3.33% w/v DEXTROSE & 0.3% w/v SODIUM CHLORIDE INJECTION USP Infusion/Solution for

What is 3.33% w/v DEXTROSE & 0.3% w/v SODIUM CHLORIDE INJECTION USP

3.33% w/v Dextrose & 0.3% w/v Sodium Chloride Injection USP is a sterile, non-pyrogenic solution intended for intravenous (IV) infusion. It contains two primary components:

• Dextrose (as monohydrate) – a simple sugar that provides a quick source of energy.
• Sodium chloride – commonly known as salt, used to replenish and maintain electrolyte balance.

This solution is used for fluid and electrolyte replenishment and as a caloric source in clinical settings. It comes in a 1000ml plastic infusion bag, designed for single-use only. The solution is especially useful in patients who need both energy and sodium replacement without receiving excessive salt or glucose.

It is often prescribed in:

• Mild to moderate fluid loss due to dehydration
• Postoperative fluid maintenance
• Conditions requiring minimal electrolyte adjustment with energy supply

The solution must be administered under medical supervision, typically in hospital or clinical environments. It should not be used for patients who require restricted sodium or glucose intake unless advised by a healthcare professional.

How to use 3.33% w/v DEXTROSE & 0.3% w/v SODIUM CHLORIDE INJECTION USP

This medication is administered as an intravenous infusion. The usage protocol depends on the patient's clinical condition, fluid and electrolyte status, and physician’s judgment.

• Route of Administration: Intravenous (IV) only, through a sterile infusion set.
• Preparation: The solution must be visually inspected for particulate matter, discoloration, or leaks before administration. Only clear, colorless solutions in intact containers should be used.
• Rate of Infusion: The rate and volume depend on age, weight, clinical condition, and co-administered therapies. It must be individualized.
• Monitoring: Regular monitoring of serum electrolytes, blood glucose levels, and hydration status is recommended during administration.

General Guidelines:

• Use only under direct medical supervision.
• Do not use in series connections to avoid air embolism.
• Use aseptic technique to prevent contamination.
• Ensure compatibility if other medications are added to the solution.

Once opened, the bag should be used immediately and should not be stored for later use.

Mode of Action 3.33% w/v DEXTROSE & 0.3% w/v SODIUM CHLORIDE INJECTION USP

This combination works by providing hydration, energy, and maintaining electrolyte balance in the body through the following mechanisms:

• Dextrose (Glucose):
  • Rapidly metabolized to produce energy (ATP) in the body.
  • Spares the use of body proteins and prevents ketosis by providing a source of carbohydrates.
  • Promotes cellular uptake of water and potassium, aiding in fluid balance.
• Sodium Chloride:
  • Maintains osmotic equilibrium between intracellular and extracellular compartments.
  • Provides sodium and chloride ions essential for nerve impulse transmission, muscle contraction, and normal kidney function.
  • Supports acid-base balance and water distribution.

Together, they act synergistically to:

• Rehydrate the body efficiently.
• Stabilize vital signs in mildly dehydrated or postoperative patients.
• Help maintain or correct mild disturbances in electrolyte balance.

3.33% w/v DEXTROSE & 0.3% w/v SODIUM CHLORIDE INJECTION USP Interactions 3.33% w/v DEXTROSE & 0.3% w/v SODIUM CHLORIDE INJECTION USP

While this solution is generally well tolerated, it can interact with other medications or medical conditions. Key interactions include:

• Diuretics: May exacerbate fluid or electrolyte imbalances, especially hypokalemia or hyponatremia.
• Corticosteroids: Can increase sodium retention and fluid overload risk.
• Insulin: Enhances cellular uptake of glucose and potassium. When co-administered, close glucose monitoring is essential.
• Cardiac medications (e.g., Digoxin): Electrolyte shifts, particularly in sodium and potassium levels, may potentiate toxicity.
• Antihypertensives: May interfere with fluid volume and blood pressure control.
• Other IV additives: Must be checked for compatibility with this solution before mixing. Precipitation or pH changes may occur.

Patients with specific medical conditions require careful monitoring:

• Diabetes Mellitus
• Congestive heart failure
• Renal impairment
• Liver disease

Always inform healthcare providers of all medications being taken before initiating this infusion.

Dosage of 3.33% w/v DEXTROSE & 0.3% w/v SODIUM CHLORIDE INJECTION USP

Dosage must be individualized based on:

• Patient's fluid and electrolyte needs
• Age and weight
• Renal and hepatic function
• Clinical condition and concurrent therapies

General Dosage Guidelines:

• Adults: 500ml to 3000ml/day based on clinical indication.
• Children: 20ml to 100ml/kg/day, adjusted per electrolyte requirements.
• Infusion Rate: Typically 1.5ml to 3ml/kg/hour; slower rates may be required in the elderly or those with heart/kidney impairment.

Adjustments should be made based on:

• Daily electrolyte measurements
• Fluid input/output balance
• Blood glucose levels

Infusion should be discontinued or modified immediately if signs of fluid overload or electrolyte imbalance occur.

Possible side effects of 3.33% w/v DEXTROSE & 0.3% w/v SODIUM CHLORIDE INJECTION USP

Although generally well tolerated, some patients may experience side effects, especially with prolonged use or inappropriate dosage. These include:

• Common Side Effects:
  • Injection site irritation or swelling
  • Mild edema
  • Temporary rise in blood sugar (hyperglycemia)
• Serious Side Effects:
  • Fluid overload (especially in renal or heart failure patients)
  • Electrolyte imbalances – hyponatremia or hypernatremia
  • Hyperglycemia or rebound hypoglycemia
  • Thrombophlebitis at infusion site
  • Metabolic acidosis or alkalosis, if improperly balanced

Seek immediate medical attention if symptoms such as chest pain, breathing difficulty, swelling of extremities, or confusion develop.

3.33% w/v DEXTROSE & 0.3% w/v SODIUM CHLORIDE INJECTION USP Contraindications 3.33% w/v DEXTROSE & 0.3% w/v SODIUM CHLORIDE INJECTION USP

This IV solution should not be used in the following situations:

• Known hypersensitivity to dextrose, sodium chloride, or any component of the formulation.
• Hyperglycemia uncontrolled by insulin therapy.
• Hypernatremia or hyperchloremia – may worsen electrolyte abnormalities.
• Fluid retention conditions:
  • Congestive heart failure (CHF)
  • Severe renal impairment or anuria
  • Liver cirrhosis with ascites
• Head trauma or stroke patients – due to risk of altered serum osmolality from dextrose.

It should also be used cautiously in neonates, diabetics, or patients on medications affecting fluid/electrolyte balance.

Storage of 3.33% w/v DEXTROSE & 0.3% w/v SODIUM CHLORIDE INJECTION USP

To ensure safety and efficacy, this medication should be stored under the following conditions:

• Storage Temperature: Between 15°C and 25°C (59°F to 77°F).
• Keep away from: Excessive heat, direct sunlight, and freezing conditions.
• Container: Store in original plastic bag and outer overwrap until ready to use.
• Do not use:
  • If the solution is discolored or contains particulate matter.
  • If the bag is leaking, swollen, or damaged.

Once the container is opened, the solution should be used immediately to avoid microbial contamination. Unused portions should be discarded appropriately.