2.5% W/V DEXTROSE & 0.45% W/V SODIUM CHLORIDE (MEDISAL) Injection/Solution for

What is 2.5% W/V DEXTROSE & 0.45% W/V SODIUM CHLORIDE (MEDISAL)

This intravenous infusion solution contains two active components: dextrose (glucose) 2.5% and sodium chloride 0.45%. It is classified as an isotonic to slightly hypotonic fluid used primarily for parenteral hydration and electrolyte replenishment.

• Dextrose (2.5%): A simple sugar that provides an immediate source of energy for cellular metabolism. It helps maintain adequate blood glucose levels, especially in patients unable to eat or under metabolic stress.
• Sodium Chloride (0.45%): A hypotonic saline solution that aids in correcting mild sodium depletion (hyponatremia), and provides necessary chloride ions to maintain acid-base balance and osmotic pressure.
• This formulation is often used when both fluid and energy replacement are needed, such as in cases of dehydration, mild hypoglycemia, or as a maintenance fluid in hospitalized patients.
• Brand: MEDISAL; Form: Polypropylene bottle for single-use intravenous infusion.

How to use 2.5% W/V DEXTROSE & 0.45% W/V SODIUM CHLORIDE (MEDISAL)

The medication is administered intravenously (IV) by healthcare professionals under sterile conditions. It is not for oral use or self-administration.

• Route: Intravenous infusion via a drip set.
• Administration Rate: The rate depends on the clinical condition, fluid balance, and age/weight of the patient. Usually infused slowly to avoid fluid overload or electrolyte imbalance.
• Preparation: The solution should be inspected for clarity and integrity of the container before use. Discard if discolored, cloudy, or contains particles.
• Monitoring: Continuous monitoring of electrolyte levels, blood glucose, and fluid balance is recommended, especially in critically ill or pediatric patients.
• Do Not Mix: Avoid mixing with incompatible medications unless compatibility is confirmed.

Mode of Action 2.5% W/V DEXTROSE & 0.45% W/V SODIUM CHLORIDE (MEDISAL)

This dual-component infusion works through two main physiological actions provided by dextrose and sodium chloride.

• Dextrose:
  • Provides an immediate energy source by entering the cells through insulin-mediated uptake.
  • Maintains euglycemia in patients with limited oral intake or increased metabolic demand.
  • Serves as a protein-sparing agent by reducing the need for protein catabolism in energy metabolism.
• Sodium Chloride:
  • Replaces sodium and chloride ions, vital for maintaining extracellular fluid volume and nerve conduction.
  • Helps restore osmotic balance and correct mild hyponatremia.
  • Supports acid-base balance and prevents hypotonic dehydration.

2.5% W/V DEXTROSE & 0.45% W/V SODIUM CHLORIDE (MEDISAL) Interactions 2.5% W/V DEXTROSE & 0.45% W/V SODIUM CHLORIDE (MEDISAL)

Though this solution is generally safe, certain interactions can occur with other medications and clinical conditions.

• Corticosteroids: May cause sodium retention and potassium loss, enhancing the risk of fluid overload or electrolyte imbalance.
• Diuretics: Concomitant use with loop or thiazide diuretics can intensify the loss of sodium and potassium, leading to dehydration or arrhythmias.
• Insulin: May enhance glucose uptake and lead to hypoglycemia if dextrose is not infused at adequate levels.
• Cardiac Medications: Use caution in patients taking digoxin due to the risk of digitalis toxicity when electrolyte levels fluctuate.
• Renal Impairment: Risk of sodium accumulation and hypervolemia in patients with reduced renal clearance.

Dosage of 2.5% W/V DEXTROSE & 0.45% W/V SODIUM CHLORIDE (MEDISAL)

Dosage must be individualized based on the patient’s fluid, electrolyte, and glucose needs as assessed by a medical professional.

• Adults: Typically 500–1000 mL over 6 to 24 hours depending on hydration status and metabolic requirements.
• Pediatrics: Dosage based on body weight, usually in the range of 20–100 mL/kg/day, closely monitored.
• Elderly: May require reduced volume and slower infusion rate to prevent fluid overload.
• In Special Conditions (e.g., burns, surgery): Dose adjusted to replace ongoing losses and maintain hemodynamic stability.
• Maximum Rate: Should not exceed the patient’s glucose metabolism capacity (~5 mg/kg/min) to prevent hyperglycemia or osmotic diuresis.

Possible side effects of 2.5% W/V DEXTROSE & 0.45% W/V SODIUM CHLORIDE (MEDISAL)

While generally well tolerated, adverse effects may arise, particularly with prolonged or inappropriate use.

• Common Side Effects:
  • Fluid retention or swelling (edema)
  • Mild pain, redness, or irritation at the infusion site
  • Headache or slight increase in blood pressure
• Serious Side Effects:
  • Hyperglycemia (especially in diabetics)
  • Electrolyte imbalances (hyponatremia, hypokalemia)
  • Pulmonary or peripheral edema due to fluid overload
  • Thrombophlebitis at the site of infusion
• Allergic Reactions (Rare): Urticaria, rash, or anaphylaxis (extremely rare with standard IV fluids).

2.5% W/V DEXTROSE & 0.45% W/V SODIUM CHLORIDE (MEDISAL) Contraindications 2.5% W/V DEXTROSE & 0.45% W/V SODIUM CHLORIDE (MEDISAL)

This medication should be avoided or used with extreme caution in specific clinical scenarios.

• Hyperglycemia or Diabetes Mellitus (uncontrolled): Dextrose may exacerbate elevated blood sugar levels.
• Hypernatremia: The sodium content may worsen the condition.
• Fluid Overload Conditions: Like congestive heart failure, pulmonary edema, or renal insufficiency.
• Severe Renal Dysfunction: Risk of fluid and sodium retention.
• Intracranial or Intraspinal Hemorrhage: Dextrose may worsen neurological outcomes.
• Anuria or Oliguria: May lead to dangerous fluid accumulation and electrolyte shifts.

Storage of 2.5% W/V DEXTROSE & 0.45% W/V SODIUM CHLORIDE (MEDISAL)

Proper storage ensures the stability and sterility of the solution before use.

• Temperature: Store below 25°C (77°F); avoid freezing.
• Protection: Keep away from direct sunlight and heat sources.
• Container Integrity: Use only if the container is intact and the solution is clear and free of particles.
• Shelf Life: Follow manufacturer’s expiration date on the label. Do not use after expiration.
• After Opening: For single-use only; discard any unused portion immediately after use to prevent contamination.
• Handling Precautions: Use aseptic techniques during connection and administration. Do not reconnect partially used containers.