5% DEXTROSE & 0.45% SODIUM CHLORIDE INJECTION USP Infusion/Solution for

What is 5% DEXTROSE & 0.45% SODIUM CHLORIDE INJECTION USP

5% Dextrose & 0.45% Sodium Chloride Injection USP is a sterile, non-pyrogenic intravenous (IV) solution formulated for fluid and electrolyte replenishment. It contains:

• Dextrose (as monohydrate) 5% w/v – a carbohydrate source for energy
• Sodium Chloride 0.45% w/v – a source of sodium and chloride ions to maintain electrolyte balance

This isotonic-to-slightly hypertonic solution is used to restore fluids and electrolytes in patients with volume depletion or imbalance due to dehydration, surgery, or medical conditions. The solution provides both energy and electrolytes, making it suitable for short-term parenteral hydration, especially in scenarios involving hypotonic fluid loss.

It is typically available in flexible plastic containers (such as a 250ml plastic bag) and is administered under the supervision of healthcare professionals in clinical settings.

How to use 5% DEXTROSE & 0.45% SODIUM CHLORIDE INJECTION USP

This intravenous solution should be administered only by trained medical personnel. Proper usage involves:

• Intravenous Administration (IV Infusion): Administered directly into a vein using a sterile IV line and appropriate infusion set.
• Rate of Administration: Depends on patient age, weight, fluid requirements, and clinical status. Must be adjusted to avoid fluid overload.
• Monitoring: Continuous monitoring of vital signs, fluid status, and electrolyte levels is essential to prevent complications like hypervolemia or hyponatremia.
• Aseptic Technique: Maintain sterility when connecting to IV lines. Do not use if the container is leaking, the solution is discolored, or contains particulate matter.
• Dosage Individualization: Dosage varies with the condition being treated and the patient's specific needs (e.g., maintenance fluid therapy, rehydration, or electrolyte balance).

Patients with conditions like heart failure, renal impairment, or fluid overload should receive careful evaluation before and during infusion.

Mode of Action 5% DEXTROSE & 0.45% SODIUM CHLORIDE INJECTION USP

The therapeutic effect of this solution results from the combined actions of its two components:

• Dextrose (5%):
  • Serves as a readily available source of energy (calories)
  • Undergoes metabolism primarily in the liver, producing CO₂ and water
  • Prevents protein catabolism by providing glucose to meet basic metabolic needs
• Sodium Chloride (0.45%):
  • Provides sodium and chloride ions that are critical for maintaining extracellular fluid volume and osmotic equilibrium
  • Supports proper nerve impulse transmission and muscle function
  • Helps correct mild hyponatremia or hypochloremia

Together, this solution restores fluid volume and corrects electrolyte imbalances, making it valuable in treating dehydration and preventing ketosis in patients unable to eat.

5% DEXTROSE & 0.45% SODIUM CHLORIDE INJECTION USP Interactions 5% DEXTROSE & 0.45% SODIUM CHLORIDE INJECTION USP

While generally safe when administered appropriately, certain drug interactions may occur:

• Corticosteroids (e.g., Prednisone): May cause sodium and fluid retention, increasing the risk of edema and hypertension.
• Diuretics: Loop and thiazide diuretics may cause additional electrolyte disturbances if not carefully monitored.
• Insulin: May alter blood glucose response to dextrose-containing fluids, particularly in diabetic patients.
• Cardiac Glycosides (e.g., Digoxin): Electrolyte imbalances (especially low potassium or magnesium) can enhance digoxin toxicity.
• Antihypertensives: Fluid and electrolyte shifts can affect blood pressure control and drug efficacy.

Always review the patient's medication profile to adjust therapy and monitor for potential interactions during infusion.

Dosage of 5% DEXTROSE & 0.45% SODIUM CHLORIDE INJECTION USP

Dosage must be individualized based on the patient’s age, clinical status, and purpose of infusion:

• Adults: Typically 500 to 3000 ml/day, infused at a controlled rate. Adjust for hydration status and ongoing losses.
• Pediatrics: Dosage should be calculated based on body weight and fluid requirements (e.g., maintenance or rehydration therapy).
• Geriatrics: Start with lower volumes due to reduced renal function and increased risk of fluid overload.

Careful titration is necessary in patients with renal or cardiac conditions. Infusion rate should not exceed the patient’s capacity to excrete fluids and process glucose.

Possible side effects of 5% DEXTROSE & 0.45% SODIUM CHLORIDE INJECTION USP

Like any intravenous therapy, this solution may lead to adverse effects, particularly if used improperly or in susceptible patients:

• Fluid Overload: May cause pulmonary edema, peripheral edema, or congestive heart failure in at-risk populations.
• Electrolyte Imbalance: Prolonged use can lead to hypo/hypernatremia, hypokalemia, or hyperchloremia.
• Hyperglycemia: Especially in diabetic or insulin-resistant patients due to dextrose content.
• Thrombophlebitis: Local vein irritation at the injection site.
• Allergic Reactions (Rare): Rash, itching, or even anaphylaxis (very rare).

Prompt assessment and discontinuation are warranted if adverse effects occur. Regular monitoring helps minimize these risks.

5% DEXTROSE & 0.45% SODIUM CHLORIDE INJECTION USP Contraindications 5% DEXTROSE & 0.45% SODIUM CHLORIDE INJECTION USP

This solution should not be used in the following scenarios:

• Fluid Overload States: Congestive heart failure, pulmonary edema, or renal failure without dialysis access.
• Severe Hyponatremia or Hypernatremia: May exacerbate electrolyte imbalances.
• Uncontrolled Diabetes Mellitus: Due to risk of hyperglycemia.
• Head Trauma or Stroke: Hypotonic solutions can increase the risk of cerebral edema.
• Known Hypersensitivity: To dextrose or any component of the solution (extremely rare).

Thorough assessment is critical before initiating therapy to avoid these high-risk situations.

Storage of 5% DEXTROSE & 0.45% SODIUM CHLORIDE INJECTION USP

Proper storage ensures the efficacy and safety of the solution:

• Temperature: Store at controlled room temperature (20°C to 25°C or 68°F to 77°F).
• Avoid Freezing: Freezing may compromise container integrity and drug stability.
• Protect from Light: While not always necessary, store away from direct sunlight when possible.
• Inspect Before Use: Do not use if the solution is discolored, cloudy, or contains visible particles.
• Single-Use Only: Discard unused portion. Do not reconnect partially used containers.

Ensure that the IV container remains sealed and intact until ready for administration.