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Kcl/d5w/nacl 0.15/0.2 Inj, 1000ml

Manufacturer BAXTER Active Ingredient Intravenous (IV) Fluids(in truh VEE nuhs FLOO ids) Pronunciation Poh-TASS-ee-um KLOR-ide / DEX-trohs / SO-dee-um KLOR-ide IN-jek-shun
It is used to give fluids to the body when more fluids and electrolytes are needed.It is used as a way to give other drugs as a shot.It may be given to you for other reasons. Talk with the doctor.
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Drug Class
Fluid, Electrolyte, and Nutrient Replenisher
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Pharmacologic Class
Electrolytes; Carbohydrates; Intravenous Solutions
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Pregnancy Category
Category C
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FDA Approved
Jan 1970
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DEA Schedule
Not Controlled

Overview

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What is this medicine?

This medication is an intravenous (IV) fluid given through a vein. It contains water, sugar (dextrose) for energy, and essential salts like sodium and potassium. It's used to help your body stay hydrated, maintain the right balance of salts, and provide some energy, especially if you can't eat or drink normally, or if you are dehydrated.
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How to Use This Medicine

Proper Use of This Medication

To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is administered as an infusion into a vein over a period of time. Your doctor may instruct you on how to self-administer this medication.

Before and after handling the medication, wash your hands thoroughly. Do not use the medication if the solution appears cloudy, is leaking, or contains particles. Additionally, do not use the solution if it has changed color.

To dispose of used needles and other sharp objects, use a needle/sharp disposal box. Never reuse needles or other items. When the disposal box is full, follow local regulations for proper disposal. If you have any questions or concerns, consult your doctor or pharmacist.

Storage and Disposal

Typically, this medication is administered in a hospital or doctor's office. If you need to store it at home, follow the storage instructions provided by your doctor.

Missed Dose

If you miss a dose, contact your doctor to determine the best course of action.
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Lifestyle & Tips

  • This medication is administered by healthcare professionals in a clinical setting. No specific lifestyle changes are required by the patient related to the medication itself, but underlying conditions requiring IV fluids should be managed as advised by your doctor.
  • Report any discomfort at the IV site (pain, swelling, redness) immediately.
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Available Forms & Alternatives

Available Strengths:

Dosing & Administration

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Adult Dosing

Standard Dose: Highly individualized based on patient's fluid, electrolyte, and caloric needs, and clinical status. Typically administered at rates to maintain hydration, electrolyte balance, and provide minimal caloric support.

Condition-Specific Dosing:

maintenance_fluid: Typically 40-80 mL/hour, adjusted based on patient's weight, clinical condition, and laboratory values.
dehydration: Higher rates may be used initially for rehydration, then adjusted to maintenance.
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Pediatric Dosing

Neonatal: Not established (use with extreme caution, highly individualized based on weight, gestational age, and clinical status; often requires specialized formulations and close monitoring).
Infant: Highly individualized based on weight, age, and clinical status. Typically 2-4 mL/kg/hour, adjusted based on fluid balance and electrolyte levels.
Child: Highly individualized based on weight, age, and clinical status. Typically 2-4 mL/kg/hour, adjusted based on fluid balance and electrolyte levels.
Adolescent: Highly individualized based on weight, age, and clinical status. Typically 2-4 mL/kg/hour, adjusted based on fluid balance and electrolyte levels, or adult dosing if appropriate.
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Dose Adjustments

Renal Impairment:

Mild: Use with caution; monitor fluid balance and electrolytes closely.
Moderate: Use with extreme caution; dosage must be significantly reduced or avoided due to risk of fluid overload, hyperkalemia, and hypernatremia. Close monitoring of fluid balance and electrolytes is essential.
Severe: Contraindicated or used with extreme caution and significant dose reduction; high risk of fluid overload, hyperkalemia, and hypernatremia. Consider alternative fluid management strategies.
Dialysis: Use with extreme caution; fluid and electrolyte needs are highly specific and depend on dialysis schedule and type. Consult nephrology.

Hepatic Impairment:

Mild: Use with caution; monitor fluid and electrolyte status closely.
Moderate: Use with caution; monitor fluid and electrolyte status closely, especially in patients with ascites or edema. Dextrose metabolism may be altered.
Severe: Use with caution; monitor fluid and electrolyte status closely, especially in patients with ascites or edema. Dextrose metabolism may be altered in severe hepatic dysfunction, potentially leading to hyperglycemia or hypoglycemia.

Pharmacology

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Mechanism of Action

Provides water, electrolytes (sodium, potassium, chloride), and calories (from dextrose) to maintain or restore fluid and electrolyte balance, and to provide a source of energy. Dextrose is metabolized to carbon dioxide and water, releasing energy. Sodium and chloride are essential for maintaining osmotic pressure, acid-base balance, and nerve/muscle function. Potassium is crucial for nerve impulse transmission, muscle contraction, and maintaining intracellular tonicity.
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Pharmacokinetics

Absorption:

Bioavailability: 100%
Tmax: Immediate (IV administration)
FoodEffect: Not applicable (IV administration)

Distribution:

Vd: Distributed throughout total body water (water, sodium, chloride); intracellular (potassium)
ProteinBinding: Not applicable (electrolytes and dextrose)
CnssPenetration: Yes (water, electrolytes, dextrose can cross blood-brain barrier)

Elimination:

HalfLife: Not applicable (components are continuously utilized or excreted)
Clearance: Primarily renal excretion for water and electrolytes; dextrose is metabolized.
ExcretionRoute: Renal (water, sodium, potassium, chloride); respiratory (CO2 from dextrose metabolism)
Unchanged: Not applicable (components are utilized or excreted)
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Pharmacodynamics

OnsetOfAction: Immediate
PeakEffect: Continuous during infusion, dependent on patient's homeostatic mechanisms
DurationOfAction: As long as infusion continues and depends on patient's homeostatic mechanisms

Safety & Warnings

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Side Effects

Urgent Side Effects: Seek Medical Help Right Away

While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
 Signs of fluid and electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain or weakness
+ Fast or abnormal heartbeat
+ Severe dizziness or passing out
+ Increased thirst
+ Seizures
+ Feeling very tired or weak
+ Decreased appetite
+ Unable to pass urine or change in the amount of urine produced
+ Dry mouth
+ Dry eyes
+ Severe upset stomach or vomiting
Signs of skin infection, such as:
+ Oozing
+ Heat
+ Swelling
+ Redness
+ Pain
 Swelling, warmth, numbness, change of color, or pain in a leg or arm
Chest pain or pressure
 Fever
Shortness of breath
 Sudden weight gain
Swelling in the arms or legs

Other Possible Side Effects

Like all medications, this drug can cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other unusual symptoms, contact your doctor for advice:

 Irritation or swelling at the injection site
* Pain at the injection site

This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
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Seek Immediate Medical Attention If You Experience:

  • Swelling in your hands, feet, or ankles (edema)
  • Difficulty breathing or shortness of breath
  • Rapid weight gain
  • Feeling confused or disoriented
  • Unusual muscle weakness or cramps
  • Feeling your heart beat irregularly or too fast (palpitations)
  • Excessive thirst or dry mouth
  • Dizziness or lightheadedness
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Before Using This Medicine

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about any allergies you have, including:
- An allergy to this medication or any of its components
- An allergy to other medications, foods, or substances
Please describe the allergy and the symptoms you experienced.

This medication may interact with other medications or health conditions. To ensure safe use, it is crucial to:
- Inform your doctor and pharmacist about all the medications you are taking, including:
- Prescription medications
- Over-the-counter (OTC) medications
- Natural products
- Vitamins
- Share information about your health problems
You must verify that it is safe to take this medication with all your current medications and health conditions.
Do not start, stop, or change the dose of any medication without first consulting your doctor.
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Precautions & Cautions

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

If your medication contains potassium, consult with your doctor before using any salt substitutes or products that have potassium in them.

For medications containing dextrose, if you have diabetes (high blood sugar), discuss this with your doctor to ensure safe use.

Regular blood tests are crucial as directed by your doctor. Be sure to discuss your test results with your doctor.

When administering this medication to newborns, exercise caution, as the risk of side effects may be increased in this age group.

If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. It is necessary to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
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Overdose Information

Overdose Symptoms:

  • Fluid overload (e.g., pulmonary edema, peripheral edema, heart failure)
  • Hyperkalemia (e.g., muscle weakness, paralysis, cardiac arrhythmias, ECG changes)
  • Hypernatremia (e.g., extreme thirst, confusion, lethargy, seizures, coma)
  • Hyperglycemia (e.g., increased urination, excessive thirst, dehydration, fatigue)

What to Do:

Immediate discontinuation of the infusion. Management is supportive and involves correcting the specific electrolyte or fluid imbalance (e.g., diuretics for fluid overload, insulin and glucose for hyperkalemia, specific electrolyte replacement or restriction). Severe cases may require dialysis. Seek immediate medical attention or call 911.

Drug Interactions

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Major Interactions

  • ACE inhibitors (e.g., lisinopril)
  • Angiotensin Receptor Blockers (ARBs) (e.g., valsartan)
  • Potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene)
  • Other potassium-containing medications or supplements
  • Corticosteroids (e.g., prednisone, hydrocortisone) - due to sodium retention
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Moderate Interactions

  • Insulin (can cause potassium shift into cells, potentially leading to hypokalemia if not monitored)
  • Digoxin (hypokalemia can potentiate digoxin toxicity, hyperkalemia can reduce digoxin effect)
  • Drugs affecting renal function (e.g., NSAIDs, cyclosporine, tacrolimus)
  • Other electrolyte-containing solutions
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Confidence Interactions

Monitoring

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Baseline Monitoring

Serum Electrolytes (Na, K, Cl)

Rationale: To establish baseline electrolyte status and identify pre-existing imbalances.

Timing: Prior to initiation of therapy.

Renal Function (BUN, Creatinine)

Rationale: To assess kidney's ability to excrete fluid and electrolytes.

Timing: Prior to initiation of therapy.

Blood Glucose

Rationale: To establish baseline glucose level, especially in diabetic patients.

Timing: Prior to initiation of therapy.

Fluid Status (Weight, Vital Signs, Edema assessment)

Rationale: To assess hydration status and risk of fluid overload.

Timing: Prior to initiation of therapy.

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Routine Monitoring

Serum Electrolytes (Na, K, Cl)

Frequency: Every 4-24 hours, or as clinically indicated, depending on patient's condition and infusion rate.

Target: Sodium: 135-145 mEq/L; Potassium: 3.5-5.0 mEq/L; Chloride: 98-107 mEq/L

Action Threshold: Values outside normal range; significant changes from baseline.

Blood Glucose

Frequency: Every 4-6 hours, or as clinically indicated, especially in diabetic patients or those at risk of hyperglycemia.

Target: 70-180 mg/dL (target may vary based on clinical context)

Action Threshold: Persistent hyperglycemia (>180 mg/dL) or hypoglycemia (<70 mg/dL).

Fluid Intake and Output (I&O)

Frequency: Every 4-8 hours, or continuously.

Target: Balanced I&O or appropriate deficit/surplus based on clinical goals.

Action Threshold: Significant positive or negative fluid balance, oliguria, or polyuria.

Vital Signs (BP, HR, RR)

Frequency: Every 4 hours, or as clinically indicated.

Target: Within patient's normal range.

Action Threshold: Changes indicative of fluid overload (e.g., hypertension, tachycardia, tachypnea) or dehydration (e.g., hypotension, tachycardia).

Daily Body Weight

Frequency: Daily

Target: Stable or desired change based on clinical goals.

Action Threshold: Rapid weight gain (>1-2 kg/day) or loss.

Signs of Fluid Overload/Dehydration

Frequency: Ongoing clinical assessment

Target: Absence of signs

Action Threshold: Presence of peripheral edema, pulmonary crackles, jugular venous distension, dry mucous membranes, decreased skin turgor.

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Symptom Monitoring

  • Peripheral edema (swelling in ankles, feet, hands)
  • Shortness of breath or difficulty breathing (dyspnea)
  • Cough
  • Rapid weight gain
  • Confusion or altered mental status
  • Muscle weakness or cramps
  • Irregular heartbeat (palpitations)
  • Excessive thirst
  • Dry mouth
  • Dizziness or lightheadedness

Special Patient Groups

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Pregnancy

Generally considered safe when clinically indicated to maintain fluid and electrolyte balance in pregnant women. However, careful monitoring of fluid status and electrolytes is essential to avoid fluid overload or electrolyte imbalances in both the mother and the fetus.

Trimester-Specific Risks:

First Trimester: Risks are primarily related to fluid and electrolyte disturbances, which can affect early fetal development if severe. Close monitoring is key.
Second Trimester: Risks are primarily related to fluid and electrolyte disturbances, which can affect placental perfusion or fetal development if severe. Close monitoring is key.
Third Trimester: Risks are primarily related to fluid and electrolyte disturbances, which can affect placental perfusion or fetal development if severe. Close monitoring is key, especially considering increased fluid volume in late pregnancy.
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Lactation

The components (water, sodium, potassium, chloride, dextrose) are endogenous and essential for normal physiological function. This solution is considered safe for use during lactation when clinically indicated. No known adverse effects on the breastfed infant are expected.

Infant Risk: L1 (Safest)
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Pediatric Use

Use with extreme caution. Pediatric patients, especially neonates and infants, have immature renal function, higher body surface area to volume ratio, and are more susceptible to rapid fluid shifts and electrolyte imbalances (e.g., hyponatremia, hyperkalemia, hyperglycemia). Dosing must be precisely calculated based on weight, age, and clinical status. Close monitoring of fluid balance, electrolytes, and glucose is critical.

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Geriatric Use

Use with caution. Elderly patients are more prone to fluid overload, electrolyte disturbances (e.g., hyperkalemia due to decreased renal function), and have reduced renal and cardiac reserve. Start with lower infusion rates and monitor fluid balance, electrolytes, and cardiac status closely. Assess for pre-existing conditions like heart failure or renal impairment.

Clinical Information

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Clinical Pearls

  • Always verify the exact formulation and concentration of the IV fluid before administration to prevent medication errors.
  • The infusion rate must be carefully controlled to avoid fluid overload, especially in patients with pre-existing cardiac, renal, or hepatic impairment.
  • Regular and frequent monitoring of serum electrolytes (sodium, potassium, chloride), blood glucose, renal function (BUN, creatinine), and fluid balance (intake and output, daily weights) is crucial.
  • Be vigilant for signs and symptoms of hyperkalemia (e.g., ECG changes, muscle weakness, paresthesias) and hypernatremia (e.g., thirst, confusion, seizures).
  • This solution provides minimal calories; for prolonged nutritional support, additional caloric sources or a more comprehensive parenteral nutrition regimen may be required.
  • Assess the patient's underlying condition and ongoing losses (e.g., vomiting, diarrhea, fever) to guide appropriate fluid and electrolyte replacement.
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Alternative Therapies

  • Oral rehydration solutions (for mild to moderate dehydration in conscious patients)
  • Enteral nutrition (tube feeding) for patients with a functional GI tract requiring nutritional support
  • Total Parenteral Nutrition (TPN) for complete nutritional support in patients unable to tolerate enteral feeding
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Cost & Coverage

Average Cost: $5 - $20 per 1000ml bag
Generic Available: Yes
Insurance Coverage: Covered by most insurance plans as a medical necessity when administered in a healthcare setting (hospital, clinic, home health).
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General Drug Facts

If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further guidance. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed to do so by a healthcare professional, do not flush medications down the toilet or pour them down the drain. If you are unsure about the proper disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek medical attention. Be prepared to provide information about the medication taken, the amount, and the time of ingestion.