10% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP Infusion/Solution for

What is 10% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

10% w/v Dextrose & 0.225% w/v Sodium Chloride Injection USP is a sterile intravenous solution commonly used in medical settings for fluid and electrolyte replenishment. This infusion solution combines dextrose (a form of glucose) and sodium chloride (common salt) at specific concentrations to provide both energy and essential electrolytes to patients.

• Dextrose 10% (w/v): Acts as a carbohydrate source providing calories to patients, especially useful in cases of hypoglycemia or when patients cannot eat.
• Sodium Chloride 0.225% (w/v): A hypotonic saline solution, helping to maintain or restore electrolyte balance and hydration status.
• Typically supplied in a 1000 ml plastic bag for intravenous infusion, suitable for slow administration over several hours.
• Used extensively in hospital settings for patients needing maintenance fluids, mild dehydration correction, or as part of parenteral nutrition.
• May be administered alone or combined with other medications depending on clinical needs.
• It is important that this solution is used under medical supervision due to potential risks associated with fluid and electrolyte imbalances.

How to use 10% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

This infusion solution is administered intravenously under strict medical supervision, following precise guidelines for safe and effective use:

• Administration route: Intravenous infusion only, using a sterile IV line and infusion pump to control the rate.
• Preparation: Inspect the solution for clarity, colorlessness, and absence of particulate matter before use.
• Dosage and rate: Determined by the physician based on patient's age, weight, clinical condition, and fluid requirements.
• Typical uses: Maintenance fluid for patients unable to take oral fluids; source of glucose for energy; electrolyte replacement.
• Monitoring: Vital signs, blood glucose levels, electrolyte balance, and signs of fluid overload or dehydration should be regularly checked during infusion.
• Infusion time: Typically administered over several hours; rate must be adjusted to avoid rapid changes in blood osmolarity.
• Compatibility: Consult compatibility charts before mixing with other intravenous drugs or solutions.
• Storage before use: Keep the solution sealed in its original container until administration to maintain sterility.

Mode of Action 10% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

The mode of action of this intravenous solution is based on its components’ physiological effects on the body’s fluid and energy balance:

• Dextrose (Glucose): Once infused, dextrose is rapidly metabolized by body cells to produce energy. It enters cells via facilitated diffusion and is phosphorylated to glucose-6-phosphate, entering metabolic pathways like glycolysis.
• Provides a direct source of calories, helping to maintain blood glucose levels and prevent catabolism, especially in patients who cannot eat or have increased metabolic needs.
• Sodium Chloride (NaCl): Dissociates into sodium (Na⁺) and chloride (Cl⁻) ions, essential electrolytes involved in maintaining osmotic pressure, acid-base balance, and normal cell function.
• 0.225% sodium chloride provides a hypotonic solution, which helps to hydrate cells by shifting water intracellularly while maintaining some plasma sodium to prevent hyponatremia.
• Maintains extracellular fluid volume, supports nerve and muscle function, and helps regulate blood pressure.
• Together, the combination maintains fluid and electrolyte homeostasis, preventing dehydration and electrolyte imbalances during treatment.
• The solution’s osmolarity is carefully balanced to minimize risks of vein irritation or fluid shifts during intravenous administration.

10% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP Interactions 10% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

When administered intravenously, this solution may interact with other drugs or medical conditions, affecting efficacy or safety:

• Compatibility with other IV drugs: Some intravenous medications may precipitate or lose potency when mixed directly with dextrose or sodium chloride solutions. Always consult compatibility guides before co-administration.
• Insulin and hypoglycemic agents: Dextrose infusion can raise blood glucose, potentially counteracting the effects of insulin or oral hypoglycemics. Close blood glucose monitoring is essential in diabetic patients.
• Electrolyte-modifying drugs: Drugs like diuretics (e.g., furosemide) or ACE inhibitors may alter sodium or fluid balance, increasing risk of electrolyte disturbances when combined.
• Drugs affecting fluid balance: Corticosteroids and NSAIDs can cause fluid retention, potentially exacerbating fluid overload risk when combined with IV fluids.
• Concurrent use with other hypertonic or hypotonic fluids: Requires careful monitoring to avoid rapid shifts in osmolarity leading to complications such as cerebral edema or dehydration.
• Patients with underlying conditions: Congestive heart failure, renal impairment, or liver disease patients are at higher risk for complications related to fluid or electrolyte imbalance with this infusion.

Dosage of 10% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

Dosage and administration of this solution are tailored individually by healthcare professionals based on clinical assessment:

• Adults: Maintenance fluid requirements typically range from 1.5 to 3 liters per day, adjusted for body weight, ongoing losses, and clinical condition.
• Children and infants: Dosage is carefully calculated based on body weight (ml/kg/hour) and clinical status to avoid fluid overload or electrolyte imbalances.
• Special conditions: In patients with hyperglycemia, renal or cardiac impairment, the infusion rate and volume may be reduced or altered.
• Typical infusion rates: Generally between 50-125 ml/hour depending on patient size and needs.
• Continuous monitoring: Fluid input/output, serum electrolytes, and glucose levels must be monitored to adjust dosing accordingly.
• Clinical scenarios: Used for maintenance hydration, mild dehydration correction, or as part of parenteral nutrition regimens.
• Adjustments: Dose adjustments are necessary if the patient shows signs of fluid overload, electrolyte abnormalities, or hyperglycemia.

Possible side effects of 10% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

Though generally safe when administered properly, this intravenous solution can cause side effects, some serious if unmonitored:

• Local reactions: Pain, redness, or phlebitis at the infusion site due to irritation from the solution’s osmolarity.
• Fluid overload: Symptoms include swelling, shortness of breath, increased blood pressure, or edema, especially in patients with heart or kidney problems.
• Electrolyte imbalances: Over-infusion may cause hyponatremia (low sodium) or hypernatremia depending on rate and patient status.
• Hyperglycemia: Elevated blood sugar levels can occur, particularly in diabetic or glucose-intolerant patients, possibly leading to osmotic diuresis or ketoacidosis if severe.
• Hypersensitivity reactions: Though rare, allergic reactions including rash, itching, or anaphylaxis may happen.
• Metabolic disturbances: Infusion of glucose may alter acid-base balance or lead to metabolic alkalosis or acidosis if not monitored carefully.
• Infection risk: Contamination during preparation or administration can cause bloodstream infections.

10% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP Contraindications 10% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

This solution should not be used in certain clinical scenarios to avoid harm:

• Severe hyperglycemia or glucose intolerance: Patients with uncontrolled diabetes or hyperosmolar states should avoid or receive with extreme caution.
• Severe hyponatremia: Infusion of hypotonic sodium chloride solutions may worsen sodium imbalance.
• Fluid overload states: Conditions such as congestive heart failure, pulmonary edema, or renal failure where additional fluid may exacerbate symptoms.
• Known hypersensitivity: Allergies to any component of the solution contraindicate its use.
• Intracranial pressure elevation: Hypotonic fluids may increase cerebral edema in patients with brain injury or stroke.
• Patients requiring strict sodium restriction: Due to the sodium content, this solution may be contraindicated in some electrolyte management protocols.

Storage of 10% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

Proper storage of this intravenous solution ensures its safety and efficacy:

• Temperature: Store at controlled room temperature, typically between 20°C to 25°C (68°F to 77°F). Avoid freezing or exposure to excessive heat.
• Protection from light: Keep the bag in its protective packaging or away from direct sunlight to prevent degradation.
• Packaging: Store in the original sealed plastic bag to maintain sterility and prevent contamination.
• Expiration: Do not use after the expiry date printed on the packaging.
• Handling: Avoid shaking vigorously; gentle inversion is sufficient if mixing is necessary.
• Inspection before use: Always check the solution for clarity, absence of particles, discoloration, or leaks before administration.
• Disposal: Dispose of unused or expired solution according to local regulations for medical waste.