DEXTROSE 5%, SODIUM CHLORIDE 0.45% AND POTASSIUM CHLORIDE 0.22% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides caloric support and prevents ketosis; sodium chloride maintains electrolyte balance; potassium chloride replaces potassium losses and restores intracellular potassium levels.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle; potassium is excreted primarily by the kidneys; sodium chloride is excreted renally. |
| Excretion | Dextrose: primarily metabolized to CO2 and water; <5% excreted unchanged in urine. Sodium, chloride, and potassium: primarily excreted renally (90%+); small fecal/biliary loss. |
| Half-life | Dextrose: plasma half-life approximately 20-30 minutes; prolonged in renal impairment or diabetes. Potassium: terminal half-life ~8 hours (intracellular equilibration); clinical context: hypokalemia correction requires monitoring. |
| Protein binding | Dextrose: negligible; Potassium: negligible; Sodium and chloride: none. |
| Volume of Distribution | Dextrose: ~0.2 L/kg (confined to extracellular fluid); Potassium: ~4-5 L/kg (total body water, with 98% intracellular); Sodium/chloride: ~0.2 L/kg (extracellular). Clinical meaning: dextrose and sodium distribute primarily in extracellular space; potassium distributes widely into cells. |
| Bioavailability | Intravenous: 100% (only route of administration for this product). No oral or other routes. |
| Onset of Action | Intravenous: immediate (within seconds to minutes) for electrolyte and glucose effects; plasma volume expansion within 5-10 minutes. |
| Duration of Action | Depends on infusion rate and patient factors; glucose effect lasts as long as infusion maintains euglycemia (typically 1-2 hours post-infusion); electrolyte effects persist until redistribution and excretion (hours). |
Intravenous infusion. Dose determined by fluid, electrolyte, and caloric requirements. Typical adult maintenance: 100-200 mL/hour (2-4 L/day) of D5 0.45% NaCl with 20 mEq/L KCl. Rate adjusted based on serum potassium and fluid status.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: reduce KCl to 10-15 mEq/L or monitor potassium closely. GFR <30 mL/min: avoid KCl unless hypokalemia documented; use with caution and reduce potassium. GFR <10 mL/min: avoid unless dialysis. Fluid restriction may be needed; use 0.45% NaCl with caution. |
| Liver impairment | Child-Pugh A/B: no specific dose adjustment required but monitor potassium. Child-Pugh C: use with caution due to risk of fluid overload and electrolyte imbalances; reduce potassium if renal impairment coexists. |
| Pediatric use | Intravenous infusion. Dose based on weight: daily maintenance fluid (e.g., 4-2-1 rule) with 5% dextrose and 0.45% NaCl. Potassium: 1-2 mEq/kg/day (max 40 mEq/L). Monitor serum potassium and glucose. Not for infants <6 months without careful monitoring. |
| Geriatric use | Start at lower infusion rates (e.g., 50-100 mL/hour) to avoid fluid overload. Monitor renal function and potassium levels closely. Adjust potassium based on GFR. Avoid if heart failure or significant renal impairment. |
| 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 milk constituents. M/P ratio not applicable; these are endogenous substances. No expected adverse effects on infant at standard infusion rates. |
| Teratogenic Risk | Not teratogenic in standard doses. Dextrose, sodium, and potassium are physiologic components; no fetal risk at therapeutic doses. High doses may cause maternal hyperglycemia with potential fetal hyperinsulinemia and macrosomia (third trimester). Use only if clearly needed. |
■ FDA Black Box Warning
Not for use in patients with intracranial or intraspinal hemorrhage, or in patients requiring high-dose potassium supplementation above 20 mEq/hour without continuous cardiac monitoring.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperkalemia, hypernatremia, hyperglycemia, anuria, acute renal failure, severe metabolic acidosis, patients with known allergy to corn (for dextrose), and concurrent use of potassium-sparing diuretics.
| Precautions | Monitor serum electrolytes, blood glucose, and renal function; avoid hyperkalemia; use with caution in heart failure, renal impairment, and conditions predisposing to hyperkalemia; risk of fluid overload; tissue necrosis if extravasation occurs. |
| Food/Dietary | No direct food interactions are known with this intravenous solution. However, patients with diabetes should monitor blood glucose as dextrose may cause hyperglycemia. Potassium-rich foods (e.g., bananas, oranges, spinach, potatoes) should not be restricted unless specifically advised by the prescriber. |
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| Fetal Monitoring | Monitor maternal serum glucose, electrolytes (Na+, K+), and fluid balance. Fetal monitoring for heart rate and growth if prolonged use or maternal hyperglycemia. Assess for signs of fluid overload (edema, hypertension). |
| Fertility Effects | No known adverse effects on fertility. Dextrose, sodium, and potassium are essential nutrients; no reproductive toxicity expected with therapeutic use. |
| Clinical Pearls | Do not administer unless solution is clear and container is undamaged. Use strict aseptic technique when spiking container. Monitor serum potassium and glucose levels during prolonged therapy, especially in renal impairment or diabetes. Incompatible with amphotericin B, diazepam, and phenytoin via Y-site. |
| Patient Advice | Do not stop or adjust the infusion rate without consulting a healthcare provider. · Report any signs of infection at the IV site (redness, swelling, pain) immediately. · Tell your doctor if you have kidney problems, diabetes, or high potassium levels. · Excessive intake of potassium-rich foods (e.g., bananas, oranges, potatoes) may need to be limited while receiving this solution. · This solution contains dextrose (sugar); monitor blood glucose if you are diabetic. |