5% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP Infusion/Solution for

What is 5% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

5% w/v Dextrose & 0.225% w/v Sodium Chloride (MEDISAL) is a sterile, non-pyrogenic intravenous (IV) infusion solution used for rehydration and electrolyte replenishment. It combines dextrose (glucose) and sodium chloride to support metabolic and fluid balance in the body.

• Generic components: Dextrose (anhydrous) 5% and Sodium Chloride 0.225% per 100ml
• Form: Infusion solution for intravenous administration
• Packaging: 500ml plastic bottle (single-use, sterile)
• Use: Maintenance fluid therapy, mild electrolyte correction, and as a carrier fluid for IV medications

This hypotonic solution is commonly used in pediatric, neonatal, and adult patients for fluid therapy when a moderate volume of low-sodium IV fluid is required. The dextrose provides calories, while the sodium chloride helps maintain osmotic and electrolyte balance.

How to use 5% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

This intravenous fluid must be administered carefully under the guidance of a healthcare professional. The 500ml plastic bottle allows for medium-volume fluid replacement or maintenance therapy.

• Pre-administration Checks:
  • Inspect the solution for clarity and absence of particles.
  • Ensure the bottle is intact and the expiration date is valid.
• Administration:
  • Use a sterile IV set and connect to a peripheral or central venous line.
  • Administer via IV drip or infusion pump depending on required control over the rate.
  • Rate of infusion should be based on patient weight, clinical condition, and laboratory results.
• During Infusion:
  • Monitor vital signs, serum glucose, and electrolytes periodically.
  • Adjust infusion rate based on ongoing fluid loss or electrolyte levels.

Do not administer with blood products in the same line. Always use aseptic techniques and discard any unused portion after opening.

Mode of Action 5% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

The therapeutic action of this solution is derived from its two active ingredients, working in synergy to rehydrate the body and support metabolism.

• Dextrose (5% w/v):
  • Acts as a carbohydrate source, providing approximately 200 kcal per liter.
  • Gets metabolized to CO₂ and water, releasing energy used by body cells.
  • Prevents ketosis and muscle protein catabolism, especially in fasting or catabolic patients.
• Sodium Chloride (0.225% w/v):
  • Supplies sodium and chloride ions, essential for neuromuscular function and fluid distribution.
  • Supports osmotic equilibrium and maintains extracellular fluid volume.

This solution is hypotonic relative to plasma, leading to fluid shift into intracellular compartments, which can be beneficial in cases of cellular dehydration but must be used with caution to avoid hyponatremia.

5% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP Interactions 5% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

Although this infusion fluid is considered safe, it may interact with certain drugs and conditions, especially those affecting glucose metabolism or fluid-electrolyte balance.

• Potential Drug Interactions:
  • Insulin: Accelerates glucose uptake from dextrose, increasing the risk of hypoglycemia if glucose levels are not monitored.
  • Corticosteroids: May lead to fluid retention and electrolyte imbalance.
  • Diuretics: Particularly loop or thiazide diuretics can disturb sodium and potassium balance.
  • Cardiac glycosides (e.g., digoxin): Hypokalemia induced by fluid therapy may enhance toxicity.
• Other Considerations:
  • Avoid mixing with blood products due to risk of hemolysis.
  • Ensure compatibility when using this solution as a diluent for intravenous medications.
  • Concurrent use with nephrotoxic agents may increase renal stress.

Healthcare providers should evaluate the patient's medication profile and perform regular electrolyte monitoring to prevent adverse interactions during therapy.

Dosage of 5% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

Dosage is individualized depending on the clinical condition, age, weight, and ongoing losses. The 500ml volume is commonly used for moderate hydration needs or maintenance therapy over a few hours.

• Adults:
  • Typically used in volumes of 500–3000 ml/day depending on clinical need and fluid deficit.
  • Infusion rate generally ranges from 50 to 150 ml/hour in adults.
• Pediatric:
  • Maintenance fluids are calculated as 100 ml/kg for the first 10 kg, 50 ml/kg for the next 10 kg, and 20 ml/kg for any weight above 20 kg.
  • Infusion rate is tailored per kg of body weight per hour.
• Neonates:
  • Requires cautious administration. Daily fluid intake typically ranges from 60 to 100 ml/kg/day in the early days.

Adjustment may be needed for patients with renal or hepatic impairment, or in the presence of ongoing fluid loss (e.g., diarrhea, vomiting, burns). Regular lab monitoring is advised to guide ongoing therapy.

Possible side effects of 5% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

While generally well tolerated, this IV solution can cause adverse reactions, particularly with improper administration, rapid infusion, or in vulnerable populations such as elderly or critically ill patients.

• Common Side Effects:
  • Localized swelling or inflammation at the infusion site (phlebitis).
  • Hyperglycemia, especially in patients with glucose intolerance or diabetes.
• Serious Side Effects:
  • Fluid overload: Presents as pulmonary edema, hypertension, or heart failure symptoms.
  • Electrolyte disturbances: Includes dilutional hyponatremia, hypokalemia, or hyperchloremia.
  • Osmotic diuresis: Excess dextrose may lead to increased urination and fluid loss.
• Hypersensitivity Reactions:
  • Rare, but may include rash, itching, or anaphylactic reactions.

Monitoring is essential during therapy to identify early signs of complications. Discontinue the infusion immediately if signs of intolerance or adverse reactions appear.

5% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP Contraindications 5% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

This solution is not suitable for all patients. A thorough patient evaluation must be completed before administration to avoid complications.

• Absolute Contraindications:
  • Known hypersensitivity to dextrose or sodium chloride.
  • Severe hyperglycemia or glucose intolerance.
  • Clinically significant hypernatremia or hyperchloremia.
• Relative Contraindications (Use with caution):
  • Renal impairment – risk of fluid and sodium retention.
  • Congestive heart failure – potential to worsen fluid overload.
  • Head trauma or post-operative states – hypotonic solutions may worsen cerebral edema.
  • Diabetes mellitus – may require insulin adjustment and close glucose monitoring.

Contraindications may vary based on the patient’s clinical scenario. Medical supervision is crucial when administering to at-risk groups.

Storage of 5% w/v DEXTROSE & 0.225% w/v SODIUM CHLORIDE INJECTION USP

Maintaining proper storage conditions ensures the safety and efficacy of the IV solution.

• Temperature:
  • Store between 15°C and 25°C (room temperature).
  • Avoid exposure to direct sunlight and freezing temperatures.
• Handling Instructions:
  • Check the bottle integrity and clarity of the solution before use.
  • Do not use if the solution is cloudy, discolored, or contains visible particles.
  • Use aseptic technique when connecting to infusion sets.
• After Opening:
  • Single-use only. Discard any unused portion after opening.
  • Do not reconnect partially used bottles.

Always follow institutional protocols for storage, handling, and disposal of IV fluids to ensure patient safety and product stability.