ISOLYTE S W/ DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for ISOLYTE S W/ DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE S W/ DEXTROSE 5% IN PLASTIC CONTAINER).
Isolyte S with Dextrose 5% is an intravenous solution providing electrolytes and calories. Dextrose supplies glucose for cellular energy metabolism, while electrolytes (sodium, potassium, magnesium, chloride, acetate, gluconate) maintain acid-base balance and osmotic pressure. Acetate and gluconate are metabolized to bicarbonate, providing alkalinizing effect.
| Metabolism | Dextrose is metabolized via glycolysis and oxidative phosphorylation. Acetate and gluconate are metabolized in the liver and other tissues to bicarbonate. |
| Excretion | Renal excretion of electrolytes and water; dextrose is metabolized to CO2 and water, with <0.5% excreted unchanged in urine. |
| Half-life | Not applicable for the combination; individual components: dextrose has an elimination half-life of 15-20 minutes, electrolytes are not eliminated as a drug. |
| Protein binding | Negligible for electrolytes and dextrose (dextrose <5% bound to albumin). |
| Volume of Distribution | Electrolytes distribute into total body water (0.6 L/kg); dextrose distributes into extracellular fluid (0.2 L/kg). |
| Bioavailability | Intravenous: 100% by definition for all components. |
| Onset of Action | Intravenous: Immediate for volume expansion and electrolyte effects. |
| Duration of Action | Intravenous: 1-2 hours for volume expansion; electrolyte effects persist as long as infusion continues and renal function maintains balance. |
| Molecular Weight | Dextrose: 180.16 Da; electrolytes (Na, K, etc.) are ions with low molecular weight. |
Intravenous infusion; dose determined by fluid and electrolyte requirements. Typical adult maintenance: 100-200 mL/h (2.4-4.8 L/day) depending on clinical status.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment; use with caution in renal impairment due to risk of electrolyte disturbances. Monitor serum potassium and glucose. GFR <30 mL/min: avoid due to potassium content. |
| Liver impairment | No specific dose adjustment; use with caution in severe hepatic impairment due to potential for electrolyte imbalances. Monitor closely. |
| Pediatric use | Intravenous infusion based on weight and clinical need. Typical maintenance: 100 mL/kg/day for first 10 kg, 50 mL/kg/day for 10-20 kg, 20 mL/kg/day for >20 kg. Adjust for dehydration or ongoing losses. |
| Geriatric use | Use with caution due to increased risk of fluid overload, electrolyte disturbances, and glucose intolerance. Start at lower infusion rates (e.g., 50-100 mL/h) and titrate based on clinical response and renal function. |
| 1st trimester | Generally considered safe; used for fluid and electrolyte replacement. No known teratogenic effects. |
| 2nd trimester | Generally considered safe; monitor maternal electrolytes and glucose. |
| 3rd trimester | Generally considered safe; avoid fluid overload in preeclampsia or compromised cardiac function. |
Clinical note
Comprehensive clinical and safety monograph for ISOLYTE S W/ DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE S W/ DEXTROSE 5% IN PLASTIC CONTAINER).
| Placental transfer | Components cross placenta; dextrose and electrolytes equilibrate across placenta. |
| Breastfeeding | Excreted in breast milk in minimal amounts; considered compatible with breastfeeding. Monitor infant for electrolyte disturbances if large volumes are infused. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | No teratogenic risk associated. Dextrose 5% and balanced electrolyte solution (Isolyte S) are not known to cause fetal harm. Use during pregnancy does not increase risk of congenital anomalies. |
| Fetal Monitoring | Monitor maternal serum electrolytes, blood glucose, fluid status, and urine output. Fetal heart rate monitoring may be indicated if maternal complications arise. |
| Fertility Effects | No known effects on fertility. The solution does not contain reproductive toxins. |
■ FDA Black Box Warning
Not for use in patients with known hypersensitivity to corn or corn products (dextrose derived from corn). Solutions containing aluminum (trace) may be toxic to neonates or patients with renal impairment.
| Serious Effects |
HyperglycemiaHypernatremiaHyperkalemiaAddison's diseaseAcute pulmonary edemaSevere dehydrationRenal failure with oliguria
| Precautions | Risk of fluid overload, especially in patients with cardiac or renal impairment, Electrolyte imbalances (e.g., hyperkalemia, hypernatremia, hypomagnesemia) should be monitored, Use with caution in patients with severe renal impairment, hepatic failure, or conditions requiring sodium restriction, May cause hyperglycemia in diabetic patients or those with glucose intolerance, Do not administer simultaneously with blood or blood products through same tubing |
| Food/Dietary | No specific food interactions. However, the dextrose component may affect blood glucose levels; patients on diabetic diets should monitor carbohydrate intake. Avoid excessive alcohol consumption due to risk of hypoglycemia or electrolyte imbalance. |
| Clinical Pearls | ISOLYTE S with Dextrose 5% is an isotonic crystalloid solution containing electrolytes and dextrose. It should not be used for resuscitation in hemorrhagic shock as it may cause hyperglycemia and osmotic diuresis. Monitor serum glucose closely in diabetic patients. Do not administer simultaneously with blood products through the same tubing due to risk of hemolysis. Discard any unused portion; do not store partially used bags. |
| Patient Advice | This solution is given through a vein to replace fluids and electrolytes. · Tell your doctor if you have diabetes, kidney problems, or heart failure. · You may need blood tests to monitor your sugar and electrolyte levels. · Report any swelling, shortness of breath, or pain at the IV site. |
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