DEXTROSE 5%, SODIUM CHLORIDE 0.45% AND POTASSIUM CHLORIDE 0.075%
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose supplies glucose for cellular metabolism, restoring blood glucose levels and providing calories. Sodium chloride and potassium chloride replace electrolytes to maintain fluid and electrolyte balance.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle. Potassium is primarily excreted by the kidneys; minor fecal loss. Sodium is predominantly excreted renally. |
| Excretion | Renal: Dextrose (glucose) is reabsorbed in proximal tubules; excess is excreted unchanged in urine. Sodium and potassium are primarily excreted renally, with potassium secretion in distal nephron; chloride follows sodium. No significant biliary or fecal elimination. |
| Half-life | Dextrose: ~15-20 min for exogenous glucose in normoglycemic states, but insulin-dependent; potassium: ~12-24 hours for total body potassium turnover, but clinical context is distributional; sodium and chloride: large body pools, no defined half-life in this context. |
| Protein binding | None for dextrose, sodium, potassium, or chloride; <10% for potassium under certain conditions but negligible. |
| Volume of Distribution | Dextrose: Vd ~0.2 L/kg (total body water); sodium and chloride: Vd ~0.2 L/kg (extracellular fluid); potassium: Vd ~0.4 L/kg (total body water). |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: Immediate (seconds to minutes) for volume expansion and electrolyte effects; glucose effect begins within minutes. |
| Duration of Action | Volume effect: 30-60 minutes for initial distribution; electrolyte effects persist as long as infusion continues; glucose effect: short-lived due to rapid metabolism. |
Intravenous infusion; typical rate 100-200 mL/hour for maintenance or as directed by clinical condition, not to exceed 25 mL/kg/hour.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR 10-50 mL/min: reduce potassium content or consider alternative; GFR <10 mL/min: avoid potassium-containing solutions unless hypokalemia present; use with caution and monitor electrolytes. |
| Liver impairment | No specific dose adjustment for Child-Pugh class A or B; however, monitor potassium levels closely in severe hepatic impairment (Child-Pugh C) due to risk of hyperkalemia. |
| Pediatric use | Weight-based dosing: 5-10 mL/kg/hour for maintenance to correct dehydration, adjusted based on electrolyte needs and clinical response; maximum infusion rate 25 mL/kg/hour (equivalent to 1.875 g dextrose/kg/hour). |
| Geriatric use | Use lower initial infusion rates (50-100 mL/hour) and monitor for fluid overload, electrolyte disturbances, and renal function; adjust potassium content based on GFR. |
| 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. Dextrose, sodium, and potassium are normal breast milk constituents; excess is unlikely to affect infant. M/P ratio not applicable as these are endogenous substances. |
| Teratogenic Risk | No evidence of teratogenic risk. Dextrose, sodium chloride, and potassium chloride are normal physiological components. However, maternal electrolyte imbalances may affect fetal development; monitor maternal serum electrolytes and glucose levels. |
■ FDA Black Box Warning
Not to be used in patients with intracranial hemorrhage, delirium tremens, or diabetes mellitus without careful monitoring. Do not administer to patients with anuria, impaired renal function, or fluid overload.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Hyperglycemia with hyperosmolarity","Anuria or severe renal impairment","Fluid overload or conditions causing sodium retention","Known hypersensitivity to any component"]
| Precautions | ["Risk of hyperglycemia, hyperosmolarity, and electrolyte imbalances","Use with caution in patients with heart failure, renal impairment, or conditions predisposing to hyperkalemia","Monitor serum glucose, electrolytes, and fluid status frequently","Do not administer if particulate matter or discoloration is present"] |
| Food/Dietary |
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| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, potassium, chloride), glucose, and fluid balance. Assess fetal heart rate and uterine activity if administered intravenously during labor. |
| Fertility Effects | No known adverse effects on fertility. Appropriate for use in women of childbearing potential. |
| No direct food interactions, but concurrent ingestion of potassium-rich foods or potassium-containing salt substitutes may increase risk of hyperkalemia. Patients should avoid excessive intake of high-potassium foods (e.g., bananas, oranges, tomatoes, spinach, potatoes) and potassium supplements while receiving this IV fluid, especially if renal function is compromised. |
| Clinical Pearls | This combination (D5 1/2NS with 20 mEq/L KCl) is commonly used for maintenance IV fluids in patients with normal renal function and no severe electrolyte disturbances. Monitor serum potassium levels closely, especially in patients with renal impairment, cardiac disease, or those on digoxin. Avoid in patients with hyperkalemia, severe dehydration, or anuria. The dextrose component may cause hyperglycemia in diabetic patients; consider insulin coverage if needed. Use with caution in pediatric and elderly patients due to risk of fluid overload. |
| Patient Advice | This IV solution contains sugar, salt, and potassium to maintain your body's fluid and electrolyte balance. · Tell your healthcare provider if you have kidney problems, heart disease, diabetes, or high potassium levels. · You may experience swelling (edema) if too much fluid is given; report unusual weight gain or difficulty breathing. · If you have diabetes, your blood sugar may increase; monitor as directed by your doctor. · Avoid consuming potassium-rich foods (e.g., bananas, oranges, potatoes) or supplements unless approved by your provider. |