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, non-pyrogenic intravenous (IV) fluid commonly used in clinical settings for fluid and electrolyte replenishment. It contains two key ingredients:

• Dextrose (5%) – a form of glucose that provides immediate energy to the body.
• Sodium chloride (0.45%) – a saline component that helps in maintaining electrolyte balance and plasma osmolarity.

This combination solution is typically available in a 100ml plastic bag for use via intravenous infusion. It is classified as a hypotonic solution with a mild glucose component and a reduced concentration of sodium chloride, making it suitable for various clinical indications, including:

• Treating dehydration due to fluid loss.
• Maintaining fluid balance in post-operative or surgical patients.
• Delivering electrolytes and calories when oral intake is insufficient.
• Serving as a vehicle for administering compatible medications intravenously.

The product is manufactured according to the United States Pharmacopeia (USP) standards to ensure safety, efficacy, and quality. It is typically used under medical supervision in hospitals, emergency settings, and outpatient clinics.

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

The administration of 5% Dextrose & 0.45% Sodium Chloride Injection USP should always be performed by qualified healthcare professionals. Here’s how it is generally used:

• Route of Administration: Intravenous (IV) infusion via peripheral or central venous access.
• Dosage: Determined by the patient's fluid and electrolyte requirements, age, body weight, and clinical condition.
• Rate of Infusion: Should be carefully controlled. Rapid infusion may lead to fluid overload or electrolyte imbalance.

Key usage guidelines include:

• Inspect the bag for leaks, particulate matter, or discoloration before use. Do not use if defects are present.
• Use aseptic technique to connect the IV set to avoid contamination.
• The solution may be administered alone or used to dilute compatible injectable medications.
• Monitor the patient for signs of fluid overload, electrolyte imbalance, or glucose metabolism issues, especially in diabetic patients or those with renal impairment.
• Do not use in series connections to avoid the risk of air embolism.

Always consult a physician or pharmacist before administration, and ensure that the fluid therapy aligns with current clinical guidelines and the patient’s condition.

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

The mechanism of action of 5% Dextrose & 0.45% Sodium Chloride Injection USP involves the physiological effects of both its components:

• Dextrose (Glucose) Component:
  • Dextrose is rapidly metabolized upon IV administration, providing a source of energy for cellular processes.
  • It helps in preventing ketosis during periods of inadequate carbohydrate intake.
  • The glucose component maintains osmolarity and supports caloric supplementation (approximately 170 kcal/L).
• Sodium Chloride Component:
  • Sodium (Na⁺) is the principal extracellular cation responsible for maintaining fluid distribution and osmotic pressure.
  • Chloride (Cl⁻) is the accompanying anion that plays a critical role in acid-base balance and osmoregulation.
  • 0.45% sodium chloride provides a hypotonic saline solution which helps rehydrate cells without contributing to sodium overload.

This dual-action solution is designed to maintain or restore fluid and electrolyte homeostasis in various clinical scenarios. It offers both volume expansion and partial energy replenishment, particularly useful for patients with mild sodium depletion or those in need of carbohydrate supplementation.

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

While 5% Dextrose & 0.45% Sodium Chloride Injection USP is generally well-tolerated, it may interact with other medications or conditions, necessitating caution. Here are some important drug and clinical interactions:

• Diuretics: Concurrent use with loop or thiazide diuretics may exacerbate electrolyte imbalances (e.g., hyponatremia, hypokalemia).
• Insulin: Co-administration requires glucose monitoring in diabetic patients as the dextrose component may increase blood sugar levels.
• Corticosteroids or ACTH: These can cause sodium and fluid retention, potentially reducing the efficacy of hypotonic solutions.
• Antihypertensives: Fluid administration may counteract the blood pressure-lowering effects of these drugs.
• Other IV Medications: Compatibility should be confirmed before mixing or co-administering with injectable drugs to avoid precipitation or chemical reactions.

Clinical condition interactions include:

• Renal impairment: May result in fluid overload or impaired excretion of sodium/chloride.
• Congestive heart failure: Risk of volume overload and pulmonary edema.
• Diabetes mellitus: Monitoring of glucose levels is essential due to the dextrose content.
• Edematous states: Such as cirrhosis or nephrotic syndrome, which require fluid administration with caution.

Always assess a patient’s medication profile and comorbidities before initiating IV fluid therapy.

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

The dosage of 5% Dextrose & 0.45% Sodium Chloride Injection USP should be individualized based on clinical needs. Here are general dosage guidelines:

• Adults: Typically, 500–3000 mL/day depending on hydration status, electrolyte levels, and caloric needs.
• Pediatrics: Dosage based on body weight (e.g., 20–100 mL/kg/day), with close monitoring of glucose and electrolyte levels.
• Elderly: Lower infusion volumes may be appropriate due to decreased cardiac and renal function.

Rate of administration must be adjusted according to:

• Patient’s fluid balance and urine output.
• Serum electrolyte and glucose levels.
• Presence of comorbid conditions like heart or kidney disease.

Maximum rates should not exceed:

• Adults: ~4–5 mL/kg/hr.
• Neonates and infants: ~10–20 mL/kg/hr (with close monitoring).

Infusion must be halted or adjusted in case of:

• Signs of fluid overload or edema.
• Electrolyte imbalances such as hyponatremia or hyperglycemia.

The solution should only be administered under the supervision of a healthcare provider.

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

Though generally safe when administered properly, 5% Dextrose & 0.45% Sodium Chloride Injection USP may cause side effects in some individuals:

• Common Side Effects:
  • Local reactions such as pain, redness, or swelling at the infusion site.
  • Mild increase in blood sugar levels (especially in diabetics).
  • Headache or nausea related to fluid or electrolyte changes.
• Serious Side Effects:
  • Fluid overload: May cause hypertension, pulmonary edema, or heart failure symptoms.
  • Electrolyte imbalances: Including hyponatremia, hypokalemia, or hyperglycemia.
  • Hypersensitivity reactions: Rash, fever, or rarely anaphylaxis.
• Metabolic Complications:
  • Hyperosmolar state due to rapid glucose metabolism.
  • Lactic acidosis in rare cases involving glucose metabolism disorders.

Patients should be monitored closely, especially those with renal, hepatic, or cardiac conditions. Immediate medical attention is necessary in case of signs of allergic reactions, confusion, respiratory difficulty, or sudden weight gain.

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

This IV solution is contraindicated in certain conditions due to the risks of fluid or electrolyte imbalance, or altered glucose metabolism. Major contraindications include:

• Congestive heart failure or pulmonary edema: Risk of volume overload exacerbating symptoms.
• Severe renal impairment: Impaired excretion of sodium may lead to fluid retention and toxicity.
• Uncontrolled diabetes mellitus: Due to the glucose content, it may worsen hyperglycemia or ketoacidosis.
• Hypersensitivity to dextrose or sodium chloride: Though rare, hypersensitivity reactions necessitate alternative therapy.
• Acute ischemic stroke or head trauma (in first 24 hours): Hyperglycemia may worsen neurologic outcomes.

Relative contraindications may include:

• Hyponatremia (correcting sodium too quickly can cause central pontine myelinolysis).
• Edematous conditions (e.g., liver cirrhosis, nephrotic syndrome).

Always consult a healthcare professional to evaluate patient history and current status before initiating therapy.

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

Proper storage conditions are critical to maintain the sterility and effectiveness of 5% Dextrose & 0.45% Sodium Chloride Injection USP. Follow these guidelines:

• Temperature: Store between 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C–30°C (59°F–86°F).
• Protection: Protect from excessive heat, light, and freezing. Do not store in direct sunlight.
• Container care:
  • Do not use if the plastic bag is damaged, discolored, or leaking.
  • Inspect visually for particulate matter or cloudiness before administration.
• Shelf life: Follow the expiration date provided by the manufacturer. Do not use expired products.
• Disposal: Discard any unused solution and IV equipment safely as per hospital or clinic protocol. Do not reuse or resterilize bags.

Keep out of reach of children and only use under the supervision of a healthcare professional.