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 intravenous infusion solution commonly used in clinical settings to provide both fluid and electrolyte replenishment. This solution contains two active components:

• Dextrose (anhydrous) 5% W/V: A form of glucose that serves as an energy source, helping to meet the body's metabolic demands when administered intravenously.
• Sodium Chloride 0.225% W/V: A hypotonic saline solution that provides essential electrolytes, primarily sodium and chloride, to help maintain fluid and electrolyte balance.

This combination makes the solution isotonic or slightly hypotonic, useful for patients who need both fluid volume expansion and a source of energy in the form of glucose. It is often prescribed in hospitals to treat dehydration, electrolyte imbalances, and as a maintenance fluid in patients who cannot take oral fluids.

The solution is packaged in a 500ml plastic bag designed for intravenous administration, ensuring sterility and ease of use. It is commonly utilized in settings such as surgery, critical care, or during illness where patients require intravenous hydration and nutrition support.

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

• Administration Route: This solution is intended for intravenous use only and must be administered by qualified healthcare professionals.
• Preparation: Before use, inspect the bag for any leaks, particulate matter, or discoloration. Do not use if the solution is cloudy or contaminated.
• Infusion: Connect the plastic bag to an appropriate intravenous line and set the infusion rate according to the patient’s clinical condition and physician’s instructions.
• Dosage Adjustment: The rate and volume of infusion depend on the patient’s fluid and electrolyte needs, age, weight, and overall health status.
• Monitoring: Continuous monitoring of vital signs, fluid balance, and electrolyte levels is essential during administration to avoid complications such as fluid overload or electrolyte imbalance.
• Compatibility: This solution can be used alone or in combination with other intravenous medications or nutrients, but compatibility must be verified prior to mixing.
• Storage during Use: Once the bag is connected and infusion started, follow aseptic techniques to prevent contamination. Do not freeze the solution.

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

• Dextrose: Once infused, dextrose is rapidly metabolized by cells to produce energy (ATP). It helps maintain blood glucose levels, especially in patients unable to ingest food orally, providing a critical source of carbohydrates.
• Sodium Chloride: Sodium and chloride ions help maintain extracellular fluid volume and osmotic balance. Sodium is crucial for nerve impulse transmission, muscle function, and maintaining blood pressure.
• Fluid and Electrolyte Balance: The combined effect replenishes lost fluids and corrects mild to moderate electrolyte disturbances by providing hypotonic saline along with glucose.
• Cellular Hydration: The hypotonic nature of the sodium chloride component allows water to move into cells, supporting cellular hydration without causing significant shifts in plasma osmolarity.
• Support in Dehydration: This infusion solution helps restore intravascular volume and prevents dehydration, which is critical for maintaining organ perfusion and metabolic functions.

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

• Electrolyte-Altering Drugs: Medications like diuretics, corticosteroids, or ACE inhibitors may alter electrolyte levels. Caution is needed to avoid hypernatremia or hyponatremia during infusion.
• Insulin: Since dextrose raises blood glucose levels, concurrent administration with insulin requires careful blood sugar monitoring to prevent hypoglycemia or hyperglycemia.
• Cardiovascular Drugs: Drugs affecting blood pressure or heart rhythm should be monitored as rapid infusion may cause fluid overload and exacerbate heart failure or hypertension.
• Other IV Medications: Compatibility must be checked before mixing with other intravenous drugs to prevent precipitation or inactivation.
• Anticoagulants: Electrolyte imbalances may affect anticoagulant activity, necessitating monitoring of coagulation parameters.
• Renal-Acting Drugs: Careful monitoring in patients on nephrotoxic drugs or with renal impairment as fluid and electrolyte shifts may worsen kidney function.

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

• Adult Dosage: Typically, the infusion rate is individualized but usually ranges between 75-125 ml/hr depending on hydration status, clinical condition, and concurrent fluid intake.
• Pediatric Dosage: Dosing is weight-based and adjusted for age and fluid needs; pediatric patients require careful electrolyte and glucose monitoring.
• Adjustment for Clinical Conditions: Dosage may be modified in cases of renal impairment, cardiac insufficiency, or electrolyte imbalance to prevent complications such as fluid overload or hyponatremia.
• Maximum Dosage: There is no absolute maximum volume; infusion is guided by clinical response and laboratory parameters.
• Duration: Duration depends on patient need; this solution may be used as maintenance therapy or until oral intake is possible.
• Monitoring: Frequent assessment of serum electrolytes, blood glucose, fluid status, and vital signs is crucial to safely guide dosing and infusion rate.

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

• Local Reactions: Pain, swelling, or phlebitis at the infusion site may occur.
• Fluid Overload: Excessive infusion can lead to edema, hypertension, or congestive heart failure symptoms, especially in patients with cardiac or renal impairment.
• Electrolyte Imbalance: Hyponatremia or hypernatremia can result if electrolyte levels are not carefully monitored and adjusted.
• Hyperglycemia or Hypoglycemia: Blood sugar fluctuations may occur due to the dextrose content, particularly in diabetic patients.
• Allergic Reactions: Though rare, hypersensitivity reactions can include rash, itching, or anaphylaxis.
• Metabolic Complications: Prolonged use without proper monitoring may cause metabolic alkalosis or acidosis.
• Infection Risk: Improper handling or contamination may lead to systemic infections or sepsis.

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

• Known Hypersensitivity: Contraindicated in patients with known allergy to dextrose, sodium chloride, or any component of the solution.
• Severe Hyperglycemia: Not suitable for patients with uncontrolled high blood sugar levels due to the dextrose content.
• Severe Hypernatremia or Fluid Overload States: Patients with conditions such as congestive heart failure or renal failure may be at risk for worsening symptoms.
• Intracranial or Cerebral Edema: Due to hypotonic nature, it should be avoided or used cautiously as it may exacerbate swelling.
• Patients with Dehydration with Hyperkalemia: Use with caution as this solution may worsen electrolyte imbalance.
• Use in Neonates and Infants: Requires careful evaluation and dose adjustment to avoid fluid or glucose overload.

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

• Temperature: Store at controlled room temperature, typically between 20°C to 25°C (68°F to 77°F). Avoid freezing as it may compromise the bag integrity and solution quality.
• Light Protection: Keep the infusion bag in its original packaging or shielded from direct light to prevent degradation.
• Handling: Inspect the solution bag before use for any discoloration, leaks, or particulate matter. Do not use if the solution appears cloudy or contaminated.
• Expiration: Use before the expiration date printed on the bag. Do not use expired products as sterility and potency cannot be guaranteed.
• After Opening: Once the bag is connected and infusion started, complete use within recommended timeframes (usually within 24 hours) to avoid microbial contamination.
• Disposal: Dispose of unused or expired bags according to local regulations for medical waste.