DEXTROSE 5%, SODIUM CHLORIDE 0.45% AND POTASSIUM CHLORIDE 20MEQ (K) IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides a source of calories and is metabolized to carbon dioxide and water, producing energy. Sodium chloride maintains electrolyte balance and osmotic pressure. Potassium chloride replaces potassium for cellular ion exchange and acid-base balance.
| Metabolism | Dextrose undergoes glycolysis and subsequent metabolism to carbon dioxide and water. Sodium chloride is excreted renally. Potassium is primarily excreted by the kidneys. |
| Excretion | Renal: >95% of dextrose (as CO2 via respiration) and sodium and chloride (with water); potassium excreted renally, ~90% reabsorbed, distal secretion under aldosterone control. Minimal fecal/biliary. |
| Half-life | Dextrose: ~15-20 min (rapid uptake into cells). Potassium: ~8-12 h (redistribution half-life ~1 h; terminal elimination depends on renal function, clinical context: prolonged in renal impairment). |
| Protein binding | Dextrose: <10% (not significantly bound). Potassium: minimal (<5%). Sodium and chloride: negligible. |
| Volume of Distribution | Dextrose: ~0.2 L/kg (total body water). Sodium: ~0.6 L/kg. Chloride: ~0.3 L/kg. Potassium: ~0.4-0.5 L/kg (primarily intracellular, >98% in cells). Clinical meaning: reflects distribution into extracellular and intracellular compartments. |
| Bioavailability | IV: 100% (complete bioavailability for all components). Not administered orally for this specific product. |
| Onset of Action | IV: Immediate for volume expansion and electrolyte correction (within minutes). |
| Duration of Action | IV: Dextrose effect on blood glucose lasts 1-2 h. Potassium repletion effect persists for 4-6 h after infusion; sustained for ongoing replacement (monitoring needed). Clinical note: duration depends on infusion rate and patient metabolic status. |
Intravenous infusion. Dosing is individualized based on fluid, electrolyte, and caloric requirements. Typical adult maintenance dose: 1-3 L/day at a rate of 50-125 mL/hour. Maximum infusion rate: 0.5 g/kg/hour for glucose; potassium infusion rate should not exceed 10 mEq/hour or 200 mEq/day in adults.
| Dosage form | INJECTABLE |
| Renal impairment | GFR > 50 mL/min: no adjustment. GFR 10-50 mL/min: dose potassium cautiously, monitor serum potassium. GFR < 10 mL/min: avoid potassium chloride unless hypokalemia is severe and monitored closely; may require reduced volume and potassium content. |
| Liver impairment | Child-Pugh A: no adjustment. Child-Pugh B: monitor potassium and glucose. Child-Pugh C: use with caution, adjust potassium based on serum levels; may require reduced infusion rate due to risk of glucose intolerance. |
| Pediatric use | Weight-based dosing: 100-200 mL/kg/day for maintenance fluids, adjusted for deficits and ongoing losses. Potassium concentration: typically 20 mEq/L, infused at a rate not exceeding 0.5-1 mEq/kg/hour. Glucose infusion rate: start at 4-8 mg/kg/min, titrate to serum glucose. |
| Geriatric use | Start at lower end of adult dose; monitor renal function and serum electrolytes closely. Reduce infusion rate if renal impairment present; avoid overhydration. Potassium supplementation should be cautious due to age-related decline in renal function. |
| 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. Supplementation in the mother does not significantly alter breast milk levels. No known adverse effects in breastfeeding infants. No M/P ratio available. |
| Teratogenic Risk | Dextrose, sodium chloride, and potassium chloride are essential nutrients and electrolytes; no teratogenic risk is expected at physiological levels. However, rapid correction of maternal electrolyte imbalances or hyperglycemia may cause fetal distress. First trimester: No known teratogenicity. Second and third trimesters: Risk is related to maternal metabolic derangements rather than direct drug effects. |
■ FDA Black Box Warning
Potassium chloride injection concentrate must be diluted before use to avoid fatal hyperkalemia.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia (serum potassium >5.5 mEq/L)","Severe renal impairment with oliguria or anuria","Hypernatremia","Cardiac decompensation or severe congestive heart failure","Known hypersensitivity to any component"]
| Precautions | ["Risk of hyperkalemia if potassium is not properly administered or in renal impairment","Risk of fluid overload in patients with cardiac or renal disease","Monitor serum electrolytes, blood glucose, and renal function","Use with caution in patients with diabetes mellitus or impaired glucose tolerance"] |
| Food/Dietary | Avoid potassium-rich foods (e.g., bananas, oranges, potatoes, tomatoes, salt substitutes) unless directed by your doctor, to prevent hyperkalemia. Maintain normal dietary intake of sodium and fluids as instructed. |
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| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, potassium, glucose), fluid balance, and renal function. Continuous fetal heart rate monitoring if administered during labor. Assess for signs of fluid overload (edema, hypertension) or electrolyte disturbances (arrhythmias, muscle weakness). |
| Fertility Effects | No known adverse effects on fertility. Essential nutrients do not impair reproductive function. |
| Clinical Pearls | This solution provides maintenance fluid with dextrose to prevent ketosis and potassium to prevent hypokalemia. Monitor serum potassium and renal function; stop infusion if urine output <0.5 mL/kg/h for 2 consecutive hours. Use with caution in patients with heart failure, renal impairment, or hyperkalemia. Do not administer rapidly; maximum infusion rate 0.5 mEq/kg/h potassium. |
| Patient Advice | Report any chest pain, shortness of breath, or swelling in your legs or ankles. · Tell your doctor if you feel muscle weakness, tingling, or irregular heartbeat. · This fluid contains sugar; if you have diabetes, your blood sugar may increase. · Do not suddenly stop the infusion; it should be tapered if discontinuing. · Keep your appointment for blood tests to monitor potassium and kidney function. |