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) solution composed of:

• Dextrose (anhydrous) – A simple sugar (glucose) that provides a quick source of energy and hydration.
• Sodium chloride – An essential electrolyte that helps in maintaining fluid balance and osmolality in the body.

This solution is used primarily in hospitals and clinical settings to manage fluid and electrolyte balance, particularly when both energy and sodium replacement are required. It combines the rehydrating properties of dextrose with the sodium-replenishing effects of sodium chloride.

Typical uses include:

• Treatment of mild to moderate dehydration
• Maintenance of fluid balance during surgery or illness
• Temporary energy source when oral intake is insufficient
• Supportive therapy in conditions involving electrolyte depletion

The solution is delivered via intravenous infusion and is typically administered under the supervision of healthcare professionals. The 250ml plastic bag format is convenient for controlled, short-duration infusions, often used in pediatric or geriatric populations or in patients requiring small-volume resuscitation.

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

This medication is administered intravenously by trained healthcare personnel. Here's how it is typically used:

• Preparation: Inspect the plastic bag for leaks, clarity, and any particulate matter. Do not use if the solution is cloudy or discolored.
• Route of administration: Intravenous infusion through a sterile IV line.
• Dosage: Determined by the patient’s clinical condition, age, weight, fluid and electrolyte needs, and ongoing losses. Pediatric and adult doses may differ significantly.
• Infusion rate: Carefully controlled using an infusion pump or gravity drip. Rapid administration may lead to complications such as hyperglycemia or electrolyte imbalance.

General guidelines:

• Ensure aseptic technique during administration to avoid infection.
• Monitor blood glucose levels, particularly in diabetic patients.
• Frequent electrolyte monitoring is advised in prolonged use.
• Adjust volume and rate based on patient response and laboratory findings.

Do not administer:

• Simultaneously with blood products through the same IV line (risk of hemolysis)
• Via intramuscular or subcutaneous route

Always follow institutional protocols or the treating physician’s guidance when using this solution.

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

This dual-component IV solution works through two primary mechanisms:

• Dextrose (Glucose):
• Once infused, dextrose is rapidly metabolized by the body into energy.
• It helps to prevent ketosis during periods of fasting or decreased oral intake.
• Provides a source of free water, which distributes throughout total body water compartments (intracellular and extracellular).
• Sodium Chloride (NaCl):
• Sodium ions help regulate extracellular fluid volume and maintain osmotic equilibrium and acid-base balance.
• Chloride ions work synergistically with sodium in maintaining cellular homeostasis.
• The 0.225% concentration is hypotonic compared to plasma, which aids in rehydration of intracellular compartments.

Together, these components:

• Restore hydration and support cellular metabolism
• Replenish electrolytes lost due to vomiting, diarrhea, sweating, or other causes
• Maintain blood glucose levels and prevent hypoglycemia during fasting or post-operative periods

This balanced combination makes the solution suitable for maintenance therapy rather than for rapid volume expansion or emergency resuscitation.

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

Though this solution is often considered safe, interactions can occur with concurrent drug therapies, particularly when administered through the same IV line or in patients with metabolic disorders.

• Drug incompatibility (physical or chemical):
• Do not mix with blood products – may cause clotting or hemolysis.
• Incompatible with amphotericin B, phenytoin, and some aminoglycosides in the same IV line.
• Risk of precipitates with calcium-containing solutions.
• Pharmacodynamic interactions:
• Use with corticosteroids or corticotropin may increase sodium retention and fluid overload.
• Co-administration with insulin or antidiabetics may require blood glucose monitoring due to risk of hypoglycemia.
• Electrolyte-altering drugs:
• Potassium-sparing diuretics (e.g., spironolactone) may interact with sodium levels.
• ACE inhibitors and ARBs can affect sodium and fluid balance, requiring close monitoring.

It is essential to monitor the patient’s clinical status and laboratory values to adjust the infusion and manage potential interactions.

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

Dosage must be individualized based on age, weight, clinical condition, and ongoing fluid and electrolyte losses. General dosage recommendations include:

• Adults: Typically 500–3000 ml/day in divided doses based on hydration needs
• Children: 50–100 ml/kg/day or more, based on age and weight
• Infants and Neonates: Dosing is more conservative and should be carefully adjusted by pediatric specialists

Infusion rate:

• Generally between 20–150 ml/hour depending on indication and fluid balance goals
• Should not exceed the maximum glucose infusion rate (usually around 4–5 mg/kg/min in adults)

Special considerations:

• Adjustments needed in renal or hepatic impairment to avoid fluid overload
• Monitor electrolytes, glucose levels, and hydration status during prolonged administration

Always follow institutional or prescriber-specific protocols.

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

Like all intravenous solutions, this medication can cause side effects, especially if not administered properly or in specific at-risk populations.

• Common adverse effects:
• Localized irritation or inflammation at the injection site
• Mild swelling (edema) or pain around the IV site
• Serious side effects:
• Fluid overload (hypervolemia), especially in patients with kidney or heart failure
• Hyponatremia (low blood sodium) or hypernatremia (high sodium), depending on infusion rate and patient condition
• Hyperglycemia, particularly in diabetic patients or if infused too quickly
• Pulmonary edema in severe fluid overload cases
• Rare but serious complications:
• Seizures (due to electrolyte imbalances)
• Thrombophlebitis or vein irritation
• Allergic reactions (extremely rare)

Prompt recognition of adverse reactions and timely discontinuation or adjustment of the infusion can mitigate most risks.

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 every patient. Contraindications include:

• Known hypersensitivity to dextrose, sodium chloride, or any of the excipients
• Hyperglycemia or diabetes mellitus that is poorly controlled
• Hypernatremia or fluid retention disorders, including congestive heart failure, severe renal insufficiency, or liver cirrhosis with ascites
• Conditions requiring fluid restriction, such as pulmonary edema or cerebral edema
• Post-operative states requiring precise fluid management where hypotonic fluids may increase the risk of hyponatremia

Use with extreme caution in neonates, infants, or the elderly unless closely monitored.

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

Proper storage of this infusion solution ensures its safety and efficacy:

• Temperature: Store below 25°C (77°F); do not freeze
• Protection: Keep the solution in its original overwrap to protect from light and contamination
• Handling: Do not use if the plastic bag is damaged, leaking, or the solution appears cloudy or discolored
• Shelf life: Refer to the manufacturer’s label; typically ranges from 24–36 months if unopened
• Post-opening: Once the bag is opened, use the solution immediately. Discard any unused portion to prevent contamination

Keep out of reach of children and store in a secure medical storage facility.