5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection, USP [Medisal] Injection/Solution for

What is 5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection, USP [Medisal]

5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection USP is a sterile, non-pyrogenic intravenous (IV) solution supplied in a 500ml polypropylene bottle. It contains:

• Dextrose (anhydrous) 5% w/v: A form of glucose, which is a simple sugar used by the body for energy.
• Sodium chloride 0.9% w/v: Also known as normal saline, it replenishes electrolytes and maintains fluid balance.

This isotonic solution is commonly used in clinical settings for fluid replacement, correction of electrolyte imbalances, and as a vehicle for the administration of compatible medications. The combination of dextrose and saline offers both caloric supply and sodium replenishment, which is essential for maintaining hemodynamic stability, particularly in patients who are dehydrated or require nutritional support.

It is typically used under the supervision of healthcare professionals in hospital or clinical environments, particularly for:

• Dehydration treatment
• Maintenance of fluid and electrolyte balance during surgery or illness
• Supportive therapy for patients unable to ingest fluids orally
• Vehicle for compatible drug infusion

How to use 5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection, USP [Medisal]

The administration of this IV solution should always be conducted by a healthcare professional trained in intravenous therapy. Usage guidelines include:

• Route of Administration: Intravenous (IV) infusion via sterile technique.
• Preparation: Ensure the solution is clear and free of particulate matter before use. Do not use if the bottle is damaged or the solution appears discolored or cloudy.
• Dosage: Individualized based on patient’s clinical condition, age, body weight, electrolyte status, and fluid requirements.
• Infusion Rate: Typically ranges between 50 to 250 ml/hour depending on patient’s needs. Infusion should be adjusted to avoid fluid overload, especially in patients with renal or cardiac impairment.
• Monitoring: Regular monitoring of fluid input/output, serum electrolytes, blood glucose levels, and renal function is essential during prolonged therapy.

Before using this solution for drug dilution or administration, healthcare professionals must check the compatibility of the added substance. Aseptic technique must always be observed to prevent infection.

Once the infusion is complete, any unused portion should be discarded. Do not reconnect partially used bottles.

Mode of Action 5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection, USP [Medisal]

This dual-component IV solution acts by providing:

• Dextrose:
  • Supplies calories that can be immediately utilized for energy production, especially during catabolic states.
  • Reduces protein catabolism by sparing amino acids from being used as an energy source.
  • Helps in preventing ketosis when carbohydrate intake is inadequate.
• Sodium Chloride (NaCl):
  • Maintains osmotic pressure and hydration status.
  • Replenishes extracellular sodium and chloride ions lost through sweat, vomiting, diarrhea, or other causes.
  • Plays a vital role in nerve transmission and muscle contraction.

Collectively, this solution maintains both energy balance and extracellular fluid volume, which is critical in patients with fluid and electrolyte disturbances. The isotonic nature of the solution ensures that there is no net fluid shift across cellular membranes, reducing the risk of cellular swelling or dehydration.

5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection, USP [Medisal] Interactions 5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection, USP [Medisal]

This IV fluid can interact with other medications or substances administered concurrently. Important interaction considerations include:

• Drug compatibility: Some drugs may precipitate or degrade when mixed with this solution. Always confirm compatibility before mixing or co-administering.
• Diuretics (e.g., furosemide, hydrochlorothiazide): Can enhance sodium loss or alter fluid balance, requiring dosage adjustments or close monitoring.
• Corticosteroids (e.g., prednisone): May promote sodium retention and fluid overload, especially in patients with heart or kidney conditions.
• Insulin: The dextrose component may necessitate increased insulin requirements in diabetic patients. Blood glucose levels should be monitored frequently.
• Potassium-sparing or depleting agents: The sodium load in this infusion may interfere with serum potassium levels and the effectiveness of such drugs.
• Antihypertensives: Fluid volume expansion may reduce the effectiveness of antihypertensive drugs.

Consult with a pharmacist or medical specialist for safe co-administration practices. Use extreme caution when combining this solution with hypertonic agents or drugs known to affect fluid or electrolyte balance.

Dosage of 5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection, USP [Medisal]

The dosage and rate of administration are tailored to the patient’s clinical condition and therapeutic goals. General guidelines include:

• Adults:
  • Typical maintenance infusion: 500 ml to 2 liters per day, based on hydration and electrolyte needs.
  • Rate: 50–150 ml/hour depending on clinical indication and comorbid conditions.
• Children:
  • Dosing is weight-based: commonly 20-100 ml/kg/day.
  • Close monitoring required due to increased sensitivity to fluid and electrolyte shifts.
• Elderly:
  • Begin at lower infusion rates due to risk of cardiac or renal impairment.

Special considerations:

• Adjust dose in patients with renal, cardiac, or hepatic impairment.
• Do not exceed maximum fluid allowance to avoid volume overload or pulmonary edema.
• Always use infusion pumps for accurate delivery in pediatric or critical care settings.

Possible side effects of 5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection, USP [Medisal]

While generally well tolerated, this IV solution may cause side effects, especially when used improperly or in high volumes. Possible adverse effects include:

• Common:
  • Injection site pain or inflammation
  • Local phlebitis or thrombophlebitis
• Metabolic:
  • Hyperglycemia, especially in diabetic patients
  • Electrolyte imbalance, such as hypernatremia or hypokalemia
  • Fluid overload leading to edema or hypertension
• Severe but rare:
  • Pulmonary edema
  • Congestive heart failure in susceptible individuals
  • Acid-base imbalances

Immediate medical attention should be sought if symptoms such as difficulty breathing, chest discomfort, or sudden swelling occur.

5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection, USP [Medisal] Contraindications 5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection, USP [Medisal]

This solution is contraindicated in patients with specific medical conditions where the administration could be harmful. These include:

• Severe renal impairment: Due to the risk of fluid retention and electrolyte accumulation.
• Uncontrolled diabetes mellitus: Because of the dextrose content, which may worsen hyperglycemia.
• Congestive heart failure or pulmonary edema: The sodium and fluid load may exacerbate volume overload.
• Hypernatremia or fluid retention disorders: Worsening of sodium imbalance may occur.
• Known hypersensitivity: Rare, but any hypersensitivity to components is a contraindication.

This IV solution should be used with caution in elderly patients, neonates, or those with liver disease. Always assess risk versus benefit before initiating therapy in borderline cases.

Storage of 5% w/v Dextrose & 0.9% w/v Sodium Chloride Injection, USP [Medisal]

Proper storage is essential to ensure the safety, sterility, and efficacy of the solution. Recommended storage conditions include:

• Temperature: Store at 15°C to 25°C (59°F to 77°F).
• Keep away from direct sunlight and freezing conditions.
• Protect from excessive heat and humidity.
• Container integrity: Use only if the polypropylene bottle is intact. Discard if the solution is discolored, cloudy, or contains particulates.
• Do not use beyond expiration date.

Once opened, the solution should be used immediately to avoid contamination. Unused portions must not be stored for later use due to the risk of microbial growth.