PLASMA-LYTE 56 AND DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for PLASMA-LYTE 56 AND DEXTROSE 5% IN PLASTIC CONTAINER (PLASMA-LYTE 56 AND DEXTROSE 5% IN PLASTIC CONTAINER).
Plasma-Lyte 56 and Dextrose 5% is a crystalloid solution that provides electrolytes and carbohydrates. Dextrose is metabolized to glucose, which is utilized for cellular energy production. The electrolytes (sodium, chloride, potassium, magnesium, and acetate) maintain or restore intravascular volume, acid-base balance, and osmotic gradients. Acetate is metabolized to bicarbonate, providing an alkalinizing effect.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle. Acetate is metabolized in the liver and peripheral tissues to bicarbonate. Electrolytes are not metabolized. |
| Excretion | Renal 100% (electrolytes and dextrose metabolized to CO2 and water; excess water and electrolytes excreted unchanged in urine). |
| Half-life | Not applicable; composition-dependent. Dextrose half-life ~2 hours. Electrolytes follow endogenous regulation; no terminal elimination half-life defined. |
| Protein binding | <5% (minimal; free ions and glucose). |
| Volume of Distribution | 0.2-0.3 L/kg (dextrose and electrolytes distribute primarily in extracellular fluid; total body water for water). |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: Immediate (within seconds) upon infusion. |
| Duration of Action | Intravenous: 2-4 hours based on dextrose metabolism and electrolyte distribution; clinical effect persists as long as infused. |
| Molecular Weight | 180.16 |
Intravenous infusion; dose depends on fluid and electrolyte requirements. Typical adult dose: 500-1000 mL as a single infusion, rate up to 333 mL/hour. Maximum 3 L/24 hours.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) due to risk of hyperkalemia and fluid overload. For GFR 30-60 mL/min: monitor potassium and fluid status closely; reduce infusion rate and volume. |
| Liver impairment | Use with caution in severe hepatic impairment (Child-Pugh C) due to risk of fluid overload and electrolyte imbalances. No specific dose adjustment defined; monitor closely. |
| Pediatric use | Weight-based: 20-40 mL/kg per dose as a single infusion, rate not to exceed 10 mL/kg/hour. For maintenance: 100-150 mL/kg/day, adjusted for age and clinical status. |
| Geriatric use | Use with caution due to decreased renal function; consider baseline GFR. Reduce rate and total volume to avoid fluid overload. Monitor electrolytes and volume status frequently. |
| 1st trimester | Generally safe when clinically indicated; no known teratogenic effects from components (dextrose, electrolytes). Use only if clearly needed. |
| 2nd trimester | Safe for use when required; monitor maternal glucose and electrolytes. |
| 3rd trimester | Safe for use; caution in conditions like preeclampsia or fluid overload. |
Clinical note
Comprehensive clinical and safety monograph for PLASMA-LYTE 56 AND DEXTROSE 5% IN PLASTIC CONTAINER (PLASMA-LYTE 56 AND DEXTROSE 5% IN PLASTIC CONTAINER).
| Placental transfer | Dextrose and electrolytes freely cross placenta; no known adverse fetal effects at therapeutic levels. |
| Breastfeeding | Dextrose and electrolytes are normal blood constituents; excretion into breast milk is negligible at therapeutic doses. Compatible with breastfeeding. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | First trimester: No known teratogenic effects. Dextrose and electrolytes are physiological components; no structural anomalies reported. Second and third trimesters: No fetal risk; used for fluid and electrolyte maintenance. High dextrose concentrations may cause maternal hyperglycemia, potentially leading to fetal hyperinsulinemia and neonatal hypoglycemia if infused rapidly or in large volumes. |
| Fetal Monitoring | Monitor maternal blood glucose, serum electrolytes (sodium, potassium, calcium, magnesium, phosphate, chloride), and fluid balance (intake/output, weight, edema). Assess for signs of hyperglycemia, hypernatremia, or fluid overload. Fetal monitoring as per gestational age (e.g., fetal heart rate, biophysical profile) if maternal fluid or electrolyte imbalance occurs. |
| Fertility Effects | No known effects on fertility. Dextrose and balanced electrolyte solutions are supportive and do not impair reproductive function. |
■ FDA Black Box Warning
None
| Serious Effects |
Hyperglycemia (uncorrected)Hypersensitivity to any componentClinically significant fluid overloadSevere electrolyte abnormalities (e.g., hyperkalemia, hypernatremia)
| Precautions | Use with caution in patients with renal impairment, heart failure, or conditions with fluid overload, Risk of electrolyte disturbances (hyperkalemia, hypermagnesemia, hypernatremia) with excessive or rapid infusion, May cause hyperglycemia in patients with diabetes mellitus or glucose intolerance, Avoid in patients with severe metabolic acidosis without adequate buffering capacity, Monitor serum electrolytes, glucose, fluid balance, and acid-base status during prolonged therapy, Not recommended for use in neonates or pediatric patients with significant renal impairment due to potassium content |
| Food/Dietary | No dietary restrictions are required. However, this solution contains dextrose, which may affect blood glucose; diabetic patients should monitor carbohydrate intake accordingly. No known food interactions. |
| Clinical Pearls | PLASMA-LYTE 56 AND DEXTROSE 5% is an isotonic solution containing electrolytes and a low dextrose concentration (5 g/dL). It provides 170 mOsm/L, making it hypotonic relative to plasma. Use cautiously in patients with increased risk of hyponatremia or cerebral edema (e.g., children, elderly, post-op). Co-administration of dextrose may cause hyperglycemia; monitor blood glucose in diabetics. Not for use as a sole source of calories; dextrose concentration insufficient for nutritional support. Contraindicated in patients with hyperkalemia, hypercalcemia, or severe lactic acidosis. Do not administer if solution is discolored or contains particulates. |
| Patient Advice | This intravenous solution provides fluids, sugar, and electrolytes to maintain hydration and balance. · Tell your healthcare provider if you have diabetes, kidney disease, heart failure, or electrolyte disorders. · Report any symptoms like headache, nausea, confusion, or swelling during infusion. · This solution is given through a vein; do not adjust the flow rate yourself. · If you experience pain, redness, or swelling at the infusion site, notify your nurse immediately. |
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