DEXTROSE 5%, SODIUM CHLORIDE 0.45% AND POTASSIUM CHLORIDE 5MEQ IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose 5% provides a source of calories and water for hydration, correcting hypoglycemia by increasing blood glucose levels. Sodium chloride 0.45% and potassium chloride 5 mEq restore electrolyte balance: sodium and chloride are essential for maintenance of extracellular fluid volume and acid-base balance; potassium is critical for neuromuscular function, cardiac contractility, and intracellular osmotic pressure.
| Metabolism | Dextrose is metabolized via glycolysis and oxidative phosphorylation; excess glucose converted to glycogen or fat. Potassium and sodium are not metabolized but excreted renally; chloride is excreted renally or in sweat. |
| Excretion | Renal: Dextrose is metabolized to CO2 and water, not excreted unchanged; sodium and potassium are primarily excreted renally (>90% of load), with minor fecal loss (<5%). |
| Half-life | Dextrose: ~1.5-2.5 minutes (rapid cellular uptake). Sodium/potassium: hours to days (depends on total body stores and renal function); in renal failure, half-life is prolonged. |
| Protein binding | Dextrose: negligible. Sodium/potassium: not protein-bound. |
| Volume of Distribution | Dextrose: ~0.2 L/kg (extracellular fluid). Sodium/potassium: Vd approximates total body water (0.6 L/kg) for potassium; sodium Vd ~0.2 L/kg (extracellular). |
| Bioavailability | Intravenous: 100% (only route used). Not administered orally for this purpose. |
| Onset of Action | Intravenous: Immediate (seconds) for volume expansion and electrolyte correction. |
| Duration of Action | Volume effect: 1-2 hours (dextrose redistributed); electrolyte effects persist until renal excretion or cellular uptake; potassium duration depends on infusion rate and renal function. |
| Molecular Weight | Dextrose: 180.16 Da; Sodium chloride: 58.44 Da; Potassium chloride: 74.55 Da |
Intravenous infusion at a rate determined by fluid and electrolyte requirements; typical adult dose is 1000-2000 mL over 24 hours, not exceeding 50 mL/kg/day.
| Dosage form | INJECTABLE |
| Renal impairment | GFR > 50 mL/min: no adjustment. GFR 10-50 mL/min: reduce dose by 50% or adjust potassium content based on serum levels. GFR < 10 mL/min: avoid use or use with extreme caution; monitor potassium closely; may require potassium restriction. |
| Liver impairment | Child-Pugh A: no adjustment. Child-Pugh B: monitor potassium levels; reduce potassium content if hyperkalemia risk. Child-Pugh C: avoid potassium-containing solutions unless severe hypokalemia; monitor serum potassium closely. |
| Pediatric use | Intravenous infusion at 5-10 mL/kg/hour initially, adjusted based on serum electrolytes and fluid status; maximum 50 mL/kg/day; potassium component requires weight-based dosing: 0.5-1 mEq/kg/day for maintenance, not to exceed 3 mEq/kg/day. |
| Geriatric use | Elderly patients: use lower initial infusion rates (e.g., 50-100 mL/hour) and titrate based on renal function and cardiac status; monitor for fluid overload and electrolyte imbalances; reduce potassium content if renal impairment present. |
| 1st trimester | Generally considered safe when used at recommended doses. Dextrose, sodium, and potassium are normal blood constituents and essential for maternal and fetal health. Use only when clearly needed. |
| 2nd trimester | Generally considered safe. Monitor for electrolyte imbalances and fluid overload, especially in preeclampsia or renal impairment. |
| 3rd trimester | Generally considered safe. Avoid large volumes that could cause maternal hyperglycemia, which may lead to fetal hyperinsulinemia and neonatal hypoglycemia. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Dextrose readily crosses the placenta via facilitated diffusion. Sodium and potassium cross via active transport and are closely regulated. This solution's components are physiological and not associated with fetal harm at normal doses. |
| Breastfeeding | Dextrose, sodium, and potassium are normal milk constituents and are not expected to cause adverse effects in breastfed infants. Intravenous administration may transiently increase glucose and electrolyte levels, but no special precautions are required. |
| Lactation Rating | Safe |
| Teratogenic Risk | No known teratogenic risk. Dextrose, sodium chloride, and potassium chloride are normal blood constituents. At clinically relevant doses, no fetal harm is expected in any trimester. |
| Fetal Monitoring | Monitor serum electrolytes (sodium, potassium, glucose), fluid balance, and urine output. Assess for signs of hyperglycemia, hypernatremia, hyperkalemia, or hypokalemia. Fetal heart rate monitoring if maternal metabolic disturbances occur. |
| Fertility Effects | No known adverse effects on fertility. The components are physiological and do not impair reproductive function. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
HyperglycemiaHyperkalemiaHypernatremiaFluid overload (e.g., heart failure, renal failure)Severe metabolic acidosis requiring correction without dextrose
| Precautions | Monitor serum potassium, glucose, and fluid balance closely; avoid in patients with severe renal impairment or oliguria; risk of hyperkalemia with rapid infusion in renal dysfunction; contains aluminum (may accumulate with prolonged use); use with caution in heart failure, pulmonary edema, or hyperosmolar states. |
| Food/Dietary | Avoid high-potassium foods (e.g., bananas, oranges, potatoes, spinach) and salt substitutes containing potassium chloride to prevent hyperkalemia. No other food interactions. |
| Clinical Pearls | Restricted in patients with hyperkalemia, severe renal impairment, or oliguria. Use with caution in heart failure, pulmonary edema, or conditions with sodium retention. Monitor serum potassium, renal function, and fluid balance. Contains 5.5 mEq/L potassium; rate must not exceed 10-20 mEq/h via peripheral line to avoid phlebitis and cardiac effects. |
| Patient Advice | This solution provides fluids, sugar, and potassium to correct dehydration and electrolyte imbalances. · Report any signs of fluid overload (swelling, shortness of breath), hyperkalemia (muscle weakness, palpitations), or infusion site reactions. · Do not consume additional potassium supplements or salt substitutes without consulting your doctor. · Tell your healthcare provider if you have kidney disease, heart problems, or are on a potassium-restricted diet. |
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