DEXTROSE 5%, SODIUM CHLORIDE 0.45% AND POTASSIUM CHLORIDE 0.15% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Provides exogenous glucose for cellular energy metabolism and corrects electrolyte imbalances. Sodium and chloride maintain osmotic pressure and acid-base balance. Potassium is essential for nerve conduction, muscle contraction, and intracellular enzyme function.
| Metabolism | Glucose is metabolized via glycolysis and the Krebs cycle to carbon dioxide and water, yielding energy. Potassium is actively transported into cells. Sodium and chloride are distributed in extracellular fluid and excreted primarily by the kidneys. |
| Excretion | Components are eliminated via renal excretion: glucose is metabolized and excreted as CO2 and water; sodium, chloride, and potassium are excreted renally with over 90% of infused potassium appearing in urine within 24 hours. |
| Half-life | Potassium: approximately 1-1.5 hours (distribution phase) with a terminal elimination half-life of about 8-12 hours in renal impairment. Dextrose: effectively infinite as it is metabolized; sodium and chloride follow body regulation with no defined half-life. |
| Protein binding | Potassium: <5% bound; dextrose: not bound; sodium and chloride: not significantly protein bound. |
| Volume of Distribution | Potassium: 0.5-0.7 L/kg (total body water); dextrose: distributes into total body water (0.6 L/kg); sodium and chloride: primarily extracellular (0.2 L/kg). Vd is the apparent volume of distribution for potassium. |
| Bioavailability | Intravenous: 100% bioavailability. |
| Onset of Action | Intravenous: immediate upon infusion for electrolyte and fluid repletion; plasma potassium levels rise within minutes. |
| Duration of Action | Electrolyte effects persist for 1-2 hours after infusion stops; fluid volume effect lasts 2-4 hours depending on renal function. |
Intravenous infusion: 1000-2000 mL/day as maintenance, adjusted based on fluid, electrolyte, and energy needs.
| Dosage form | INJECTABLE |
| Renal impairment | No dose adjustment required for potassium content; monitor serum potassium and renal function. For anuria or severe renal impairment, use with caution and adjust potassium based on serum levels. |
| Liver impairment | No specific dose adjustment per Child-Pugh class; monitor potassium and glucose levels due to risk of hyperkalemia or hypoglycemia. |
| Pediatric use | IV infusion: 100-200 mL/kg/day for maintenance, adjusted for age and clinical status. For neonates and infants, use with caution and monitor electrolytes. |
| Geriatric use | Use lowest effective dose; monitor for fluid overload, hyperglycemia, and electrolyte imbalances due to age-related decreased renal function and comorbidities. |
| 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, and potassium are normal constituents of breast milk. Intravenous administration of this solution is considered compatible with breastfeeding. No specific M/P ratio is available; however, these electrolytes are tightly regulated in the body and do not accumulate in milk. |
| Teratogenic Risk | Dextrose, sodium chloride, and potassium chloride are physiological components at therapeutic doses and are not associated with teratogenicity. No fetal risks are established in any trimester when used appropriately for fluid and electrolyte maintenance. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperkalemia, hypernatremia, severe renal impairment with oliguria or anuria, fluid overload, and known hypersensitivity to any component.
| Precautions | Risk of hyperkalemia in patients with impaired renal function or conditions predisposing to potassium retention. Monitor serum electrolytes, fluid balance, and renal function. Use with caution in patients with heart failure, pulmonary edema, or hypernatremia. Do not administer if solution is cloudy or contains precipitate. |
| Food/Dietary | No specific food interactions. Encourage normal dietary intake of potassium and sodium as tolerated unless contraindicated. Avoid excessive potassium-rich foods (e.g., bananas, oranges, spinach) if hyperkalemia risk is present. Maintain adequate fluid intake unless fluid restriction is ordered. |
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| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, potassium, glucose), fluid balance (intake/output, edema), and renal function. Fetal monitoring as per standard obstetric care; no additional fetal monitoring specifically required for this infusion unless maternal electrolyte disturbances occur. |
| Fertility Effects | No known adverse effects on fertility from therapeutic use of dextrose, sodium chloride, or potassium chloride. Standard fluid and electrolyte therapy is not expected to impair reproductive function. |
| Clinical Pearls | This hypertonic solution (osmolarity ~560 mOsm/L) is contraindicated in patients with hyperkalemia, severe renal impairment, or anuria. Administer via central line to avoid phlebitis; peripheral administration may cause sclerosis. Monitor serum potassium, glucose, and renal function closely. Do not use if solution is discolored or contains precipitate. Use within 24 hours of opening. |
| Patient Advice | This solution is given through a vein to correct dehydration and electrolyte imbalances. · Report any signs of allergic reaction (rash, itching, swelling) or infusion site pain, redness, or swelling. · Do not stop the infusion or adjust the rate without consulting your healthcare provider. · Tell your doctor if you have kidney problems, diabetes, or any heart conditions. · May cause temporary discomfort at the injection site. |