PLASMA-LYTE 56 AND DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive 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. |
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 | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
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).
| Breastfeeding | Dextrose and electrolytes are normal constituents of breast milk. No adverse effects expected. M/P ratio not applicable as components are endogenous. |
| 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. |
■ FDA Black Box Warning
None
| Serious Effects |
["Hyperkalemia","Hypernatremia","Severe renal failure with oliguria or anuria","Severe metabolic acidosis (e.g., lactic acidosis, diabetic ketoacidosis)","Concurrent administration of medications that may exacerbate hyperkalemia (e.g., potassium-sparing diuretics, ACE inhibitors)","Patients with known allergy to any component"]
| 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"] |
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| 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. |