hypoglycemia; sodium chloride replaces sodium and chloride ions to maintain electrolyte balance; potassium chloride replaces potassium for maintenance of normal cellular function.
| Metabolism | Dextrose is metabolized to carbon dioxide and water via glycolysis and the citric acid cycle; sodium and potassium are excreted primarily by the kidneys; chloride is excreted as the anion. |
| Excretion | Glucose is metabolized to carbon dioxide and water; potassium is primarily eliminated renally (90-95%) with minor fecal loss; sodium and chloride are excreted renally according to homeostasis. |
| Half-life | Glucose: rapid, <15 min (physiologic turnover); Potassium: 6-8 h (intracellular redistribution phase); Sodium: prolonged, 24-48 h (dependent on renal function). |
| Protein binding | Potassium: negligible (<5%); glucose: negligible; sodium and chloride: not bound. |
| Volume of Distribution | Potassium: ~0.4-0.6 L/kg (total body water); glucose: ~0.2 L/kg (extracellular fluid); sodium: ~0.2-0.3 L/kg (extracellular space). |
| Bioavailability | IV: 100% for all components. |
| Onset of Action | IV infusion: immediate (seconds to minutes) for electrolyte and fluid effects. |
| Duration of Action | Fluid effects: 2-4 h (distribution phase); electrolyte effects: 6-8 h for potassium, sustained for sodium/chloride until renal excretion. |
| Molecular Weight | Dextrose: 180.16 Da; Sodium chloride: 58.44 Da; Potassium chloride: 74.55 Da |
Intravenous infusion, typical adult dose: 1000-2000 mL per 24 hours, rate adjusted based on fluid and electrolyte status. Potassium chloride content provides 15 mEq per liter; infusion rate should not exceed 10-20 mEq/hr potassium.
| Dosage form | INJECTABLE |
| Renal impairment | GFR > 50: No adjustment. GFR 30-50: Monitor serum potassium; rate reduction may be needed. GFR < 30: Use with caution; consider potassium restriction; avoid if oliguric. |
| Liver impairment | Child-Pugh A: No adjustment. Child-Pugh B/C: Use cautiously; monitor electrolytes due to potential fluid retention and electrolyte imbalances. |
| Pediatric use | Weight-based: 0.45% sodium chloride with KCl 15 mEq/L; typical maintenance: 100-150 mL/kg/24h for first 10 kg, then 50 mL/kg/24h for next 10 kg, then 20 mL/kg/24h for remaining weight; adjust potassium rate to 0.5-1 mEq/kg/hr max. |
| Geriatric use | Use lower initial infusion rates (e.g., 50-100 mL/hr) and frequent monitoring of serum electrolytes and renal function; potassium clearance may be reduced. |
| 1st trimester | Dextrose, sodium chloride, and potassium chloride are essential nutrients and electrolytes. No evidence of teratogenicity. Use only if clearly needed to correct fluid and electrolyte imbalances. |
| 2nd trimester | Same as t1. Monitor serum electrolytes and glucose to avoid maternal/neonatal complications. |
| 3rd trimester | Same as t1. Use caution in preeclampsia or heart failure. Avoid excess fluid volume. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Dextrose, sodium, and potassium readily cross the placenta. In utero exposure is continuous with maternal levels. Transfer depends on concentration gradients; clinical effects are due to maternal fluid and electrolyte status. |
| Breastfeeding | Dextrose, sodium, and potassium are normal constituents of breast milk. IV administration may increase maternal serum levels, but concentrations in milk are unlikely to affect the infant. Use with caution in lactating women, especially if high doses cause electrolyte imbalance. |
| Lactation Rating | Safe |
| Teratogenic Risk | Dextrose, sodium chloride, and potassium chloride are physiological components with no known teratogenic risk. Dextrose is a source of calories and is not associated with malformations. Sodium and potassium are essential ions; imbalances may occur but are not teratogenic. Potassium chloride at standard doses is not teratogenic. However, infusion of large volumes or high concentrations may cause maternal electrolyte disturbances that could indirectly affect the fetus. Use in pregnancy requires attention to maternal fluid and electrolyte status but presents no direct teratogenicity. |
| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, potassium, chloride), glucose, and urine output. Assess for signs of fluid overload (edema, pulmonary congestion) or dehydration. In prolonged parenteral therapy, monitor maternal renal function and acid-base balance. Fetal monitoring includes assessment of fetal heart rate and growth if infusion is high volume or in high-risk pregnancies. Watch for maternal adverse effects such as hyperglycemia, hyperkalemia (if potassium given), or hyponatremia. |
| Fertility Effects | No evidence of adverse effects on fertility. Dextrose, sodium chloride, and potassium chloride are physiologic substances essential for cellular function. Fertility impairment has not been reported with appropriate therapeutic use. |
■ FDA Black Box Warning
Not for use in patients with hyperkalemia, severe renal impairment, or conditions predisposing to hyperkalemia. Use in neonates may be associated with aluminum toxicity. Contains aluminum that may be toxic with prolonged administration in patients with impaired kidney function.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperglycemia not controlled by insulinSevere hypokalemia or potassium intoxicationHypernatremiaAnuria or severe renal failure with fluid overload
| Precautions | Use with caution in patients with heart failure, renal impairment, or conditions associated with fluid overload, Monitor serum electrolytes, fluid balance, and renal function, Risk of hyperkalemia, particularly in patients with impaired renal function or those receiving potassium-sparing diuretics, Avoid rapid infusion to prevent hyperglycemia and osmotic diuresis, Not for use in treating lactic acidosis or severe hyperglycemia |
| Food/Dietary | Avoid high-potassium foods (e.g., bananas, oranges, spinach) to prevent hyperkalemia. Monitor carbohydrate intake if diabetic; adjust insulin as needed. |
| Clinical Pearls | Administer via central line if concentration exceeds peripheral tolerance. Monitor potassium levels closely; risk of hyperkalemia in renal impairment. Do not use in patients with hyperkalemia or fluid overload. Use with caution in heart failure, renal failure, or conditions predisposing to hyperkalemia. Check serum osmolality and glucose in diabetic patients. |
| Patient Advice | This solution contains dextrose (sugar) and potassium; inform your doctor if you have diabetes or kidney problems. · Report any signs of high potassium levels such as muscle weakness, irregular heartbeat, or tingling sensations. · You may experience increased urination or temporary weight gain due to fluid; report any shortness of breath or swelling. · Do not stop the infusion without consulting your healthcare provider. · Keep all appointments for blood tests to monitor your electrolytes and glucose. |
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