4.3% w/v DEXTROSE & 0.18% w/v SODIUM CHLORIDE INJECTION USP Infusion/Solution for

What is 4.3% w/v DEXTROSE & 0.18% w/v SODIUM CHLORIDE INJECTION USP

4.3% w/v Dextrose & 0.18% w/v Sodium Chloride Injection USP is a sterile, non-pyrogenic solution used for intravenous (IV) infusion. It contains two active ingredients:

• Dextrose (Anhydrous) – 4.3% w/v
• Sodium Chloride – 0.18% w/v

This solution is supplied in a 500ml plastic bottle and is primarily used for fluid replenishment, partial nutritional support, and as a vehicle for drug delivery in clinical settings.

Therapeutic Uses:

• Treatment of mild to moderate dehydration, especially in pediatric or elderly patients
• Maintenance of fluid and electrolyte balance in conditions such as vomiting, diarrhea, or post-operative recovery
• Temporary source of calories and hydration
• Supportive therapy in metabolic disturbances like hypoglycemia or hyponatremia

This solution is isotonic to slightly hypotonic, making it suitable for gradual rehydration and for patients who require both glucose and sodium supplementation. It is often selected when a balanced replacement of water and essential solutes is needed, without the risk of fluid overload.

How to use 4.3% w/v DEXTROSE & 0.18% w/v SODIUM CHLORIDE INJECTION USP

4.3% Dextrose & 0.18% Sodium Chloride Injection is administered intravenously under strict medical supervision. It is typically infused using a sterile IV administration set in hospital or clinical environments.

Steps for proper administration:

• Inspect the bottle for particulate matter or discoloration before use. Do not use if the solution is cloudy or leaking.
• Administer via an appropriate IV line and infusion pump if needed.
• The infusion rate and total volume are determined based on age, body weight, clinical condition, and fluid-electrolyte requirements of the patient.

General Guidelines:

• For adults: The rate is usually adjusted to deliver 500ml to 2000ml/day, depending on clinical needs.
• For pediatric patients: The volume and rate are carefully calculated based on body weight and clinical status.
• Frequent monitoring of blood glucose and serum electrolytes is essential during therapy, especially in patients with renal or endocrine disorders.

It should not be administered simultaneously with blood transfusions through the same IV line due to risk of hemolysis or clot formation.

Precautions:

• Use aseptic techniques during administration.
• Adjust dose for patients with fluid restrictions or electrolyte imbalances.
• Monitor for signs of fluid overload or hyperglycemia during prolonged use.

Mode of Action 4.3% w/v DEXTROSE & 0.18% w/v SODIUM CHLORIDE INJECTION USP

The therapeutic effects of 4.3% Dextrose & 0.18% Sodium Chloride Injection arise from its two key components, each serving specific physiological functions:

Dextrose (4.3% w/v):

• Serves as a readily available source of energy and carbohydrates.
• Is metabolized by the body's cells to produce ATP (adenosine triphosphate), fueling cellular activities.
• Helps to prevent protein catabolism by providing glucose during times of caloric insufficiency.

Sodium Chloride (0.18% w/v):

• Supplies essential electrolytes—sodium and chloride—which are crucial for:
  • Maintaining extracellular fluid volume
  • Regulating acid-base balance
  • Supporting neuromuscular function

Osmotic and Volume Effects:

• This solution is slightly hypotonic to isotonic, depending on the patient’s osmolar environment.
• It promotes mild expansion of extracellular fluid and hydration of tissues, especially useful in dehydration.
• Dextrose contributes to osmotic pressure but is rapidly utilized, leaving behind a more hypotonic fluid effect that supports water replenishment.

In combination, the solution provides dual benefits—glucose energy and electrolyte support—making it suitable for rehydration, mild sodium supplementation, and partial caloric needs.

4.3% w/v DEXTROSE & 0.18% w/v SODIUM CHLORIDE INJECTION USP Interactions 4.3% w/v DEXTROSE & 0.18% w/v SODIUM CHLORIDE INJECTION USP

While 4.3% Dextrose & 0.18% Sodium Chloride Injection is generally safe when used under supervision, interactions may occur with certain drugs or medical conditions that affect fluid or electrolyte balance.

Potential interactions include:

• Corticosteroids or ACTH: May cause sodium and fluid retention, increasing risk of hypernatremia or fluid overload.
• Diuretics: May alter sodium and potassium balance, necessitating electrolyte monitoring.
• Insulin: Enhances glucose uptake into cells, which may lead to hypoglycemia if glucose infusion is not carefully monitored.
• Potassium-wasting drugs (e.g., amphotericin B, certain diuretics): Risk of hypokalemia if not addressed concurrently.
• Antihypertensives: Volume expansion due to infusion may affect blood pressure control in patients on these medications.

Incompatibility concerns:

• Do not mix with drugs that are physically or chemically incompatible (e.g., certain antibiotics or blood products).
• Always check compatibility charts before adding medications to the solution.

Monitoring is essential when used in patients with renal impairment, diabetes mellitus, heart failure, or those on multiple medications affecting fluid/electrolyte status.

Dosage of 4.3% w/v DEXTROSE & 0.18% w/v SODIUM CHLORIDE INJECTION USP

The dosage of 4.3% Dextrose & 0.18% Sodium Chloride Injection depends on individual patient needs, age, weight, and clinical status. It must be tailored by a healthcare provider.

Adult Dosage:

• Typical volume: 500ml to 2000ml per 24 hours
• Rate of infusion: Generally 50–150 ml/hour depending on hydration status and glucose requirements

Pediatric Dosage:

• Administered based on body weight (usually 100ml/kg/day)
• Careful calculation of fluid, sodium, and glucose needs is critical

Special considerations:

• Adjust dose in patients with renal, cardiac, or hepatic impairment to prevent fluid overload
• Use slower infusion rates in elderly or debilitated patients
• Monitor serum electrolytes and glucose regularly during prolonged therapy

Maximum daily volume: Should be determined based on the patient’s total fluid intake, ongoing losses (e.g., diarrhea, vomiting), and comorbidities. Always adhere to the physician’s orders and institutional protocols.

Possible side effects of 4.3% w/v DEXTROSE & 0.18% w/v SODIUM CHLORIDE INJECTION USP

4.3% Dextrose & 0.18% Sodium Chloride Injection is usually well tolerated when used under supervision. However, potential side effects can occur, particularly with prolonged or inappropriate use.

Common side effects:

• Local reactions at the injection site:
  • Redness, swelling, or tenderness
  • Phlebitis (inflammation of the vein)
• Mild hyperglycemia (especially in diabetics)
• Electrolyte imbalance (e.g., mild hyponatremia or hypokalemia)

Serious side effects (rare, but require immediate attention):

• Fluid overload or pulmonary edema—especially in patients with renal or cardiac dysfunction
• Severe hyperglycemia leading to osmotic diuresis and dehydration
• Hypokalemia if potassium is not concurrently administered during prolonged infusion
• Allergic reactions (very rare): rash, itching, or anaphylaxis

Monitoring:

• Vital signs, serum glucose, and electrolytes should be monitored routinely
• Urine output and fluid balance must be documented to prevent overload

Side effects are minimized when the solution is administered by trained professionals and under appropriate indications.

4.3% w/v DEXTROSE & 0.18% w/v SODIUM CHLORIDE INJECTION USP Contraindications 4.3% w/v DEXTROSE & 0.18% w/v SODIUM CHLORIDE INJECTION USP

This IV solution is contraindicated in certain medical conditions where administration may worsen the patient's clinical state.

Absolute Contraindications:

• Hypersensitivity to dextrose, sodium chloride, or any component of the solution
• Severe hyperglycemia or diabetes mellitus that is poorly controlled
• Hypernatremia or severe fluid retention states
• Congestive heart failure with fluid overload
• Established or impending pulmonary edema

Relative Contraindications / Use with Caution:

• Renal insufficiency or anuria – risk of fluid overload and electrolyte accumulation
• Liver cirrhosis – altered fluid handling and sodium retention
• Patients on corticosteroids or salt-retaining drugs

Use must be guided by regular assessment of clinical and laboratory parameters. If contraindications exist, consider alternative rehydration or electrolyte management therapies.

Storage of 4.3% w/v DEXTROSE & 0.18% w/v SODIUM CHLORIDE INJECTION USP

This IV solution is contraindicated in certain medical conditions where administration may worsen the patient's clinical state.

Absolute Contraindications:

• Hypersensitivity to dextrose, sodium chloride, or any component of the solution
• Severe hyperglycemia or diabetes mellitus that is poorly controlled
• Hypernatremia or severe fluid retention states
• Congestive heart failure with fluid overload
• Established or impending pulmonary edema

Relative Contraindications / Use with Caution:

• Renal insufficiency or anuria – risk of fluid overload and electrolyte accumulation
• Liver cirrhosis – altered fluid handling and sodium retention
• Patients on corticosteroids or salt-retaining drugs

Use must be guided by regular assessment of clinical and laboratory parameters. If contraindications exist, consider alternative rehydration or electrolyte management therapies.