1. Clinical Overview
A sterile, non-pyrogenic, isotonic solution for intravenous infusion. It provides 5 grams of dextrose monohydrate (equivalent to 4.85 g of anhydrous dextrose) and 0.37 grams of sodium chloride per 100 mL, resulting in a 5% dextrose and 0.37% sodium chloride solution. It is primarily used for fluid and electrolyte replacement, caloric supplementation, and as a vehicle for IV drug administration. The solution is isotonic (approx. 308 mOsm/L) and provides approximately 170 kcal/L from dextrose.
| Onset | Duration | Bioavailability |
|---|---|---|
| Immediate upon intravenous administration. | Duration is variable and depends on the rate of infusion, volume administered, and patient's metabolic and renal status. The dextrose is metabolized within minutes to hours; sodium and chloride ions are regulated by renal function. | 100% for intravenous route. |
2. Mechanism of Action
Dextrose provides a readily metabolizable source of calories and water. It spares body protein and prevents ketosis. Sodium chloride provides essential extracellular electrolytes (sodium and chloride ions) necessary for maintaining extracellular fluid volume, plasma osmolality, acid-base balance, and nerve/muscle function. The combined solution expands plasma volume and provides isotonic fluid replacement.
3. Indications & Uses
- Fluid and electrolyte replacement in dehydration
- Source of calories/carbohydrates in patients unable to ingest orally
- As a vehicle for intravenous administration of compatible medications
4. Dosage & Administration
Adult Dosage: Dosage is highly individualized based on patient's age, weight, clinical condition, and fluid/electrolyte needs. Typical maintenance: 1500-3000 mL/24 hours. For replacement: Based on deficit calculation. Maximum infusion rate for dextrose: 0.5 g/kg/hr (approx. 5-6 mg/kg/min) to avoid hyperglycemia and glycosuria.
Administration: For intravenous infusion only. Use sterile equipment. Check for particulate matter and discoloration. Do not administer if seal is broken. Use a dedicated line or flush line before/after administration of incompatible drugs. Infusion rate must be controlled using an infusion pump, especially in pediatric, geriatric, and cardiac patients. Do not connect flexible plastic containers in series.
5. Side Effects
Common side effects may include:
- Fluid overload (if infused too rapidly)
- Hyperglycemia (especially in diabetics or with rapid infusion)
- Local reactions at injection site: pain, irritation, thrombophlebitis
6. Drug Interactions
| Drug | Effect | Severity |
|---|---|---|
| Insulin or Oral Hypoglycemics | Additive glycemic effect. Co-administration may require adjustment of antidiabetic drug dose to prevent hypoglycemia. | Major |
| Corticosteroids (e.g., Prednisolone, Dexamethasone) | May cause hyperglycemia and sodium retention, antagonizing the fluid/electrolyte balance. | Moderate |
| Potassium-Sparing Diuretics (e.g., Spironolactone) | Increased risk of hyperkalemia when combined with solutions that may shift potassium; however, this solution does not contain potassium. Risk is more related to overall fluid/electrolyte management. | Moderate |
| Loop Diuretics (e.g., Furosemide) | May lead to excessive sodium and water loss, altering the intended fluid replacement effect. | Moderate |
| Blood Products | Physical incompatibility may occur. Should not be administered simultaneously through the same IV line unless compatibility is confirmed. Normal saline (0.9%) is preferred for blood product administration. | Major |
7. Patient Counselling
- Do report any pain, redness, or swelling at the injection site.
- Do inform your doctor if you have a history of heart, kidney, or liver disease, or diabetes.
- Do not adjust the infusion rate yourself.
- Do inform healthcare providers of all medications you are taking.
8. Toxicology & Storage
Overdose: Symptoms of fluid/electrolyte/solute overload: Headache, dizziness, restlessness, hypervolemia (e.g., elevated blood pressure, distended neck veins, pulmonary rales, dyspnea, edema), hyperglycemia (thirst, polyuria, confusion), hypernatremia (fever, flushing, edema, restlessness), hyperchloremic metabolic acidosis (rapid breathing, confusion).
Storage: Store below 30°C. Do not freeze. Protect from light. Keep in outer carton until use. Use immediately after opening the container. Do not use if the solution is cloudy, contains particles, or if the container is leaking or damaged. For single use only. Discard any unused portion.