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 designed to replenish fluids, electrolytes, and provide energy in the form of glucose. This formulation contains 5% dextrose (as monohydrate) and 0.45% sodium chloride, making it a hypotonic crystalloid solution commonly used in hospitals and clinical settings.

• Dextrose (5%): Acts as a source of carbohydrate calories. When metabolized, it provides energy to the body, which is especially important for patients unable to ingest adequate nutrition orally or enterally.
• Sodium Chloride (0.45%): Provides essential electrolytes, primarily sodium and chloride ions, which help maintain fluid balance, osmotic pressure, and proper cellular function.
• Hypotonic nature: The sodium chloride concentration (0.45%) is half that of normal saline, which allows this solution to provide free water to the cells and extracellular spaces, useful in correcting dehydration or maintenance of fluid balance.

This 250ml plastic bag formulation is suitable for controlled infusion volumes where precise fluid management is necessary. It is commonly indicated in patients requiring maintenance fluids, mild dehydration correction, or those needing supplemental calories intravenously.

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

The administration of this IV infusion must be carefully managed by healthcare professionals to ensure safety and therapeutic effectiveness. Important usage considerations include:

• Route of administration: Administered intravenously, typically via a peripheral vein or central venous catheter, depending on the patient’s condition and duration of therapy.
• Preparation: Confirm the solution is clear, free from particulate matter, and the bag integrity is intact before use. Employ aseptic technique when connecting the infusion set.
• Infusion rate: Determined by the patient’s fluid and metabolic needs, comorbidities, and overall clinical condition. Rates should be individualized and may range from slow maintenance rates to faster corrections of dehydration under medical supervision.
• Monitoring: Vital signs, blood glucose levels, and electrolyte panel should be regularly monitored during infusion. Watch for signs of fluid overload, electrolyte imbalance, or hyperglycemia, especially in vulnerable patients such as diabetics or those with renal impairment.
• Compatibility: Check for compatibility with any concurrently administered IV drugs to prevent precipitation or loss of efficacy. When in doubt, administer separately or consult pharmacy resources.
• Duration: Duration of infusion is guided by the clinical scenario; continuous monitoring is essential to adjust the fluid rate or discontinue if adverse effects occur.

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

The therapeutic effects stem from the combined actions of dextrose and sodium chloride in the solution:

• Dextrose: After IV administration, dextrose is rapidly taken up by cells and metabolized to provide immediate energy. It spares the breakdown of body fats and proteins for energy, which is critical in malnourished or fasting patients. The provision of glucose also helps maintain blood sugar homeostasis during periods of inadequate oral intake.
• Sodium Chloride: Sodium and chloride ions help maintain extracellular fluid volume, osmotic balance, and proper nerve and muscle function. Sodium is the main extracellular cation, critical for water distribution between compartments.
• Fluid distribution: Being hypotonic, this solution supplies free water that distributes into both intracellular and extracellular compartments, helping to rehydrate cells and restore fluid balance.
• Overall physiological effect: The solution replenishes lost fluids, restores electrolyte balance, and provides an energy source, collectively supporting homeostasis and aiding recovery from dehydration or fluid imbalance.

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

Interactions with other drugs or clinical conditions can influence the safety and efficacy of this infusion solution. Key points to consider:

• Insulin and oral hypoglycemics: Dextrose increases blood glucose, which may necessitate dose adjustments of antidiabetic medications.
• Diuretics (e.g., loop, thiazide): Can cause electrolyte imbalances; concurrent use with this infusion requires close monitoring of sodium, potassium, and fluid status.
• Cardiac glycosides (e.g., digoxin): Electrolyte disturbances caused by the solution can potentiate digoxin toxicity; monitoring potassium and magnesium is critical.
• Potassium supplements: The sodium chloride component may affect potassium balance; potassium dosing should be carefully adjusted.
• Other IV drugs: Compatibility must be checked before co-administration; some drugs may precipitate or lose efficacy if mixed with dextrose-containing solutions.
• Underlying renal or cardiac disease: Fluid and electrolyte shifts caused by the infusion may exacerbate these conditions; dosage and infusion rate need careful adjustment.

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

Dosage is individualized based on patient age, weight, clinical condition, and specific needs. General guidelines include:

• Adults: Maintenance fluid requirements typically range from 1 to 3 liters per day depending on ongoing losses and clinical status. This 250ml bag is often administered multiple times per day or as part of a larger fluid regimen.
• Pediatrics: Dose calculated according to body weight and hydration status. Frequent monitoring is necessary to avoid fluid overload or electrolyte disturbances.
• Infusion rate: Typically started at slow rates (e.g., 50–100 ml/hr) and adjusted based on clinical response, vital signs, urine output, and lab results.
• Adjustments: Fluid and electrolyte replacement should be tailored if abnormalities such as hypernatremia, hyponatremia, hyperglycemia, or fluid overload develop.
• Special populations: In patients with renal insufficiency or heart failure, dose and rate must be reduced to prevent complications.
• Monitoring: Frequent assessment of hydration status, electrolyte balance, and glucose levels guides ongoing dosing adjustments.

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

While generally well tolerated when used appropriately, this infusion solution may cause some adverse effects, including:

• Local reactions: Pain, phlebitis, or inflammation at the IV site due to vein irritation.
• Fluid overload: Manifesting as peripheral edema, pulmonary edema, hypertension, and dyspnea, especially in patients with compromised cardiac or renal function.
• Electrolyte imbalances: Hyponatremia or hypernatremia may occur from inappropriate dosing. Potassium imbalances may also arise secondary to sodium and fluid shifts.
• Hyperglycemia: Excess dextrose can elevate blood glucose, which is especially concerning in diabetic or insulin-resistant patients.
• Hypoglycemia: Rare but possible if infusion is abruptly stopped after prolonged administration without oral intake resumption.
• Allergic reactions: Rare cases of hypersensitivity or anaphylaxis have been reported.
• Metabolic disturbances: Acid-base imbalances can develop due to electrolyte shifts or abnormal metabolism of dextrose.

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

This solution is contraindicated in certain clinical situations, including:

• Known hypersensitivity: To dextrose, sodium chloride, or any components of the formulation.
• Severe hypernatremia or hyperchloremia: Administration of sodium-containing fluids may worsen these conditions.
• Fluid overload states: Including congestive heart failure, pulmonary edema, or severe renal impairment where additional fluid may exacerbate symptoms.
• Diabetic ketoacidosis: Administration of dextrose without insulin can worsen hyperglycemia and ketosis.
• Hyponatremia with fluid overload: Hypotonic solutions may exacerbate cerebral edema or sodium dilution.
• Patients requiring isotonic or hypertonic solutions: This hypotonic fluid is unsuitable where plasma osmolarity correction requires isotonic fluids.

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

Proper storage is essential to maintain sterility and efficacy:

• Temperature: Store at controlled room temperature between 20°C to 25°C (68°F to 77°F). Avoid freezing or exposure to extreme heat.
• Light protection: Keep in original packaging to protect from light and contamination until use.
• Integrity: Inspect the bag and solution before administration for leaks, cloudiness, discoloration, or particulate matter.
• Handling: Avoid shaking or agitation that could damage the plastic bag or affect solution quality.
• Expiration: Do not use after the expiration date printed on the packaging.
• Disposal: Dispose of unused or expired bags following institutional biomedical waste protocols.