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 formulated to provide both hydration and energy to patients requiring fluid and electrolyte replacement. Packaged in a large-volume 2000ml plastic bag, this solution is commonly used in clinical settings where prolonged or substantial fluid administration is needed.

• Dextrose (anhydrous) 5% W/V: Serves as a source of glucose, an essential carbohydrate that supplies energy to body cells, especially when oral intake is limited or impossible.
• Sodium Chloride 0.225% W/V: Provides sodium and chloride ions to help maintain electrolyte balance, regulate osmotic pressure, and support physiological functions.

This hypotonic solution gently rehydrates cells while replenishing extracellular fluid volume. The relatively low concentration of sodium chloride reduces the risk of sodium overload and fluid retention, making it suitable for patients who need maintenance fluids without excessive sodium intake. The 2000ml bag size allows for longer infusion periods or administration of larger volumes to meet the hydration needs of patients with moderate to severe fluid deficits.

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

• Administration Route: This solution is intended strictly for intravenous infusion using a sterile IV setup.
• Pre-Use Checks: Inspect the bag for leaks, cloudiness, or particulate matter. Do not use if the solution appears discolored or compromised.
• Infusion Rate: Adjust the infusion rate according to the patient’s age, clinical condition, fluid balance, and ongoing losses. Typical infusion rates range from 50 to 200 ml/hour but must be individualized.
• Compatibility: Can be co-administered with compatible intravenous medications; confirm compatibility before mixing.
• Monitoring: Regular monitoring of vital signs, blood glucose, and serum electrolytes is essential to avoid complications such as hyperglycemia or electrolyte imbalances.
• Duration: Used as maintenance fluid therapy or for correction of mild to moderate dehydration, until oral hydration is feasible or clinical goals are met.

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

• Dextrose Metabolism: After intravenous administration, dextrose is rapidly absorbed by cells and metabolized via glycolysis to produce ATP, the energy currency required for various cellular processes.
• Sodium and Chloride Role: Sodium is a major extracellular cation that maintains fluid balance, osmotic pressure, and nerve conduction. Chloride, the predominant extracellular anion, contributes to acid-base balance and osmotic regulation.
• Fluid and Electrolyte Balance: The hypotonic sodium chloride concentration allows controlled movement of water into cells, preventing abrupt osmolarity changes and cellular dehydration.
• Volume Expansion: Helps restore extracellular fluid volume, improving circulation, organ perfusion, and tissue oxygenation.
• Maintenance Therapy: Supports ongoing hydration and electrolyte needs during illness, surgery, or fasting periods.

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: May influence electrolyte and fluid balance when co-administered with diuretics (e.g., furosemide), potentially increasing the risk of sodium or potassium imbalances.
• Insulin: Since the solution contains glucose, insulin dosing may require adjustment to maintain optimal blood sugar levels.
• Cardiovascular Drugs: Patients on medications such as ACE inhibitors, beta-blockers, or digoxin need careful monitoring as fluid overload or electrolyte changes can affect cardiac function.
• Electrolyte Modifiers: Corticosteroids or potassium-sparing agents can alter electrolyte homeostasis and may require dose adjustments or close monitoring.
• Nephrotoxic Agents: Use with caution alongside drugs affecting renal function to avoid fluid or electrolyte disturbances.
• IV Drug Compatibility: Always check compatibility before mixing with other intravenous medications to prevent precipitation or reduced efficacy.

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

• Adult Patients: Dosage is individualized based on clinical assessment. Typical maintenance rates range from 75 to 150 ml/hour but may be increased for dehydration or fluid deficits.
• Pediatric Patients: Dosing is weight-based and requires frequent monitoring of electrolytes and blood glucose.
• Adjustment in Comorbidities: Reduce rates in patients with cardiac or renal impairment to avoid fluid overload.
• Duration: Continue until the patient can maintain adequate oral hydration or until clinical objectives are achieved.
• Monitoring: Essential to guide dose adjustments and ensure safety, including assessment of fluid status, electrolytes, and glucose.

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

• Local Reactions: Pain, redness, or inflammation at the infusion site due to vein irritation.
• Fluid Overload: Rapid or excessive infusion can lead to edema, hypertension, pulmonary congestion, or exacerbate heart failure.
• Electrolyte Imbalance: Risk of hyponatremia or hypernatremia if serum electrolytes are not monitored.
• Blood Glucose Fluctuations: Hyperglycemia is possible, especially in diabetic patients or those with impaired glucose tolerance.
• Allergic Reactions: Rarely, hypersensitivity reactions such as rash, itching, or anaphylaxis may occur.
• Metabolic Issues: Potential for acid-base imbalances with prolonged use.
• Infection Risk: Potential for bloodstream infections if aseptic technique is not followed during infusion.

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: Allergy to any component of the solution, including dextrose or sodium chloride.
• Severe Hyperglycemia: Avoid use in patients with uncontrolled diabetes or hyperosmolar states.
• Fluid Overload States: Contraindicated in patients with pulmonary edema, congestive heart failure, or conditions prone to fluid retention.
• Severe Hypernatremia: Should not be used when sodium levels are markedly elevated.
• Intracranial Pressure: Avoid in cases of cerebral edema where hypotonic fluids could worsen swelling.
• Severe Hyponatremia or Hypokalemia: Use caution and consult specialist advice.

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

• Storage Conditions: Store at controlled room temperature, typically 20°C to 25°C. Avoid freezing to prevent damage to the plastic bag and maintain solution integrity.
• Light Protection: Keep the solution protected from direct sunlight to avoid degradation of components.
• Inspection Before Use: Always check the bag for leaks, cloudiness, or particulate matter. Do not use if any abnormalities are detected.
• Expiry Date: Use before the printed expiration date. Do not use expired products.
• After Opening: Once the bag is punctured or infusion started, complete administration within recommended timeframes (usually within 24 hours) to reduce contamination risk.
• Disposal: Dispose of unused or expired bags according to local biomedical waste regulations.