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 infusion solution used primarily for fluid and electrolyte replenishment combined with caloric support. It consists of 5% dextrose (as monohydrate) and 0.45% sodium chloride, commonly referred to as “half-normal saline with dextrose.” Packaged in a 1000ml plastic bag, it is designed for use in patients who require both hydration and energy supplementation.

• Dextrose 5%: Provides a source of glucose, essential for cellular metabolism and energy production. It is especially important for patients who cannot consume food orally or require intravenous nutrition.
• 0.45% Sodium Chloride: Delivers sodium and chloride ions, critical electrolytes that help maintain osmotic balance, nerve function, and acid-base equilibrium.
• Hypotonic Nature: The solution is hypotonic compared to plasma, facilitating the movement of free water into intracellular spaces, thereby aiding in cellular hydration.
• Indications: Used for maintenance of fluid and electrolyte balance, treatment of mild dehydration, providing calories during fasting or illness, and correcting sodium deficits in patients.
• Volume: The 1000ml size allows for flexible administration in various clinical scenarios, from maintenance fluids to moderate volume replacement therapy.

Overall, this solution is a versatile intravenous fluid supporting hydration, electrolyte balance, and energy requirements in hospitalized or outpatient care settings.

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

The administration of this solution should be carried out by trained healthcare professionals with continuous patient monitoring:

• Route of Administration: Intravenous infusion via a peripheral or central venous catheter depending on patient condition and duration of therapy.
• Preparation: Inspect the solution bag for any particulate matter, discoloration, or damage. Use aseptic techniques to maintain sterility during setup.
• Infusion Rate: Tailor the infusion rate based on the patient’s fluid requirements, cardiac and renal status, and clinical response. Common rates range from maintenance fluid rates of 50–150 ml/hr to higher rates for volume resuscitation.
• Compatibility: Confirm compatibility with any other intravenous drugs before co-administration. If compatibility is uncertain, administer through separate lines.
• Monitoring: Regularly assess vital signs, fluid input/output, electrolyte levels, and blood glucose to prevent complications like fluid overload, electrolyte imbalance, or hyperglycemia.
• Adjustments: Modify infusion speed or volume based on ongoing assessments, laboratory results, and clinical condition.
• Duration: Use the solution only as long as clinically indicated, with reassessment to determine ongoing need.

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

The therapeutic effect of this solution stems from its dual components:

• Dextrose (5%): Once infused, dextrose is taken up by cells and metabolized via glycolysis to produce ATP, providing vital energy for cellular activities. This energy source helps prevent catabolism of body tissues during periods of inadequate nutrition.
• Sodium Chloride (0.45%): Supplies sodium and chloride ions to the extracellular fluid, maintaining plasma osmolarity, facilitating nerve impulse transmission, muscle contraction, and acid-base homeostasis.
• Fluid Distribution: Due to its hypotonicity, the solution distributes free water to both the extracellular and intracellular compartments, improving cellular hydration and overall fluid balance.
• Physiological Impact: The combined effects help restore and maintain fluid and electrolyte homeostasis, support metabolic demands, and stabilize hemodynamics during dehydration or illness.

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

Interactions with other drugs or patient conditions can influence the efficacy and safety of this infusion:

• Insulin and antidiabetic agents: Dextrose increases blood glucose, potentially necessitating adjustments in insulin or oral hypoglycemics to avoid hyperglycemia.
• Diuretics (loop or thiazide): May cause electrolyte disturbances, requiring close monitoring of sodium, potassium, and fluid balance during concurrent use.
• Cardiac glycosides (e.g., digoxin): Electrolyte imbalances, especially hypokalemia, can increase digoxin toxicity risk.
• Potassium supplements or potassium-sparing diuretics: Electrolyte shifts may affect potassium homeostasis; careful dosing and monitoring are essential.
• Other IV medications: Verify compatibility to avoid precipitation or inactivation when administered via the same IV line.
• Renal or cardiac impairment: May alter fluid and electrolyte handling, necessitating dose and infusion rate adjustments.

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

Dosage should be individualized based on patient weight, age, clinical condition, and hydration status:

• Adults: Maintenance fluid requirements typically range from 1 to 3 liters daily. The 1000ml bag allows flexibility for adjustment depending on fluid needs and clinical indications.
• Pediatrics: Dosing is weight-based and carefully titrated to avoid overhydration or electrolyte imbalances.
• Infusion Rate: Common initial rates range from 50 to 150 ml/hour; can be adjusted according to vital signs, urine output, and lab results.
• Special Populations: In patients with renal or cardiac dysfunction, slow infusion rates and close monitoring are critical to avoid fluid overload.
• Adjustments: Ongoing assessment of electrolyte levels, fluid status, and glucose guides changes in dosing.

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

Although generally safe when used appropriately, potential adverse effects include:

• Local reactions: Pain, phlebitis, or inflammation at the infusion site.
• Fluid overload: Manifested by edema, hypertension, pulmonary congestion, especially in patients with cardiac or renal compromise.
• Electrolyte disturbances: Hyponatremia or hypernatremia can develop with improper dosing. Potassium imbalances secondary to shifts in fluid and electrolytes are possible.
• Hyperglycemia: Excess glucose can elevate blood sugar, particularly in diabetic patients.
• Hypoglycemia: May occur if infusion is stopped abruptly without alternative nutrition after prolonged use.
• Hypersensitivity: Rare allergic reactions including rash, itching, or anaphylaxis.
• Metabolic derangements: Acid-base disturbances or hyperosmolar states can occur if misused.

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

Contraindications include:

• Known allergy: Hypersensitivity to dextrose, sodium chloride, or any component of the solution.
• Severe hypernatremia or hyperchloremia: Administration may worsen these electrolyte imbalances.
• Fluid overload states: Such as congestive heart failure or pulmonary edema, where fluid restriction is required.
• Diabetic ketoacidosis: Use without insulin may worsen hyperglycemia and ketosis.
• Hyponatremia with fluid overload: Hypotonic fluids can exacerbate cerebral edema.
• Need for isotonic or hypertonic solutions: This hypotonic solution is inappropriate for resuscitation or severe electrolyte deficits.

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

Proper storage ensures efficacy and sterility:

• Temperature: Store at controlled room temperature between 20°C to 25°C (68°F to 77°F). Avoid freezing or excessive heat exposure.
• Light Protection: Keep the solution in its original packaging until use to minimize light exposure.
• Inspection: Examine the solution before use for clarity, absence of particulate matter, or damage to the bag.
• Handling: Avoid shaking or dropping the bag to prevent damage or contamination.
• Expiration: Use before the expiration date printed on the label.
• Disposal: Dispose of unused or expired solution according to institutional biomedical waste guidelines.