5% w/v DEXTROSE & 0.9% w/v SODIUM CHLORIDE INJECTION USP Infusion/Solution for

What is 5% w/v DEXTROSE & 0.9% w/v SODIUM CHLORIDE INJECTION USP

5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection USP is a sterile, non-pyrogenic intravenous solution composed of two key components:

• Dextrose (5% w/v): A simple sugar (glucose) that provides immediate energy by supplying calories. It is especially useful in patients who cannot eat or require extra energy due to illness.
• Sodium Chloride (0.9% w/v): Commonly known as normal saline, this solution helps restore and maintain fluid and electrolyte balance in the body.

This combination provides a dual benefit: it replenishes fluid and electrolytes while offering a source of glucose. The 100ml bag is typically used for:

• Hydration in patients with mild dehydration
• Correction of sodium and chloride depletion
• Glucose supplementation in patients with hypoglycemia or increased metabolic demand
• A carrier fluid for intravenous medications

It is commonly used in hospital and outpatient settings, especially in patients with limited oral intake, mild electrolyte disturbances, or when IV medication dilution is needed.

How to use 5% w/v DEXTROSE & 0.9% w/v SODIUM CHLORIDE INJECTION USP

This solution should only be administered by trained healthcare professionals using aseptic techniques. Its administration involves specific procedures to ensure patient safety:

• Before Use:
  • Visually inspect the solution for any particulate matter, discoloration, or damage to the bag.
  • Do not use if the solution appears cloudy or if the seal is broken.
• Administration Route:
  • Administer intravenously through a sterile IV line, either peripherally or centrally.
  • Connect the 100ml bag to an infusion set using a luer-lock connection or compatible device.
• Infusion Rate:
  • The rate of administration should be adjusted based on the patient’s age, weight, medical condition, and fluid/electrolyte requirements.
  • For adults, a typical infusion rate may range from 50 to 150 ml/hour, or as directed by a physician.
• During Use:
  • Monitor for signs of fluid overload, especially in patients with cardiac or renal impairments.
  • Regularly assess blood glucose and electrolytes to ensure appropriate physiological response.

The 100ml volume is often used as a flush solution or to dilute medications for intermittent administration.

Mode of Action 5% w/v DEXTROSE & 0.9% w/v SODIUM CHLORIDE INJECTION USP

This IV solution works through the pharmacologic actions of both dextrose and sodium chloride, each playing a distinct role:

• Dextrose (5%):
  • Upon infusion, dextrose is rapidly absorbed and metabolized to provide energy (in the form of ATP) to cells throughout the body.
  • It helps prevent the catabolism of body proteins and fats by acting as an immediate energy substrate.
  • Dextrose also aids in maintaining blood glucose levels in fasting or malnourished patients.
• Sodium Chloride (0.9%):
  • Provides isotonic sodium and chloride ions, essential for fluid balance, nerve impulse transmission, and muscle function.
  • Helps maintain plasma osmolality and prevents cellular dehydration or swelling by keeping the extracellular fluid isotonic.

Together, the components restore fluid volume, correct electrolyte imbalances, and provide metabolic energy, making it ideal in numerous clinical settings including surgery, trauma, infections, and general supportive care.

5% w/v DEXTROSE & 0.9% w/v SODIUM CHLORIDE INJECTION USP Interactions 5% w/v DEXTROSE & 0.9% w/v SODIUM CHLORIDE INJECTION USP

This IV solution is generally well tolerated but may interact with certain drugs or medical conditions:

• Insulin or Antidiabetic Medications:
  • Dextrose can increase blood glucose levels, potentially requiring dose adjustments of insulin or oral hypoglycemics.
• Diuretics (e.g., Furosemide, Thiazides):
  • Can alter sodium balance and increase the risk of dehydration or electrolyte imbalances.
• Corticosteroids and NSAIDs:
  • May cause sodium and fluid retention, potentially compounding the effects of the solution.
• Potassium-Sparing Agents (e.g., Spironolactone, ACE inhibitors):
  • Although this solution does not contain potassium, it may indirectly affect potassium levels and require monitoring.
• Calcium-containing Medications:
  • May precipitate in the presence of phosphate; consult compatibility before co-administration.

Monitor fluid status, renal function, and electrolytes when used concurrently with the above medications. Compatibility testing should be done before mixing with other IV drugs.

Dosage of 5% w/v DEXTROSE & 0.9% w/v SODIUM CHLORIDE INJECTION USP

The dosage must be tailored to individual patient needs, based on fluid balance, electrolyte status, age, and clinical condition. The 100ml bag is typically used for short-term infusions or medication dilution.

• Adults:
  • Commonly administered at rates ranging from 50 to 150 ml/hr depending on indication (e.g., hydration, medication carrier).
  • Used in emergencies or during surgery for maintaining circulatory volume or energy supply.
• Pediatrics:
  • Requires strict weight-based calculations (e.g., 10–20 ml/kg/day) under physician guidance.
• Geriatric Patients:
  • May require lower volumes and slower infusion rates to prevent fluid overload or cardiac stress.

The volume and rate may be increased or decreased depending on ongoing losses (e.g., diarrhea, vomiting, surgery) or conditions like renal insufficiency. Always adjust based on ongoing clinical and laboratory assessment.

Possible side effects of 5% w/v DEXTROSE & 0.9% w/v SODIUM CHLORIDE INJECTION USP

Most patients tolerate this solution well; however, adverse effects may occur, especially if infused inappropriately or in patients with predisposing conditions.

• Common Side Effects:
  • Injection site reactions (pain, redness, or phlebitis)
  • Mild swelling or fluid retention
• Metabolic Effects:
  • Hyperglycemia due to dextrose, particularly in diabetics or those with glucose intolerance
  • Electrolyte imbalances, especially if infused rapidly or without monitoring (e.g., hypernatremia)
• Serious Adverse Effects:
  • Pulmonary edema or congestive heart failure due to fluid overload
  • Allergic reactions (rare), presenting with rash, itching, or anaphylaxis
  • Thrombophlebitis or catheter-related infections

Adverse effects are minimized by monitoring infusion rate, serum glucose, and electrolyte levels. Any unusual symptoms should prompt immediate medical evaluation.

5% w/v DEXTROSE & 0.9% w/v SODIUM CHLORIDE INJECTION USP Contraindications 5% w/v DEXTROSE & 0.9% w/v SODIUM CHLORIDE INJECTION USP

This solution is contraindicated or used with caution in specific conditions:

• Uncontrolled Diabetes Mellitus: Due to risk of hyperglycemia from dextrose content.
• Hypernatremia or Sodium Retention Disorders: Sodium chloride can worsen these conditions.
• Congestive Heart Failure or Pulmonary Edema: Risk of fluid overload and respiratory compromise.
• Renal Impairment: Reduced excretion may lead to fluid and sodium retention.
• Known Allergy or Sensitivity: To any component of the solution.

Use caution in elderly patients or those with a history of fluid imbalance. Always individualize treatment under physician supervision.

Storage of 5% w/v DEXTROSE & 0.9% w/v SODIUM CHLORIDE INJECTION USP

Proper storage ensures the solution remains effective and safe for use:

• Store at room temperature between 20°C to 25°C (68°F to 77°F).
• Protect from extreme temperatures—do not freeze or expose to direct sunlight.
• Keep the solution in its original plastic bag until ready for use to maintain sterility.
• Do not use the product after the expiration date stated on the label.
• Once opened or punctured, use immediately and discard any unused portion in accordance with institutional protocols.

Visually inspect the bag before use. Any cloudy appearance, discoloration, or visible particulate matter indicates contamination, and the product should be discarded.