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 to provide both hydration and caloric support. This solution combines 5% dextrose (as monohydrate) and 0.45% sodium chloride (half-normal saline) to deliver fluids, electrolytes, and energy simultaneously.

• Dextrose (5%): Serves as an immediate source of glucose, which is metabolized by cells to provide energy. This is critical in patients who cannot obtain adequate nutrition orally or require supplemental calories during illness or surgery.
• Sodium Chloride (0.45%): Provides essential sodium and chloride ions, which are vital electrolytes for maintaining fluid balance, nerve function, and acid-base homeostasis.
• Hypotonic solution: The sodium chloride concentration is half that of normal saline, making it hypotonic. This allows the solution to deliver free water to the intracellular space, assisting in cellular rehydration and correcting mild dehydration.
• Formulation volume: Packaged in a 500ml plastic bag, it allows for controlled fluid administration in patients requiring moderate volume replacement or maintenance fluid therapy.

This solution is indicated for maintenance of fluid and electrolyte balance in patients who require intravenous hydration, mild correction of extracellular fluid deficits, or additional caloric intake in the form of glucose.

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

Administration of this solution must be done under strict medical supervision, with attention to patient-specific requirements and clinical monitoring.

• Route: Intravenous infusion via a peripheral or central venous catheter depending on the patient’s condition and duration of therapy.
• Preparation: Inspect the bag for clarity, absence of particles, and integrity before use. Use aseptic technique when connecting to IV sets.
• Infusion rate: Individualized according to patient’s fluid needs, ongoing losses, cardiac and renal status, and metabolic demands. Rates typically range from slow maintenance infusion to more rapid correction depending on clinical judgment.
• Monitoring: Regular monitoring of vital signs, fluid balance, blood glucose, and electrolytes is crucial to avoid complications such as fluid overload, electrolyte disturbances, or hyperglycemia.
• Compatibility: Verify compatibility if co-administering with other IV medications to avoid precipitation or loss of potency. When uncertain, administer separately.
• Adjustment: Modify infusion volume or rate based on patient response and laboratory parameters.
• Duration: Duration of infusion is guided by clinical need; continuous reassessment is necessary.

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

The solution works through a combination of its components providing fluid, electrolytes, and energy:

• Dextrose: Upon infusion, dextrose enters cells via facilitated transport and is metabolized to produce ATP, the body’s energy currency. This spares endogenous protein and fat stores from catabolism, supporting cellular function and recovery.
• Sodium Chloride: The sodium and chloride ions maintain extracellular fluid volume and osmolarity, essential for nerve conduction, muscle function, and maintaining acid-base balance.
• Fluid distribution: Being hypotonic relative to plasma, this solution delivers free water that distributes into both extracellular and intracellular compartments, rehydrating cells and restoring overall fluid balance.
• Physiological effects: Replenishment of fluids and electrolytes supports cardiovascular stability, organ perfusion, and cellular metabolism, especially during dehydration, fasting, or illness.

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

Drug and clinical interactions can influence the safety and effectiveness of this infusion solution:

• Insulin and antidiabetic drugs: Dextrose increases blood glucose levels and may require adjustment of insulin or oral hypoglycemic medications.
• Diuretics (e.g., furosemide, thiazides): Can cause electrolyte imbalances. Concurrent administration requires close monitoring of sodium, potassium, and fluid status.
• Cardiac glycosides (digoxin): Electrolyte disturbances, especially hypokalemia, may increase the risk of digoxin toxicity.
• Potassium supplements: Electrolyte shifts caused by this infusion may affect potassium levels, necessitating careful potassium dosing and monitoring.
• Concurrent IV medications: Verify compatibility before co-administration to prevent precipitation or loss of efficacy.
• Underlying renal or cardiac impairment: Fluid administration may exacerbate edema or heart failure; dosage and infusion rate must be adjusted accordingly.

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

Dosage depends on patient age, weight, clinical condition, and specific fluid and electrolyte needs:

• Adults: Typical maintenance fluid needs range from 1 to 3 liters per day, depending on clinical situation. The 500ml bag is administered repeatedly or as part of a larger regimen.
• Pediatrics: Dosage is calculated based on weight and hydration status. Careful monitoring is required to avoid overhydration.
• Infusion rates: Generally started at slow rates (50–100 ml/hour) and titrated according to patient response, vital signs, urine output, and lab data.
• Special populations: In patients with renal or cardiac dysfunction, dose and rate adjustments are essential to prevent complications.
• Monitoring: Continuous assessment of fluid balance, electrolytes, and glucose guides dosing adjustments.

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

Adverse effects are uncommon when used correctly but may include:

• Local reactions: Pain, inflammation, or thrombophlebitis at the infusion site.
• Fluid overload: Signs include edema, hypertension, pulmonary congestion, especially in patients with cardiac or renal impairment.
• Electrolyte disturbances: Hyponatremia or hypernatremia can develop if dosing is inappropriate. Potassium imbalances may also occur secondary to shifts caused by sodium and fluid changes.
• Hyperglycemia: Excess dextrose can elevate blood sugar levels, particularly in diabetic patients.
• Hypoglycemia: Can occur if infusion is abruptly stopped without resuming nutrition after prolonged use.
• Hypersensitivity reactions: Rare allergic reactions including anaphylaxis.
• Metabolic complications: Acid-base imbalances or hyperosmolar states may result from improper use.

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

This solution should not be used in the following situations:

• Known hypersensitivity: To dextrose, sodium chloride, or any component of the solution.
• Severe hypernatremia or hyperchloremia: Administration can worsen these electrolyte imbalances.
• Fluid overload conditions: Such as congestive heart failure or pulmonary edema where additional fluids could be harmful.
• Diabetic ketoacidosis: Use without insulin may exacerbate hyperglycemia and ketosis.
• Hyponatremia with fluid overload: Hypotonic fluids can worsen cerebral edema or sodium dilution.
• Patients needing isotonic or hypertonic fluids: This hypotonic solution is inappropriate for such indications.

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

Proper storage conditions are essential to maintain the product's sterility and efficacy:

• Temperature: Store at controlled room temperature, ideally between 20°C and 25°C (68°F to 77°F). Avoid freezing or exposure to excessive heat.
• Light protection: Keep the solution in its original packaging until use to protect from light and contamination.
• Inspection: Prior to administration, check the bag for leaks, cloudiness, discoloration, or particulate matter. Do not use if any abnormalities are present.
• Handling: Avoid shaking vigorously or dropping the bag to prevent damage.
• Expiration: Use before the expiration date printed on the packaging.
• Disposal: Dispose of unused or expired bags according to biomedical waste protocols.