PLASMA-LYTE 148 AND DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for PLASMA-LYTE 148 AND DEXTROSE 5% IN PLASTIC CONTAINER (PLASMA-LYTE 148 AND DEXTROSE 5% IN PLASTIC CONTAINER).
Plasma-Lyte 148 and Dextrose 5% is an intravenous solution that provides maintenance fluid, electrolytes, and calories. Dextrose provides energy and prevents ketosis. Plasma-Lyte 148 contains electrolytes (sodium, potassium, magnesium, calcium, chloride, acetate, gluconate) to replace losses and maintain acid-base balance.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water, producing energy. Acetate and gluconate are metabolized in the liver and tissues to bicarbonate. Electrolytes are not metabolized but are excreted or reutilized. |
| Excretion | Components are excreted renally. Dextrose is metabolized; electrolytes are eliminated via kidneys (sodium, chloride, acetate, gluconate, magnesium, potassium). No biliary or fecal elimination. |
| Half-life | Not applicable as it is a balanced electrolyte solution with dextrose. Components distribute and are eliminated rapidly; dextrose half-life ~15-30 minutes in normoglycemia. |
| Protein binding | Electrolytes and dextrose have negligible protein binding (<1%). No significant binding. |
| Volume of Distribution | Vd approximates extracellular fluid volume: ~0.15-0.25 L/kg for electrolyte components; dextrose distributes into total body water (~0.6 L/kg). |
| Bioavailability | Intravenous: 100% (by definition). Not administered via other routes. |
| Onset of Action | Intravenous: Immediate (within seconds) for volume expansion and electrolyte correction; dextrose metabolism begins immediately. |
| Duration of Action | Duration varies: volume effect lasts 2-4 hours; electrolyte adjustments persist while infusion continues and are rapidly cleared post-infusion. Clinical context: continuous infusion for maintenance. |
| Molecular Weight | Dextrose: 180.16 Da; electrolytes: variable (Na 23, K 39.1, Mg 24.3, Cl 35.5, acetate 59.04, gluconate 196.16). |
IV infusion at a rate of 10-20 mL/kg/hour, not to exceed 100 mL/hour in adults without cardiac or renal compromise; adjust based on fluid status and serum electrolytes.
| Dosage form | INJECTABLE |
| Renal impairment | If GFR < 30 mL/min, reduce infusion rate by 50% and monitor potassium and phosphate levels closely; avoid in severe renal impairment if hyperkalemia or hyperphosphatemia is present. |
| Liver impairment | No specific Child-Pugh-based adjustment required; use with caution in severe hepatic impairment due to risk of fluid overload and electrolyte disturbances. |
| Pediatric use | Neonates and children: IV infusion at 5-10 mL/kg/hour, titrated to clinical need; maximum rate 20 mL/kg/hour; monitor electrolytes frequently. |
| Geriatric use | Start at lower infusion rate (5-10 mL/kg/hour) due to age-related decline in renal function; reassess fluid status regularly to avoid volume overload. |
| 1st trimester | No known teratogenic risk; use only if clearly needed. |
| 2nd trimester | Safe for maternal resuscitation and maintenance; monitor for fluid/electrolyte imbalance. |
| 3rd trimester | Safe for maternal resuscitation and maintenance; monitor for fluid/electrolyte imbalance. |
Clinical note
Comprehensive clinical and safety monograph for PLASMA-LYTE 148 AND DEXTROSE 5% IN PLASTIC CONTAINER (PLASMA-LYTE 148 AND DEXTROSE 5% IN PLASTIC CONTAINER).
| Placental transfer | Dextrose and electrolytes cross placenta; no known adverse effects at therapeutic doses. |
| Breastfeeding | Excreted in breast milk in negligible amounts; compatible with breastfeeding. |
| Lactation Rating | Safe |
| Teratogenic Risk | Plasma-Lyte 148 and Dextrose 5% is an intravenous electrolyte and carbohydrate solution. At therapeutic doses, no direct fetal toxicity or teratogenicity is expected as electrolytes and dextrose are physiological substances. However, careful monitoring is required during pregnancy to avoid fluid overload, electrolyte imbalances, or hyperglycemia, which could indirectly affect fetal development. No specific trimester-specific risks are identified. |
| Fetal Monitoring | Monitor maternal fluid and electrolyte status, serum glucose, and signs of fluid overload. Fetal monitoring may be warranted if maternal status is unstable or if signs of hyperglycemia or electrolyte disturbances occur. |
| Fertility Effects | No expected impact on fertility, as the components are physiological and not known to affect reproductive function. |
■ FDA Black Box Warning
Not approved for use in patients with known hypersensitivity to any component. Not for use as a primary source of nutrition in neonates or low birth weight infants due to risk of aluminum toxicity.
| Serious Effects |
HyperglycemiaHypersensitivity to any componentKetoacidosisRenal failure with oliguria
| Precautions | Risk of fluid overload and electrolyte disturbances, especially in patients with renal impairment, heart failure, or severe dehydration, May cause hyperglycemia, particularly in diabetic patients, Monitor serum electrolytes, blood glucose, and fluid balance during infusion, Aluminum toxicity with prolonged use in renal impairment, Do not administer simultaneously with blood products through same IV line |
| Food/Dietary | No direct food interactions. However, dextrose content may affect blood glucose; patients with diabetes should monitor glucose levels closely and adjust insulin/oral hypoglycemic agents as directed. Use with caution in patients on sodium or potassium-modifying diets. |
| Clinical Pearls | PLASMA-LYTE 148 and Dextrose 5% is an isotonic solution containing electrolytes and dextrose. Use within 24 hours of spiking the container. Avoid administering through the same line as blood products due to risk of hemolysis from electrolyte content. Monitor serum glucose, electrolytes, and fluid balance, especially in patients with impaired renal function, diabetes, or heart failure. The solution has a pH of ~5.5; consider compatibility with co-administered drugs. |
| Patient Advice | This solution provides fluids and sugar to help maintain hydration and energy. · Tell your healthcare provider if you have diabetes, heart problems, or kidney disease. · You may experience swelling, shortness of breath, or changes in urination; report these immediately. · Your blood sugar and electrolyte levels will be monitored during treatment. · Do not use this solution if it is cloudy, discolored, or contains particles. |
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