DEXTROSE 5%, SODIUM CHLORIDE 0.45% AND POTASSIUM CHLORIDE 5MEQ IN PLASTIC CONTAINER
Clinical safety rating: safe
No 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. |
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 | 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 | Safe during breastfeeding. Components are normal plasma constituents and enter breast milk in negligible amounts. M/P ratio not applicable. |
| 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. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
Hyperkalemia, hypernatremia, severe renal impairment with oliguria, anuria, or impaired potassium excretion; clinically significant fluid overload; hypersensitivity to any component; patients with sickle cell disease (risk of thrombosis).
| 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. |
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| 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. |