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 infusion solution commonly used in clinical practice to provide both fluid and nutritional support. It combines dextrose, a form of glucose, with a dilute sodium chloride solution in a 1000 ml plastic bag, making it suitable for intravenous administration. This solution is formulated to supply energy in the form of glucose while maintaining electrolyte and fluid balance through sodium chloride.

• Dextrose 10% w/v: Provides a source of carbohydrates to meet caloric requirements and prevent protein breakdown in patients who are unable to consume food orally.
• Sodium Chloride 0.225% w/v: A hypotonic saline solution supplying essential sodium and chloride ions, helping maintain extracellular fluid volume and electrolyte homeostasis.
• This infusion is typically used for maintenance fluid therapy, mild dehydration, and as a component of parenteral nutrition.
• Supplied in a plastic bag to minimize contamination risk and facilitate ease of administration.
• Commonly used in hospital settings under medical supervision to ensure appropriate dosing and monitoring of fluid and electrolyte balance.

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

This intravenous infusion must be administered under strict medical supervision with adherence to sterile technique and correct dosing protocols.

• Route of administration: Intravenous infusion only, typically via peripheral or central venous catheter depending on patient status.
• Preparation: Verify the solution’s integrity—clear, colorless, and free of particulate matter—before use.
• Infusion rate: Determined by the treating physician based on patient’s age, weight, clinical condition, and fluid requirements. Typically ranges from 50 to 125 ml/hour in adults.
• Monitoring: Continuous monitoring of vital signs, blood glucose levels, and electrolyte concentrations is essential to avoid complications.
• Compatibility: Confirm compatibility with any concurrently administered intravenous medications to avoid precipitation or loss of efficacy.
• Infusion duration: Usually administered over several hours, with rate adjustments as needed based on patient response.
• Patient considerations: Adjustments may be necessary for patients with diabetes, renal or cardiac impairment.

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

The therapeutic effects of this infusion stem from the combined physiological roles of its two key components:

• Dextrose: Acts as a metabolic substrate by entering cells and undergoing glycolysis, producing ATP to meet cellular energy demands. It helps prevent catabolism by providing an exogenous energy source.
• Dextrose is rapidly absorbed and metabolized, helping to maintain adequate blood glucose levels especially in patients who cannot consume food orally.
• Sodium Chloride: Dissociates into sodium (Na⁺) and chloride (Cl⁻) ions, vital electrolytes that regulate fluid balance, osmotic pressure, nerve conduction, and muscle function.
• The 0.225% concentration is hypotonic relative to plasma, promoting water movement into cells to aid hydration without causing rapid electrolyte shifts.
• Together, these components help maintain extracellular fluid volume, provide essential electrolytes, and support cellular metabolism during clinical treatments.
• The controlled osmolarity minimizes vein irritation and supports safe 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

Several drug and patient condition interactions should be considered during administration of this solution:

• Insulin and other hypoglycemics: Dextrose infusion can increase blood glucose levels, potentially reducing the effectiveness of insulin and oral hypoglycemic agents, necessitating close glucose monitoring.
• Diuretics: Medications like loop or thiazide diuretics alter electrolyte balance and may exacerbate sodium or fluid imbalances during infusion.
• ACE inhibitors and ARBs: These drugs affect renal sodium handling and potassium levels, increasing the risk of electrolyte disturbances when combined with sodium-containing fluids.
• Corticosteroids and NSAIDs: Can cause fluid retention, compounding risk of overload when combined with intravenous fluids.
• Other IV drugs: Compatibility must be checked to avoid precipitation or reduced efficacy when co-administered.
• Underlying conditions: Renal or cardiac impairment may alter the body’s handling of fluids and electrolytes, requiring adjustment of infusion rate and close monitoring.

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

Dosage is individualized depending on patient’s clinical needs, fluid status, and metabolic demands:

• Adults: Maintenance fluid requirements generally range from 1.5 to 3 liters per day; infusion rates commonly 50-125 ml/hour depending on clinical condition.
• Pediatric patients: Dosage calculated based on body weight (ml/kg/hour) and clinical assessment to avoid fluid overload or electrolyte imbalance.
• Patients with renal or cardiac disease: Doses should be carefully reduced and titrated to avoid fluid retention or worsening organ function.
• Special situations: Adjustments needed in diabetic patients to balance glucose delivery with insulin therapy.
• Monitoring: Regular assessment of fluid input/output, blood glucose, and electrolyte levels is essential to guide dosing adjustments.

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

While generally safe, potential side effects may occur during or after infusion:

• Local site reactions: Pain, irritation, phlebitis, or thrombophlebitis at the injection site due to osmolarity or catheter placement.
• Fluid overload: Signs include peripheral edema, hypertension, pulmonary edema, and shortness of breath, particularly in patients with cardiac or renal insufficiency.
• Electrolyte disturbances: Over-infusion can lead to hyponatremia or hypernatremia depending on individual response and underlying conditions.
• Hyperglycemia: Elevated blood glucose may develop in diabetic or glucose-intolerant patients, potentially leading to osmotic diuresis or ketoacidosis if unmonitored.
• Allergic reactions: Rare but may include rash, itching, or anaphylaxis.
• Metabolic imbalances: Disturbances in acid-base balance may occur with prolonged or inappropriate use.
• Infections: Risk of bloodstream infections if aseptic technique is compromised during administration.

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 be avoided or used with caution in specific clinical scenarios:

• Uncontrolled hyperglycemia or diabetic ketoacidosis: Dextrose may worsen these conditions.
• Severe hyponatremia: Hypotonic sodium chloride solutions may exacerbate low sodium levels.
• Fluid overload states: Conditions such as congestive heart failure, pulmonary edema, or renal failure where additional fluid may cause harm.
• Hypersensitivity: Known allergy to any component of the solution.
• Increased intracranial pressure: Hypotonic solutions may worsen cerebral edema.
• Patients requiring sodium restriction: Use cautiously as sodium content may be contraindicated.

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

Proper storage conditions help preserve the integrity and safety of the infusion solution:

• Temperature: Store at controlled room temperature, ideally between 20°C to 25°C (68°F to 77°F). Avoid freezing or exposure to high heat.
• Light protection: Keep the solution in its original packaging away from direct sunlight to prevent degradation.
• Packaging: Retain in the sealed plastic bag until use to maintain sterility and avoid contamination.
• Inspection: Prior to use, check the solution for clarity, absence of particulate matter, discoloration, or leaks.
• Expiration: Do not use beyond the expiry date indicated on the packaging.
• Handling: Avoid vigorous shaking; gentle inversion is sufficient if mixing is required.
• Disposal: Dispose of any unused or expired solution according to local biomedical waste regulations.