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 designed to provide both fluid and electrolyte replenishment along with a source of energy in the form of glucose. Packaged in a 1000ml plastic bag, this preparation is widely used in hospital and clinical settings to maintain or restore hydration and electrolyte balance in patients unable to take fluids orally.

• Dextrose (anhydrous) 5% W/V: Provides glucose, which is essential for cellular energy metabolism and helps prevent catabolism in patients who are fasting or have increased metabolic needs.
• Sodium Chloride 0.225% W/V: Supplies sodium and chloride ions to maintain osmotic equilibrium and proper electrolyte balance in the extracellular fluid.

This formulation is hypotonic or mildly isotonic, making it suitable for patients requiring gentle fluid replacement without excessive sodium load. The solution is particularly useful in treating mild dehydration, supplying maintenance fluids, and preventing hypoglycemia during parenteral therapy.

Because of its 1000ml volume, it is ideal for longer infusion periods or higher fluid requirements, allowing healthcare providers to administer adequate hydration while ensuring careful control of electrolyte and glucose intake.

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

• Administration: Intended exclusively for intravenous use, administered through a sterile IV line by trained healthcare professionals.
• Preparation: Check the bag for leaks, discoloration, or particulate matter before use. Do not administer if the solution appears cloudy or contaminated.
• Infusion Rate: Adjust the infusion rate based on clinical assessment, patient’s hydration status, weight, and comorbid conditions. Typical infusion rates range from 75 to 150 ml/hour but should be individualized.
• Compatibility: Can be administered alone or in combination with other compatible intravenous medications or nutrients; however, always verify compatibility before mixing.
• Monitoring: Regularly monitor vital signs, blood glucose levels, and serum electrolytes during infusion to detect and manage any potential complications such as hyperglycemia, hyponatremia, or fluid overload.
• Duration: Use as maintenance fluid therapy or until oral hydration is restored, with continuous evaluation of the patient’s needs.

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

• Dextrose Metabolism: Once administered, the dextrose is rapidly taken up by cells and metabolized to produce adenosine triphosphate (ATP), the primary energy currency of cells. This energy supports vital cellular functions, particularly in patients unable to consume food orally.
• Sodium and Chloride Ions: Sodium plays a critical role in maintaining extracellular fluid volume, osmotic pressure, and nerve impulse conduction. Chloride helps maintain acid-base balance and is a major extracellular anion.
• Fluid Distribution: The hypotonic nature of 0.225% sodium chloride allows for gentle rehydration, promoting water movement into cells without causing abrupt changes in plasma osmolarity.
• Maintenance of Electrolyte Balance: Supplies essential electrolytes to replace losses from dehydration, diarrhea, or vomiting, supporting overall physiological stability.
• Support of Circulatory Volume: Helps restore and maintain adequate intravascular volume, ensuring proper organ perfusion and function during illness or surgical recovery.

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

• Diuretics: Drugs such as loop or thiazide diuretics can alter sodium and fluid balance, increasing the risk of electrolyte disturbances when used alongside this infusion.
• Insulin: Since the infusion contains dextrose, insulin therapy requires careful monitoring to avoid hypo- or hyperglycemia.
• Cardiac Medications: Use with caution in patients on drugs affecting cardiac output or blood pressure, as fluid overload may exacerbate conditions like congestive heart failure.
• Other IV Drugs: Always confirm compatibility before co-administration to prevent precipitation or reduced efficacy.
• Electrolyte Modifying Agents: Corticosteroids, ACE inhibitors, or potassium-sparing diuretics can influence electrolyte levels, necessitating close monitoring.
• Nephrotoxic Drugs: Combination with drugs that affect kidney function requires careful fluid and electrolyte management.

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

• Adults: Dosage and infusion rate are determined by individual fluid requirements, clinical condition, and ongoing losses. Typical rates range from 75 to 150 ml/hr but must be tailored based on monitoring results.
• Pediatric Patients: Dosing should be carefully calculated according to body weight and clinical status, with frequent assessment of electrolytes and glucose levels.
• Adjustment Factors: Modify infusion rates for patients with renal or cardiac impairments to avoid fluid overload or electrolyte imbalance.
• Duration: The infusion can be continued as maintenance therapy until the patient can resume oral intake or as indicated by clinical progress.
• Monitoring: Regular laboratory tests and clinical evaluation guide dose adjustments, ensuring safety and effectiveness.

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

• Local Reactions: Inflammation, phlebitis, or pain at the infusion site are possible due to vein irritation.
• Fluid Overload: Excessive or rapid infusion can cause edema, hypertension, pulmonary congestion, or exacerbate heart failure.
• Electrolyte Imbalance: Potential for hyponatremia or hypernatremia if electrolyte monitoring is inadequate.
• Blood Glucose Fluctuations: Hyperglycemia can occur, particularly in diabetic patients; hypoglycemia may also arise if insulin therapy is not adjusted.
• Allergic Reactions: Rarely, hypersensitivity responses including rash, itching, or anaphylaxis can happen.
• Metabolic Disturbances: Prolonged administration may lead to acid-base imbalances such as metabolic alkalosis or acidosis.
• Infections: Risk of systemic infections if aseptic technique is breached during administration.

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

• Hypersensitivity: Known allergy to dextrose, sodium chloride, or any component of the solution.
• Severe Hyperglycemia: Should not be used in patients with uncontrolled high blood glucose levels.
• Severe Hypernatremia or Fluid Overload: Contraindicated in patients at risk of or presenting with fluid overload or severe electrolyte disturbances.
• Intracranial or Cerebral Edema: Use with caution or avoid as hypotonic solutions may exacerbate cerebral swelling.
• Severe Dehydration with Hyperkalemia: Use cautiously to prevent worsening electrolyte abnormalities.
• Neonates and Infants: Requires specialist evaluation and careful dosing.

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

• Temperature: Store at controlled room temperature (20°C to 25°C). Avoid freezing, which can damage the bag and compromise sterility.
• Light Protection: Keep in original packaging or shielded from direct sunlight to prevent degradation.
• Inspection: Prior to use, inspect the bag for leaks, discoloration, or particulate matter. Do not use if compromised.
• Expiration: Use before the expiry date printed on the packaging; discard if expired.
• After Opening: Once the infusion has started, complete the administration promptly, typically within 24 hours, to minimize contamination risk.
• Disposal: Dispose of unused or expired solution according to medical waste regulations.