Monday, September 29, 2008

Dextrose 5% water D5W

Type of solution

Hypertonic solution

Classification

Generic Name: sodium chloride, sodium lactate, potassium chloride and
calcium chloride

Content

Each 100 mL contains 5 g Dextrose Hydrous, USP*; 600 mg Sodium Chloride,
USP (NaCl); 310 mg Sodium Lactate (C3H5NaO3); 30 mg of Potassium Chloride, USP
(KCl); and 20 mg Calcium Chloride, USP (CaCl2 · 2H20). It contains no
antimicrobial agents. Approximate pH 5.0 (4.0 to 6.5).

Mechanism of action

5% Dextrose in Lactated Ringer's Injection provides electrolytes and
calories, and is a source of water for hydration. It is capable of inducing
diuresis depending on the clinical condition of the patient. This solution also
contains lactate which produces a metabolic alkalinizing effect.
Sodium, the
major cation of the extracellular fluid, functions primarily in the control of
water distribution, fluid balance and osmotic pressure of body fluids. Sodium is
also associated with chloride and bicarbonate in the regulation of the acid-base
equilibrium of body fluid. Potassium, the principal cation of intracellular
fluid, participates in carbohydrate utilization and protein synthesis, and is
critical in the regulation of nerve conduction and muscle contraction,
particularly in the heart.
Chloride, the major extracellular anion, closely
follows the metabolism of sodium, and changes in the acid-base balance of the
body are reflected by changes in the chloride concentration. Calcium, an
important cation, provides the framework of bones and teeth in the form of
calcium phosphate and calcium carbonate. In the ionized form, calcium is
essential for the functional mechanism of the clotting of blood, normal cardiac
function, and regulation of neuromuscular irritability.
Sodium lactate is a
racemic salt containing both the levo form, which is oxidized by the liver to
bicarbonate, and the dextro form, which is converted to glycogen. Lactate is
slowly metabolized to carbon dioxide and water, accepting one hydrogen ion and
resulting in the formation of bicarbonate for the lactate consumed. These
reactions depend on oxidative cellular activity.
Dextrose provides a source
of calories. Dextrose is readily metabolized, may decrease losses of body
protein and nitrogen, promotes glycogen deposition and decreases or prevents
ketosis if sufficient doses are provided

INDICATIONS AND USAGE

Lactated Ringer’s and 5% Dextrose Injection, USP is indicated as a source
of water, electrolytes and calories or as an alkalinizing agent,

CONTRAINDICATIONS

solutions containing dextrose may be contraindicated in patients with known
allergy to corn or corn products.

How supplied

Lactated Ringer’s and 5% Dextrose Injection, USP in VIAFLEX plastic
containers is available as follows:
Code
Size
NDC
2B2073
500 mL
NDC 0338-0125-03
2B2074
1000 mL
NDC 0338-0125-04
Exposure of
pharmaceutical products to heat should be minimized. Avoid excessive heat. It is
recommended the product be stored at room temperature (25°C); brief exposure up
to 40°C does not adversely affect the product
Dose

DOSAGE AND ADMINISTRATION

As directed by a physician. Dosage is dependent upon the age, weight and
clinical condition of the patient as well as laboratory
determinations.
Parenteral drug products should be inspected visually for
particulate matter and discoloration prior to administration whenever solution
and container permit.
All injections in VIAFLEX plastic containers are
intended for intravenous administration using sterile equipment.
As reported
in the literature, the dosage and constant infusion rate of intravenous dextrose
must be selected with caution in pediatric patients, particularly neonates and
low weight infants, because of the increased risk of
hyperglycemia/hypoglycemia.
Additives may be incompatible. Complete
information is not available. Those additives known to be incompatible should
not be used. Consult with pharmacist, if available. If, in the informed
judgement of the physician, it is deemed advisable to introduce additives, use
aseptic technique. Mix thoroughly when additives have been introduced. Do not
store solutions containing additives

Nursing
responsibilities
1. Suspend container from eyelet
support.
2. Remove plastic protector from outlet
port at bottom of container.
3. Attach
administration set. Refer to complete directions accompanying
set
1. Clinical evaluation and periodic laboratory
determinations are necessary to monitor changes in fluid balance, electrolyte
concentrations, and acid base balance during prolonged parenteral therapy or
whenever the condition of the patient warrants such
evaluation.
2. Lactated Ringer’s and 5% Dextrose
Injection, USP should be used with caution. Excess administration may result in
metabolic alkalosis.
3. Caution must be exercised in
the administration of Lactated Ringer’s and 5% Dextrose Injection, USP to
patients receiving corticosteroids or
corticotropin.
4. Lactated Ringer’s and 5% Dextrose
Injection, USP should be used with caution in patients with overt or subclinical
diabetes mellitus
5. If an adverse reaction does
occur, discontinue the infusion, evaluate the patient, institute appropriate
therapeutic countermeasures


No comments: