PLASMA-LYTE M AND DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for PLASMA-LYTE M AND DEXTROSE 5% IN PLASTIC CONTAINER (PLASMA-LYTE M AND DEXTROSE 5% IN PLASTIC CONTAINER).
Plasma-Lyte M and Dextrose 5% is an intravenous solution that provides electrolytes and calories. Dextrose is a monosaccharide that serves as a source of calories and water for cellular metabolism. Electrolytes (sodium, potassium, magnesium, chloride, acetate, gluconate) maintain fluid and electrolyte balance, and acetate and gluconate act as bicarbonate precursors to correct acidosis.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water, providing energy. Acetate and gluconate are metabolized primarily in the liver and skeletal muscle to bicarbonate. Electrolytes are not metabolized. |
| Excretion | Renal: 90% (as water and electrolytes); Dextrose is metabolized to CO2 and water, with negligible renal excretion of unchanged drug. |
| Half-life | Dextrose: <15 minutes (rapidly cleared from plasma); Electrolytes: No true half-life, as they are distributed and excreted according to homeostatic mechanisms. |
| Protein binding | Minimal (<5%) for electrolytes and dextrose; not significantly bound to plasma proteins. |
| Volume of Distribution | Electrolytes: Vd of sodium ~0.6 L/kg (total body water); Dextrose: Vd ~0.2-0.3 L/kg (extracellular fluid); overall Vd approximates 0.6 L/kg. |
| Bioavailability | Not applicable; drug is only administered intravenously (IV), so bioavailability is 100%. |
| Onset of Action | Intravenous: Immediate, with plasma volume expansion occurring within minutes; Dextrose infusion provides rapid glucose elevation (within 2-5 minutes) if hypoglycemic. |
| Duration of Action | Intravenous: 2-4 hours for volume effect, depending on fluid shifts; Glucose effect lasts as long as infusion continues, with return to baseline after cessation. |
Intravenous infusion; adult dose determined by fluid and electrolyte needs; typical maintenance: 100-200 mL/hour (2-3 L/day) for normovolemic patients; adjust based on serum electrolytes, glucose, and clinical status.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (eGFR < 30 mL/min/1.73 m²) due to risk of potassium and magnesium accumulation; for eGFR 30-59 mL/min/1.73 m², reduce infusion rate by 50% and monitor electrolytes; no adjustment for eGFR ≥ 60 mL/min/1.73 m². |
| Liver impairment | Child-Pugh Class A or B: no adjustment needed; Child-Pugh Class C: monitor serum magnesium and potassium closely due to reduced clearance; consider reduced infusion rate (e.g., 75% of normal) and frequent electrolyte monitoring. |
| Pediatric use | Intravenous infusion; dose based on weight: infants: 100-150 mL/kg/day; children: 100-200 mL/kg/day; adjust for ongoing losses and serum glucose; not recommended for neonates due to risk of hyperkalemia; maximum infusion rate 2-5 mL/kg/hour depending on age and clinical status. |
| Geriatric use | Elderly patients: use lower initial rates (e.g., 50-100 mL/hour) with careful monitoring of fluid overload, serum electrolytes, and glucose tolerance; due to age-related renal decline, consider dose reduction if eGFR < 60 mL/min/1.73 m²; avoid in patients with heart failure or significant renal impairment. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for PLASMA-LYTE M AND DEXTROSE 5% IN PLASTIC CONTAINER (PLASMA-LYTE M AND DEXTROSE 5% IN PLASTIC CONTAINER).
| Breastfeeding | Compatible with breastfeeding. Components (dextrose, electrolytes) are endogenous and present in breast milk. No known M/P ratio available as the solution is composed of substances normally present in milk. Excretion is not clinically relevant; no adverse effects expected. |
| Teratogenic Risk | No evidence of teratogenicity. Plasma-Lyte M and Dextrose 5% is an isotonic crystalloid solution; dextrose and electrolytes are normal physiological constituents. Fetal risk is negligible as the solution is designed to replace fluids and electrolytes. No teratogenic effects reported in animal studies or human data. Trimester-independent low risk, but use only if clearly needed. |
■ FDA Black Box Warning
Not for use in patients with intracranial or intraspinal hemorrhage, or in patients with known hypersensitivity to any component.
| Serious Effects |
["Severe hyperglycemia (e.g., diabetic ketoacidosis)","Hyperkalemia","Severe renal impairment with oliguria or anuria","Hypersensitivity to any component"]
| Precautions | ["Use with caution in patients with heart failure, renal impairment, or conditions predisposing to fluid overload.","Monitor serum glucose, electrolytes, and fluid status regularly.","Avoid rapid infusion to prevent hyperglycemia and osmotic diuresis.","Do not administer simultaneously with blood through the same infusion set (risk of hemolysis) unless using a Y-type connector with proper flushing."] |
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| Fetal Monitoring | Monitor maternal serum electrolytes, fluid balance, blood glucose (especially in gestational diabetes or impaired glucose tolerance), and signs of fluid overload (e.g., edema, pulmonary congestion). Fetal monitoring not routinely required unless maternal condition warrants (e.g., preeclampsia); assess fetal heart rate if maternal electrolyte disturbances or fluid overload occur. |
| Fertility Effects | No known adverse effects on fertility. The solution contains normal physiological components; no reproductive toxicity or impact on spermatogenesis or oogenesis reported. Use in IVF protocols for fluid resuscitation without fertility impairment. |