DEXTROSE 5%, SODIUM CHLORIDE 0.45% AND POTASSIUM CHLORIDE 0.3% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides a source of calories and hydration. Sodium chloride and potassium chloride replace extracellular fluid and electrolytes.
| Metabolism | Dextrose is metabolized to carbon dioxide and water via glycolysis and the Krebs cycle. Electrolytes are excreted or retained based on renal function. |
| Excretion | Dextrose is metabolized to carbon dioxide and water, with negligible renal elimination of unchanged glucose unless hyperglycemia exceeds renal threshold. Sodium and chloride are primarily excreted renally, with >90% of filtered sodium reabsorbed; potassium is predominantly excreted renally (90%) with minor fecal loss (<10%) under normal renal function. |
| Half-life | Not applicable as a primary pharmacokinetic parameter for this combination; dextrose follows glucose disposition with a half-life of approximately 1-2 hours in euglycemic individuals, prolonged in diabetes. Electrolytes distribute and are eliminated with functional half-lives reflecting renal handling (e.g., potassium half-life ~6-8 hours). |
| Protein binding | Dextrose: negligible (<1%); sodium: negligible; chloride: negligible; potassium: negligible (<1% bound to albumin). |
| Volume of Distribution | Dextrose: approximately 0.2-0.3 L/kg (mainly extracellular fluid); sodium: 0.25 L/kg (extracellular); chloride: 0.25 L/kg; potassium: approximately 0.5 L/kg (distributes into intracellular compartment). |
| Bioavailability | Intravenous: 100% (complete bioavailability); not administered via other routes. |
| Onset of Action | Intravenous: Immediate upon infusion; dextrose increases blood glucose within minutes; electrolyte effects occur as the solution is administered. |
| Duration of Action | Duration is infusion-dependent; after discontinuation, dextrose effects persist for ~30-60 minutes depending on metabolic state; electrolyte effects persist until renal excretion; clinical guidelines recommend monitoring for volume and electrolyte status during and after administration. |
| Molecular Weight | Dextrose: 180.16 Da; Sodium chloride: 58.44 Da; Potassium chloride: 74.55 Da |
Intravenous infusion; rate and volume determined by patient's fluid, electrolyte, and caloric requirements; typical adult dose is 1000-2000 mL per 24 hours, infused at a rate of 50-100 mL/hour.
| Dosage form | INJECTABLE |
| Renal impairment | In patients with severe renal impairment (eGFR <30 mL/min/1.73 m²), reduce volume and monitor potassium closely; may require potassium restriction; dosing based on fluid and electrolyte status. |
| Liver impairment | No specific adjustment for Child-Pugh class A or B; in severe hepatic impairment (Child-Pugh class C), monitor potassium and glucose levels; adjust rate to avoid fluid overload. |
| Pediatric use | Dose based on weight: 100-200 mL/kg per 24 hours for maintenance; adjust for dehydration or electrolyte deficits; typical infusion rate 5-10 mL/kg/hour; maximum rate 15 mL/kg/hour. |
| Geriatric use | Use with caution due to increased risk of fluid and electrolyte imbalances; start at lower end of dosing range; monitor renal function and cardiac status; avoid rapid infusion. |
| 1st trimester | Dextrose, sodium chloride, and potassium chloride are essential nutrients and electrolytes; no known teratogenic effects. Use only if clearly needed to correct deficiency or maintain fluid/electrolyte balance. |
| 2nd trimester | Safe for use as indicated; monitor maternal electrolytes and glucose levels. |
| 3rd trimester | Safe for use as indicated; monitor maternal and fetal status, especially fluid overload and electrolyte disturbances. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Dextrose, sodium, chloride, and potassium readily cross the placenta via passive diffusion and active transport, reaching fetal concentrations similar to maternal levels. |
| Breastfeeding | Dextrose, sodium chloride, and potassium chloride are normal constituents of breast milk and are safe during breastfeeding at recommended doses. No adverse effects on infant reported. |
| Lactation Rating | Safe |
| Teratogenic Risk | Dextrose, sodium chloride, and potassium chloride are physiological components present in normal body fluids. There is no evidence of teratogenic risk with appropriate use during pregnancy. However, electrolyte imbalances or hyperglycemia from improper administration could pose risks to the fetus. High doses of dextrose in the third trimester may cause fetal hyperinsulinemia and neonatal hypoglycemia. Overall, FDA Pregnancy Category C: risk cannot be ruled out, but use when clearly needed. |
| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, potassium, chloride), glucose levels, fluid balance, and acid-base status, especially with prolonged or rapid infusion. Fetal monitoring (ultrasound, heart rate) is not specifically required but should follow standard obstetric care. In cases of maternal hyperglycemia (e.g., dextrose > 10%), consider monitoring for fetal hyperinsulinemia. |
| Fertility Effects | No known adverse effects on fertility from dextrose, sodium chloride, or potassium chloride at therapeutic doses. These substances are essential nutrients, and their administration in appropriate amounts is not expected to impair reproductive function. |
■ FDA Black Box Warning
No FDA black box warning.
| Common Effects | fluid replacement |
| Serious Effects |
Clinically significant hyperglycemiaHypernatremiaHyperchloremiaHyperkalemiaSevere renal impairment with oliguria or anuriaFluid overload (e.g., congestive heart failure, pulmonary edema)
| Precautions | Use with caution in patients with renal impairment, heart failure, or edema, Monitor serum electrolytes, glucose, and fluid status, Risk of hyperglycemia, hyperkalemia, or fluid overload, Avoid in patients with intracranial hemorrhage or hemolytic anemia |
| Food/Dietary | No known food interactions. However, the potassium content may need to be considered in patients on potassium-restricted diets. Dextrose may affect blood glucose levels; dietary adjustments may be necessary for diabetic patients. |
| Clinical Pearls | This multi-electrolyte solution is commonly used for maintenance and replacement of fluid, electrolytes, and calories. Do not administer simultaneously with blood products due to risk of red cell agglutination and hemolysis. Monitor serum potassium closely in renal impairment. Use with caution in patients with heart failure or edema. Incompatible with amphotericin B, diazepam, and phenytoin. |
| Patient Advice | Do not use this solution if the container is damaged or the solution is cloudy. · Report any signs of infusion site reactions, such as pain, redness, or swelling. · Inform your healthcare provider about all medications you are taking, especially potassium supplements or potassium-sparing diuretics. · This solution contains dextrose (sugar); monitor blood glucose if you have diabetes. · Tell your doctor if you have kidney problems, heart disease, or are on a sodium-restricted diet. |
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