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 intended for fluid replenishment, electrolyte balance, and partial caloric supplementation. Each 1000ml of solution contains 50g of dextrose (as monohydrate) and 4.5g of sodium chloride, dissolved in water for injection.

• Dextrose serves as a readily available energy source, metabolized to provide glucose needed for cellular respiration and metabolic functions.
• Sodium chloride helps maintain plasma osmolality, supports neuromuscular function, and restores fluid and electrolyte balance in conditions such as dehydration or sodium loss.
• The solution is commonly used in clinical settings to treat mild to moderate fluid and electrolyte deficiencies, especially when a moderate sodium and glucose intake is needed.
• It is classified as an isotonic solution, though it becomes hypotonic after glucose metabolism.

Typical clinical indications include postoperative hydration, gastrointestinal fluid losses, mild hypoglycemia, and volume expansion in patients who cannot eat or drink.

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

Administration of this solution should always be performed under the supervision of a qualified healthcare provider, and usage must be tailored based on individual patient needs.

• Route: Administered intravenously via peripheral or central vein depending on patient condition and required infusion rate.
• Infusion rate: Adjust according to age, body weight, clinical status, and electrolyte requirements. Overly rapid infusion may lead to fluid overload or electrolyte imbalance.
• Pre-use inspection: Always inspect the solution for particulate matter or discoloration. Do not use if the solution is cloudy, discolored, or contains foreign particles.
• Equipment: Use a sterile IV administration set. Ensure compatibility with other additives before co-administering medications.
• Monitoring: Regularly monitor fluid balance, serum glucose, and electrolytes during therapy, particularly in pediatric, renal-compromised, or elderly patients.

This solution is often used in hospitals for short-term hydration, and it is not suitable for long-term maintenance of electrolyte or nutritional balance without supplementation.

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

The therapeutic effects of this intravenous solution arise from the combined actions of its two primary constituents:

• Dextrose: After infusion, dextrose is rapidly metabolized in the body to carbon dioxide and water, providing calories (approximately 200 kcal per liter) and contributing to cellular energy production. It helps prevent ketosis and protein catabolism in patients unable to eat.
• Sodium chloride: Provides essential sodium and chloride ions. Sodium plays a key role in maintaining fluid distribution, osmotic pressure, and acid-base balance. Chloride helps regulate osmotic equilibrium and gastric acid production.
• Osmotic effect: The initial isotonicity of the solution helps in expanding intravascular volume. As dextrose is metabolized, the solution becomes hypotonic, facilitating intracellular fluid replenishment.

The combination enables short-term fluid and electrolyte replacement, with minimal risk of sudden fluid shifts when administered properly. It is especially useful in managing dehydration with concurrent caloric requirements.

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

This solution may interact with various medications and physiological conditions. Awareness of potential interactions is essential during concurrent therapies.

• Corticosteroids & ACTH: May cause sodium retention and fluid overload, increasing the risk of hypertension or edema.
• Diuretics: Concurrent use with loop or thiazide diuretics may cause electrolyte imbalances, especially potassium and magnesium depletion.
• Insulin: Insulin facilitates glucose uptake and may enhance the hypoglycemic effect when combined with dextrose solutions.
• Cardiac glycosides (e.g., digoxin): Electrolyte disturbances, especially hypokalemia from sodium overload, may increase the risk of digoxin toxicity.
• Other IV drugs: Additives should not be mixed without verifying compatibility, as precipitation or inactivation may occur.

Always consult a pharmacist or clinician when adding medications to the infusion. Monitor serum electrolytes, especially when used in patients with renal, cardiac, or endocrine disorders.

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

Dosage must be individualized based on the patient’s fluid requirements, underlying condition, and clinical setting.

• Adults: Typically, 500–1000ml may be administered at a time, with a maximum of 2–3 liters per day depending on clinical status. Rate should not exceed 5 ml/kg/hr unless specified.
• Pediatrics: Use caution and tailor the dose based on age, weight, and fluid requirements. Frequent monitoring of blood glucose and electrolytes is essential.
• Geriatric patients: Often require reduced volumes and slower infusion rates to avoid fluid overload or cardiac strain.
• Adjustments: May be required in patients with renal impairment, hepatic insufficiency, congestive heart failure, or endocrine disorders (e.g., SIADH, diabetes).

The solution should not be administered rapidly or in large volumes without close monitoring due to risks of hyponatremia, hyperglycemia, and fluid overload.

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

While generally safe under medical supervision, this infusion may cause several adverse effects, especially with prolonged use or incorrect administration.

• Fluid overload: Edema, hypertension, pulmonary congestion, or heart failure may occur, especially in susceptible individuals.
• Electrolyte imbalances: Hypokalemia, hypernatremia, or dilutional hyponatremia can develop with inappropriate dosing.
• Hyperglycemia: Especially in diabetic patients or those with impaired glucose tolerance.
• Thrombophlebitis: Localized pain, inflammation, or thrombosis at the infusion site.
• Infections: Risk increases with prolonged catheter use or poor aseptic technique.
• Acid-base disturbances: Particularly hyperchloremic metabolic acidosis.

Immediate medical attention is necessary if symptoms such as shortness of breath, swelling, confusion, or rapid heartbeat occur.

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

The use of this IV solution is contraindicated in several medical conditions due to the risks of fluid or electrolyte complications.

• Hypernatremia or sodium retention: May exacerbate fluid overload and cause further electrolyte disturbance.
• Hyperglycemia or glucose intolerance: Dextrose may worsen metabolic derangements in uncontrolled diabetes.
• Severe renal impairment: Risk of volume overload, sodium retention, and uremia.
• Congestive heart failure (CHF): Can aggravate fluid retention and lead to decompensation.
• Acute pulmonary edema: Contraindicated due to risk of worsening respiratory status.
• Allergy or hypersensitivity: Though rare, hypersensitivity reactions to components of the solution should be considered.

Patients with endocrine disorders, liver disease, or on specific medications should be evaluated thoroughly before administration.

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

Proper storage ensures the stability, sterility, and safety of the solution prior to administration.

• Temperature: Store at controlled room temperature between 15°C and 30°C (59°F and 86°F).
• Light protection: Keep away from direct sunlight and sources of heat to prevent degradation.
• Packaging: Do not remove from outer wrap until ready for use. Do not use if the container is damaged or leaking.
• Do not freeze: Freezing may cause crystallization or compromise the integrity of the plastic bag.
• Shelf life: Follow manufacturer’s expiry date. Discard any unused portion after opening.

Always ensure aseptic conditions during handling and administration. Single-use only—do not reuse partially infused bags.