2.5% w/v DEXTROSE & 0.45% w/v SODIUM CHLORIDE INJECTION USP Infusion/Solution for

What is 2.5% w/v DEXTROSE & 0.45% w/v SODIUM CHLORIDE INJECTION USP

2.5% W/V Dextrose & 0.45% W/V Sodium Chloride (MEDISAL) is a sterile intravenous infusion solution commonly used in clinical settings to provide both fluid and nutritional support. It combines two essential components: dextrose and sodium chloride, formulated in a balanced manner to address dehydration, electrolyte imbalances, and mild energy deficits.

• Dextrose (2.5%) is a form of glucose, a simple sugar that serves as a critical energy source for cellular metabolism. It supports patients who cannot consume adequate calories orally or who require supplemental glucose during illness or fasting.
• Sodium Chloride (0.45%) is a hypotonic saline solution that helps restore sodium and chloride ions lost due to dehydration, sweating, or other medical conditions. It maintains osmotic balance and supports proper nerve and muscle function.
• This particular formulation is slightly hypotonic, meaning it can provide free water to cells while maintaining vascular volume, making it ideal for maintenance hydration or correcting mild electrolyte disturbances.
• It comes in a 500ml plastic bottle suitable for controlled intravenous infusion under medical supervision.

How to use 2.5% w/v DEXTROSE & 0.45% w/v SODIUM CHLORIDE INJECTION USP

This solution is designed strictly for intravenous infusion and must be administered by healthcare professionals in controlled clinical environments. Proper administration is crucial to avoid complications.

• Administration Route: Intravenous infusion through a suitable venous access device (e.g., cannula or central line).
• Preparation: Before use, inspect the solution for clarity, colorlessness, and absence of particulate matter. Do not use if the container is damaged or the solution appears cloudy.
• Infusion Rate: Tailored to the patient's fluid and metabolic needs, typically started at a slow rate and adjusted according to clinical response and laboratory results.
• Monitoring: Continuous monitoring of vital signs, blood glucose, and serum electrolytes is recommended, especially for patients with diabetes, renal impairment, or cardiac disease.
• Compatibility: Avoid mixing with incompatible drugs in the same infusion line unless compatibility is verified.
• Single-use container: Discard any unused portion after opening to prevent contamination.

Mode of Action 2.5% w/v DEXTROSE & 0.45% w/v SODIUM CHLORIDE INJECTION USP

The therapeutic effects arise from the combined physiological actions of dextrose and sodium chloride in this infusion.

• Dextrose:
  • Rapidly metabolized by cells to produce energy via glycolysis, supporting vital functions during fasting or illness.
  • Helps maintain blood glucose levels, preventing hypoglycemia in patients unable to eat or with increased metabolic demands.
  • Acts as a protein-sparing agent, reducing catabolism of body proteins by providing an alternative energy source.
• Sodium Chloride:
  • Supplies sodium ions essential for maintaining extracellular fluid volume and osmotic pressure.
  • Supports neuromuscular function by preserving ionic gradients across membranes.
  • Provides chloride ions, which play a role in acid-base balance and gastric secretions.
  • The hypotonic nature facilitates free water movement into cells, aiding in cellular hydration.

2.5% w/v DEXTROSE & 0.45% w/v SODIUM CHLORIDE INJECTION USP Interactions 2.5% w/v DEXTROSE & 0.45% w/v SODIUM CHLORIDE INJECTION USP

While generally safe, this infusion can interact with certain medications and clinical conditions, which must be taken into account during treatment planning.

• Insulin and Hypoglycemic Agents: Insulin enhances cellular glucose uptake; concomitant use may increase the risk of hypoglycemia if dextrose supply is insufficient or if insulin dosage is not adjusted.
• Diuretics (Loop and Thiazide): May cause enhanced loss of sodium and potassium, potentially leading to electrolyte imbalances when combined with this infusion.
• Corticosteroids and Mineralocorticoids: These can promote sodium retention and potassium loss, exacerbating fluid overload or electrolyte disturbances.
• Cardiac Glycosides (e.g., Digoxin): Electrolyte imbalances, particularly hypokalemia, induced by this infusion or other drugs can increase the risk of digoxin toxicity.
• Renal Impairment: Reduced clearance of sodium and fluids can lead to fluid overload and electrolyte imbalance, necessitating close monitoring.

Dosage of 2.5% w/v DEXTROSE & 0.45% w/v SODIUM CHLORIDE INJECTION USP

Dosage depends on the individual patient's clinical condition, fluid requirements, and metabolic status. Only a qualified healthcare provider should determine dosing.

• Adults: Typically administered at 500 to 1000 mL per day, adjusted based on hydration status and electrolyte needs.
• Children: Dose is weight-based, generally ranging from 20 to 100 mL/kg/day, with careful monitoring of fluid balance.
• Elderly and Patients with Renal/Cardiac Disease: Reduced volume and slower infusion rates are recommended to avoid fluid overload.
• Special Conditions: Dosage may vary in conditions such as burns, surgery, or metabolic disturbances, guided by ongoing clinical and laboratory evaluation.
• Infusion Rate: Should not exceed metabolic capacity to metabolize glucose (~4-6 mg/kg/min) to prevent hyperglycemia and osmotic diuresis.

Possible side effects of 2.5% w/v DEXTROSE & 0.45% w/v SODIUM CHLORIDE INJECTION USP

Although generally well tolerated, side effects can occur, especially if used improperly or in vulnerable populations.

• Common Side Effects:
  • Infusion site irritation, pain, or phlebitis
  • Mild fluid retention or peripheral edema
  • Transient headaches or dizziness
• Serious Side Effects:
  • Hyperglycemia, particularly in diabetic patients or if glucose metabolism is impaired
  • Electrolyte disturbances such as hyponatremia or hypernatremia if improperly dosed
  • Fluid overload leading to pulmonary edema, especially in cardiac or renal impairment
  • Thrombophlebitis or vascular complications at infusion site
• Rare Allergic Reactions: Rash, itching, or very rarely anaphylaxis

2.5% w/v DEXTROSE & 0.45% w/v SODIUM CHLORIDE INJECTION USP Contraindications 2.5% w/v DEXTROSE & 0.45% w/v SODIUM CHLORIDE INJECTION USP

The infusion should be avoided or used cautiously in patients with certain medical conditions.

• Known hypersensitivity to any component of the infusion.
• Hyperglycemia or uncontrolled diabetes mellitus: Additional glucose may worsen hyperglycemia.
• Hypernatremia or fluid overload states: Use may exacerbate volume overload or increase sodium levels.
• Severe renal impairment or anuria: Risk of fluid retention and electrolyte imbalance.
• Intracranial or intraspinal hemorrhage: Hyperosmolar solutions like dextrose may worsen cerebral edema.
• Severe dehydration with hyperosmolarity: Risk of osmotic shifts causing complications.

Storage of 2.5% w/v DEXTROSE & 0.45% w/v SODIUM CHLORIDE INJECTION USP

Proper storage conditions are essential to maintain the safety and efficacy of the infusion solution.

• Store the solution at controlled room temperature, preferably below 25°C (77°F).
• Protect from direct sunlight, heat sources, and freezing conditions, as these can degrade the solution.
• Ensure the plastic bottle remains sealed and intact; do not use if the container is damaged or shows signs of leakage.
• Use before the expiration date printed on the label; do not use expired solutions.
• After opening, use immediately and discard any unused portion to avoid contamination and infection risk.
• Handle under aseptic conditions during preparation and administration to maintain sterility.