Dextrose 10% + Sodium Chloride 0.9%
Indications
Dextrose 10% + Sodium Chloride 0.9% is used for:
Dehydration, Fluid and Electrolytes imbalance
Adult Dose
Dosage is to be directed by a physician and is dependent upon age, weight, clinical condition of the patient and laboratory determinations. Frequent laboratory determinations and clinical evaluation are essential to monitor changes in blood glucose and electrolyte concentrations, and fluid and electrolyte balance during prolonged parenteral therapy.
In the average adult, daily requirements of sodium and chloride are met by the infusion of one liter of fluid containing 0.9% sodium chloride (154 mEq each of sodium and chloride).
Fluid administration should be based on calculated maintenance or replacement fluid requirements for each patient.
Child Dose
Renal Dose
Administration
These solutions are for intravenous use only.
When a hypertonic solution is to be administered peripherally, it should be slowly infused through a small bore needle, placed well within the lumen of a large vein to minimize venous irritation. Carefully avoid infiltration.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
Contra Indications
These solutions are contraindicated where the administration of sodium or chloride could be clinically detrimental.
Solutions containing dextrose may be contraindicated in patients with hypersensitivity to corn products.
Precautions
These solutions should be used with care in patients with hypervolemia, renal insufficiency, urinary tract obstruction, or impending or frank cardiac decompensation.
Sodium-containing solutions should be administered with caution to patients receiving corticosteroids or corticotropin, or to other salt-retaining patients. Care should be exercised in administering solutions containing sodium to patients with renal or cardiovascular insufficiency, with or without congestive heart failure, particularly if they are postoperative or elderly.
Infusion of more than one liter of isotonic (0.9%) sodium chloride per day can exceed normal tolerance, resulting in hypernatremia; this may also cause a loss of bicarbonate ions, resulting in an acidifying effect.
Solutions containing dextrose should be used with caution in patients with overt or known subclinical diabetes mellitus, or carbohydrate intolerance for any reason. Hypokalemia may develop during parenteral administration of hypertonic dextrose solutions. Sufficient amounts of potassium should be added to dextrose solutions administered to fasting patients with good renal function, especially those on digitalis therapy.
These solutions are intended for intravenous administration using sterile equipment. It is recommended that intravenous administration apparatus be replaced at least once every 24 hours.
Pregnancy-Lactation
Interactions
Adverse Effects
Side effects of Dextrose 10% + Sodium Chloride 0.9% :
Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation and hypervolemia.
Too rapid infusion of hypertonic solutions may cause local pain and venous irritation. Rate of administration should be adjusted according to tolerance. Use of the largest peripheral vein and a small bore needle is recommended.
Symptoms may result from an excess or deficit of one or more of the ions present in the solution; therefore, frequent monitoring of electrolyte levels is essential.
Hypernatremia may be associated with edema and exacerbation of congestive heart failure due to the retention of water, resulting in an expanded extracellular fluid volume. If infused in large amounts, chloride ions may cause a loss of bicarbonate ions, resulting in an acidifying effect.
Mechanism of Action
Dextrose and sodium chloride solutions are used as sources of electrolytes, calories and water for hydration. Sodium and chloride ions are responsible for regulating the acid-base balance of the body. Dextrose is a source of calories. It is readily metabolised and helps to decrease losses of body protein and nitrogen. It also promotes glycogen deposition and decreases or prevents ketosis.