DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 30MEQ IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides glucose for cellular metabolism, replenishing energy stores and correcting hypoglycemia. Sodium chloride and potassium chloride restore electrolyte balance, maintaining osmolality and membrane potentials.
| 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, with regulation by hormonal and renal mechanisms. |
| Excretion | Renal: Dextrose is metabolized to CO2 and water, not excreted unchanged. Sodium and chloride are excreted renally (90-95% of filtered load reabsorbed). Potassium is excreted renally (90% of daily intake, with 10% fecal). |
| Half-life | Dextrose: Not applicable (endogenous). Potassium: Rapid distribution phase (1-1.5 h) with terminal half-life 12-24 h (dose-dependent due to intracellular uptake). Sodium and chloride: Governed by renal regulation, no true half-life. |
| Protein binding | Dextrose: Not bound. Sodium: Not bound. Potassium: Not bound. Chloride: Not bound. |
| Volume of Distribution | Dextrose: 0.2 L/kg (extracellular space). Sodium: 0.15-0.2 L/kg. Chloride: 0.15-0.2 L/kg. Potassium: 0.4-0.6 L/kg (total body water). |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: Immediate (within seconds to minutes) for hemodynamic effects and electrolyte correction. |
| Duration of Action | Duration depends on infusion rate and patient status. Dextrose action persists while infusing; potassium redistribution continues for hours post-infusion. Clinical correction of hypokalemia may require several hours. |
Intravenous infusion. Typical adult dose: 1000 mL to 2000 mL per 24 hours, administered at a rate of 50-100 mL/hour, adjusted based on fluid and electrolyte status.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR 30-50 mL/min: reduce dose by 25%. For GFR 15-29 mL/min: reduce dose by 50%. For GFR <15 mL/min: avoid use or use with extreme caution, monitoring potassium levels closely. |
| Liver impairment | No specific Child-Pugh based dose adjustment required, but monitor potassium levels in severe hepatic impairment due to risk of hyperkalemia. |
| Pediatric use | Weight-based dosing: 5-10 mL/kg over 24 hours, not to exceed adult daily fluid requirements; potassium supplementation calculated as 1-3 mEq/kg/day, titrated to serum levels. |
| Geriatric use | Start at lower end of dosing range; consider reduced initial infusion rate (50 mL/hour) and monitor renal function and potassium levels closely due to age-related decline in GFR and higher risk of hyperkalemia. |
| 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 chloride, and potassium chloride are normal constituents of breast milk. Administration of these components at replacement doses does not pose a risk to the nursing infant. M/P ratio not applicable as these are endogenous substances. |
| Teratogenic Risk | No evidence of teratogenic risk from dextrose, sodium chloride, or potassium chloride at standard replacement doses. Electrolyte imbalances, if severe, could theoretically impair fetal development. First trimester: low risk. Second and third trimesters: low risk; caution with potassium administration to avoid maternal hyperkalemia, which may cause fetal bradycardia. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Severe metabolic acidosis","Severe renal impairment (oliguria, anuria)","Hypernatremia","Fluid overload states (e.g., pulmonary edema)"]
| Precautions | ["Risk of fluid and electrolyte imbalances, including hyperglycemia, hyperkalemia, hypokalemia, and hypernatremia","Monitor serum glucose, electrolytes, and fluid status closely","Avoid in patients with severe renal impairment or conditions predisposing to fluid overload","Use caution in patients with heart failure, pulmonary edema, or hepatic cirrhosis"] |
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| Fetal Monitoring | Monitor serum electrolytes (potassium, sodium), blood glucose, and renal function. In pregnancy, assess fluid balance and signs of hyperkalemia or fluid overload. Fetal heart rate monitoring if potassium infusion rate is high or if maternal hyperkalemia occurs. |
| Fertility Effects | No known adverse effects on fertility with standard replacement doses. Severe electrolyte disturbances may impact reproductive function, but this is not specific to the drug combination. |