5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION USP Infusion/Solution for

What is 5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION USP

5% Dextrose & 0.45% Sodium Chloride Injection USP is a sterile intravenous (IV) infusion solution commonly used in clinical settings for fluid and electrolyte replenishment. This solution combines two key components: dextrose (as monohydrate) at 5% concentration and sodium chloride at 0.45% concentration, making it a hypotonic solution relative to plasma.

• Dextrose: A form of glucose that provides a source of calories and energy to the body. It is metabolized quickly and helps prevent catabolism (breakdown of body tissues) when the patient is unable to take food orally.
• Sodium chloride: A salt that helps restore and maintain the balance of electrolytes in the body, particularly sodium and chloride ions. The 0.45% concentration indicates it is a half-normal saline, used to provide free water and sodium chloride to the body.

This IV solution is often prescribed to treat dehydration, electrolyte imbalances, and as maintenance fluid therapy in patients who require parenteral nutrition or cannot consume fluids orally. It helps to correct fluid deficits while providing glucose to meet metabolic energy needs. The 50ml plastic bag size is typically used for small volume infusions or controlled administration in clinical care.

How to use 5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION USP

Proper administration of 5% Dextrose & 0.45% Sodium Chloride Injection requires adherence to medical protocols to ensure safety and efficacy. Below are key points on its use:

• Administration route: This solution is given intravenously (IV) through a suitable vein, usually via a peripheral or central venous catheter depending on the patient’s condition.
• Preparation: Use aseptic technique when handling the solution. Inspect the bag for any particulate matter, discoloration, or leaks before use. Do not use if the solution appears cloudy or contaminated.
• Infusion rate: The infusion rate should be determined by the healthcare provider based on the patient’s fluid and electrolyte needs, age, weight, and clinical status. Rapid infusion may cause fluid overload or electrolyte disturbances.
• Compatibility: Ensure compatibility with other intravenous medications or fluids administered simultaneously. Consult drug compatibility charts or pharmacists before mixing with other agents.
• Monitoring: Monitor the patient’s vital signs, fluid balance, electrolyte levels, blood glucose, and overall response during the infusion to prevent complications such as hyperglycemia or fluid overload.

Mode of Action 5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION USP

The therapeutic effect of this injection arises from the combined actions of its two main components:

• Dextrose: After intravenous administration, dextrose is rapidly metabolized by body cells to produce energy. It serves as a carbohydrate source, providing approximately 170 kilocalories per liter of solution. This helps maintain blood glucose levels, supports cellular metabolism, and prevents the breakdown of fat and protein for energy.
• Sodium chloride: Sodium chloride dissociates into sodium and chloride ions in the bloodstream. Sodium ions help maintain extracellular fluid volume and osmotic balance, supporting proper nerve and muscle function. Chloride ions contribute to maintaining acid-base balance through their role in bicarbonate exchange mechanisms.
• Fluid balance: The hypotonic nature (due to 0.45% sodium chloride) means the solution provides free water that moves into cells and extracellular spaces to hydrate body tissues, making it useful in correcting dehydration where cellular dehydration is present.
• Overall effect: By restoring fluid and electrolyte balance and supplying energy in the form of glucose, this solution supports physiological homeostasis in patients unable to meet their nutritional and hydration needs orally.

5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION USP Interactions 5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION USP

Several drug and condition interactions may occur when using this infusion solution, impacting safety and effectiveness:

• Diuretics (e.g., furosemide, thiazides): May enhance sodium and water loss, altering electrolyte balance. Close monitoring of sodium and potassium levels is required.
• Insulin and hypoglycemic agents: Dextrose administration can raise blood glucose levels, potentially counteracting diabetes medications. Blood sugar should be monitored carefully.
• Cardiac glycosides (e.g., digoxin): Changes in potassium and fluid balance caused by this infusion may increase the risk of digoxin toxicity.
• Potassium supplements or potassium-sparing diuretics: Sodium chloride solution may affect potassium levels; adjustments in potassium dosing may be necessary.
• Concurrent intravenous medications: Mixing this solution with incompatible drugs may cause precipitation or loss of efficacy. Always check compatibility.
• Conditions like renal impairment or congestive heart failure: Fluid administration must be carefully adjusted to avoid fluid overload or worsening electrolyte disturbances.

Dosage of 5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION USP

The dosage of this intravenous infusion depends on the patient’s clinical condition, age, weight, and specific fluid and electrolyte requirements. General guidelines include:

• Adult dose: Typically ranges from 500 ml to 2000 ml per day depending on hydration status, ongoing fluid losses, and maintenance needs.
• Pediatric dose: Calculated based on weight and hydration status; close monitoring of fluid balance and electrolytes is essential.
• Rate of infusion: Usually initiated at a slow rate (e.g., 50-100 ml/hr) and adjusted according to patient tolerance and clinical response.
• Adjustments: Dosage and infusion rate should be modified based on laboratory values (electrolytes, glucose levels), urine output, cardiovascular status, and underlying diseases.
• Special considerations: In patients with renal or cardiac impairment, more conservative fluid administration and close monitoring are required to prevent overload.
• Maximum dose: Determined by total fluid requirement and electrolyte balance; exceeding appropriate limits can lead to complications such as hyponatremia or hyperglycemia.

Possible side effects of 5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION USP

While generally safe when used properly, this infusion solution can cause some adverse effects, especially if improperly administered:

• Local reactions: Phlebitis, pain, or inflammation at the injection site due to irritation of veins.
• Fluid overload: Symptoms may include swelling (edema), shortness of breath, elevated blood pressure, and pulmonary edema, especially in patients with cardiac or renal impairment.
• Electrolyte imbalances: Hyponatremia or hypernatremia can occur if sodium levels become imbalanced. Hypokalemia or hyperkalemia may result from shifts in electrolyte balance.
• Hyperglycemia: Excess glucose infusion can raise blood sugar levels, particularly problematic for diabetic patients.
• Hypoglycemia: Rare but may occur if infusion is stopped suddenly after prolonged use.
• Allergic reactions: Although rare, patients may experience rash, itching, or anaphylaxis.
• Metabolic disturbances: Acid-base imbalance due to chloride load or dextrose metabolism.

5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION USP Contraindications 5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION USP

Use of this solution is contraindicated in certain conditions where it may exacerbate patient status or cause harm:

• Severe hypernatremia or hyperchloremia: Administration of sodium-containing solutions can worsen these conditions.
• Known hypersensitivity: To any component of the solution including dextrose or sodium chloride.
• Severe fluid overload states: Such as congestive heart failure, pulmonary edema, or renal failure where additional fluid administration is harmful.
• Diabetic ketoacidosis: Dextrose infusion without appropriate insulin therapy can worsen hyperglycemia.
• Hyponatremia with fluid overload: Because hypotonic fluids may exacerbate cerebral edema or electrolyte imbalances.
• Conditions requiring isotonic or hypertonic fluids: Where this hypotonic solution would not provide adequate plasma osmolarity.

Storage of 5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION USP

Proper storage ensures the safety and efficacy of this intravenous solution. Key storage recommendations include:

• Temperature: Store at controlled room temperature, typically between 20°C to 25°C (68°F to 77°F). Avoid exposure to excessive heat or freezing.
• Light protection: Keep the solution in its original packaging until use to protect from light and contamination.
• Handling: Avoid shaking or agitation that may cause foaming or degradation.
• Expiration: Do not use beyond the expiration date printed on the packaging. Check integrity of the bag and solution before administration.
• Contamination prevention: Use aseptic technique when opening and administering to avoid microbial contamination.
• Disposal: Dispose of unused or expired solution according to hospital or local biomedical waste protocols.