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Pot Chl/dextrose 5%/nacl0.45% Inj

Manufacturer B. BRAUN MCGAW Active Ingredient Intravenous (IV) Fluids(in truh VEE nuhs FLOO ids) Pronunciation POH-tass-ee-um KLOR-ide / DEX-trohs five per-SENT / SO-dee-um KLOR-ide point four-five per-SENT 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
Electrolyte Solution; Carbohydrate Solution; Hypotonic Saline Solution
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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 sugar (dextrose) for energy, and important salts (sodium, potassium, chloride) that your body needs to stay hydrated and for your nerves, muscles, and heart to work properly. It's used when you can't drink enough fluids or need extra salts and sugar.
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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

  • Report any unusual symptoms immediately to your healthcare provider.
  • Understand that this medication is given in a hospital or clinic setting and requires close monitoring by healthcare professionals.
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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, clinical condition, and laboratory values. Typically administered via continuous intravenous infusion.

Condition-Specific Dosing:

maintenance_fluid: Typically 20-40 mL/kg/day, adjusted for individual needs and electrolyte balance.
dehydration: Rate and volume depend on severity of dehydration and ongoing losses.
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Pediatric Dosing

Neonatal: Highly individualized based on weight, gestational age, fluid balance, and electrolyte status. Close monitoring required.
Infant: Highly individualized based on weight, fluid balance, and electrolyte status. Close monitoring required.
Child: Highly individualized based on weight, fluid balance, and electrolyte status. Close monitoring required.
Adolescent: Highly individualized based on weight, fluid balance, and electrolyte status. Close monitoring required.
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Dose Adjustments

Renal Impairment:

Mild: Use with caution; monitor electrolytes (especially potassium) and fluid balance closely.
Moderate: Reduce infusion rate and/or volume; monitor electrolytes (especially potassium) and fluid balance frequently. May require specific electrolyte adjustments.
Severe: Contraindicated in severe renal failure with anuria or oliguria due to risk of hyperkalemia and fluid overload. If used, extreme caution and continuous monitoring are required.
Dialysis: Contraindicated or used with extreme caution and close monitoring, as fluid and electrolyte balance are managed by dialysis. Consult nephrologist.

Hepatic Impairment:

Mild: Generally no specific dose adjustment required, but monitor fluid status and electrolytes due to potential for fluid retention.
Moderate: Monitor fluid status and electrolytes closely due to potential for fluid retention and electrolyte imbalances.
Severe: Monitor fluid status and electrolytes closely due to potential for fluid retention, ascites, and electrolyte imbalances. Adjust rate as needed to avoid fluid overload.

Pharmacology

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Mechanism of Action

This solution provides water, electrolytes (sodium, potassium, chloride), and calories (dextrose). Dextrose is metabolized to carbon dioxide and water, providing a source of energy and reducing protein catabolism. Sodium and chloride are essential for maintaining fluid and electrolyte balance, osmotic pressure, and acid-base balance. Potassium is a major intracellular cation critical for nerve impulse transmission, muscle contraction, and kidney function.
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Pharmacokinetics

Absorption:

Bioavailability: 100% (administered intravenously)
Tmax: Not applicable (continuous infusion)
FoodEffect: Not applicable (intravenous administration)

Distribution:

Vd: Distributed throughout total body water and extracellular fluid compartments (for water and electrolytes). Dextrose is distributed throughout the body and enters cells via glucose transporters.
ProteinBinding: Not applicable (electrolytes and dextrose do not significantly bind to plasma proteins in this context)
CnssPenetration: Yes (water, electrolytes, and glucose readily cross the blood-brain barrier)

Elimination:

HalfLife: Not applicable (components are continuously utilized or excreted)
Clearance: Renal excretion for water and electrolytes; metabolic clearance for dextrose.
ExcretionRoute: Renal (water, electrolytes); Respiratory (CO2 from dextrose metabolism)
Unchanged: Not applicable (components are either utilized or excreted)
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Pharmacodynamics

OnsetOfAction: Immediate (upon intravenous administration)
PeakEffect: Dependent on infusion rate and patient's metabolic needs
DurationOfAction: Continuous (as long as infusion is maintained and components are utilized/excreted)

Safety & Warnings

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Side Effects

Urgent Side Effects: Seek Medical Help Right Away

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

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 fainting
+ Increased thirst
+ Seizures
+ Feeling extremely tired or weak
+ Decreased appetite
+ Unable to pass urine or changes in urine production
+ Dry mouth
+ Dry eyes
+ Severe stomach upset or vomiting
Signs of skin infection, such as:
+ Oozing
+ Heat
+ Swelling
+ Redness
+ Pain
 Swelling, warmth, numbness, color changes, 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. While many people may not experience any side effects or only have mild ones, it's essential to discuss any concerns with your doctor. If you experience 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, don't hesitate to reach out to 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
  • Shortness of breath or difficulty breathing
  • Unusual thirst or dry mouth
  • Feeling very tired or weak
  • Confusion or dizziness
  • Irregular heartbeat
  • Muscle cramps or pain
  • Nausea or vomiting
  • Frequent urination or not urinating much
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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 the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
 All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor and pharmacist assess potential interactions between this medication and other substances you are taking.
* Any existing health problems, as this medication may interact with certain conditions.

To ensure your safety, it is crucial to verify that it is safe to take this medication with all your current medications and health conditions. Never start, stop, or adjust the dosage 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 your doctor before using any salt substitutes or products that also contain potassium.

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 while taking this medication. Follow your doctor's instructions for scheduling these tests and discuss the results with them.

When administering this medication to newborns, exercise caution due to a potentially higher risk of side effects in this age group.

If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. It is crucial to discuss the benefits and risks of this medication for 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, hypertension)
  • Hyperkalemia (e.g., muscle weakness, paresthesias, cardiac arrhythmias, cardiac arrest)
  • Hypernatremia (e.g., thirst, lethargy, confusion, seizures, coma)
  • Hyperglycemia (e.g., polyuria, polydipsia, dehydration, diabetic ketoacidosis in susceptible patients)

What to Do:

Immediate medical attention is required. Treatment involves discontinuing the infusion, administering diuretics for fluid overload, insulin for hyperglycemia, and specific treatments for electrolyte imbalances (e.g., calcium gluconate, insulin/glucose, sodium bicarbonate, or dialysis for severe hyperkalemia). Call 1-800-222-1222 (Poison Control).

Drug Interactions

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Contraindicated Interactions

  • Patients with known hypersensitivity to any component
  • Patients with severe hyperkalemia
  • Patients with severe hypernatremia
  • Patients with severe fluid overload or pulmonary edema
  • Patients with anuria or severe oliguria (due to potassium content)
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Major Interactions

  • Potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene): Increased risk of severe hyperkalemia.
  • ACE inhibitors (e.g., lisinopril, enalapril): Increased risk of hyperkalemia.
  • Angiotensin Receptor Blockers (ARBs) (e.g., valsartan, losartan): Increased risk of hyperkalemia.
  • Non-steroidal anti-inflammatory drugs (NSAIDs): May impair renal potassium excretion, increasing hyperkalemia risk.
  • Cyclosporine, Tacrolimus: May increase risk of hyperkalemia.
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Moderate Interactions

  • Corticosteroids: May cause sodium and fluid retention, potentially exacerbating fluid overload.
  • Insulin: May cause a shift of potassium into cells, potentially lowering serum potassium (though this solution contains potassium).
  • Digoxin: Hypokalemia can potentiate digoxin toxicity; hyperkalemia can reduce digoxin effects. Careful monitoring of potassium is crucial.

Monitoring

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Baseline Monitoring

Serum Electrolytes (Na, K, Cl)

Rationale: To establish baseline fluid and electrolyte status and guide initial infusion rate.

Timing: Prior to initiation of therapy

Renal Function (BUN, Creatinine)

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

Timing: Prior to initiation of therapy

Blood Glucose

Rationale: To establish baseline glucose level, especially in diabetic patients or those at risk of hyperglycemia.

Timing: Prior to initiation of therapy

Fluid Status (Intake/Output, Weight, Vital Signs, Physical Exam)

Rationale: To assess hydration status and identify signs of fluid overload or dehydration.

Timing: Prior to initiation of therapy

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Routine Monitoring

Serum Electrolytes (Na, K, Cl)

Frequency: Every 4-24 hours, depending on clinical stability and infusion rate.

Target: Within normal physiological limits (e.g., K: 3.5-5.0 mEq/L, Na: 135-145 mEq/L)

Action Threshold: Significant deviations from normal range or rapid changes; adjust infusion rate or add/remove specific electrolytes.

Blood Glucose

Frequency: Every 4-6 hours, or more frequently in diabetic patients or those with glucose intolerance.

Target: 70-180 mg/dL (target may vary based on patient condition)

Action Threshold: Persistent hyperglycemia (>180 mg/dL) or hypoglycemia (<70 mg/dL); adjust infusion rate or administer insulin/dextrose.

Renal Function (BUN, Creatinine)

Frequency: Daily or as clinically indicated.

Target: Stable or improving

Action Threshold: Worsening renal function; re-evaluate fluid and electrolyte management.

Fluid Status (Intake/Output, Weight, Vital Signs, Physical Exam)

Frequency: Every 4-8 hours or continuously.

Target: Stable weight, balanced I/O, absence of edema/dehydration signs

Action Threshold: Signs of fluid overload (e.g., edema, crackles, dyspnea, rapid weight gain) or dehydration (e.g., poor skin turgor, dry mucous membranes, orthostasis); adjust infusion rate.

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Symptom Monitoring

  • Signs of hyperkalemia (e.g., muscle weakness, paresthesias, fatigue, cardiac arrhythmias)
  • Signs of hypokalemia (e.g., muscle weakness, cramps, constipation, cardiac arrhythmias)
  • Signs of hypernatremia (e.g., thirst, lethargy, confusion, seizures)
  • Signs of hyponatremia (e.g., headache, nausea, confusion, seizures)
  • Signs of fluid overload (e.g., shortness of breath, swelling, weight gain)
  • Signs of hyperglycemia (e.g., polyuria, polydipsia, fatigue)
  • Signs of hypoglycemia (e.g., sweating, tremors, dizziness, confusion)

Special Patient Groups

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Pregnancy

Generally considered safe for use during pregnancy when clinically indicated for fluid, electrolyte, and caloric replacement, but close monitoring of fluid and electrolyte balance is essential. Category C due to the need for careful monitoring of potassium levels.

Trimester-Specific Risks:

First Trimester: No specific increased risk identified beyond general fluid/electrolyte management.
Second Trimester: No specific increased risk identified beyond general fluid/electrolyte management.
Third Trimester: No specific increased risk identified beyond general fluid/electrolyte management. Monitor for fluid overload, especially in pre-eclampsia.
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Lactation

Components (water, sodium, potassium, chloride, glucose) are natural constituents of breast milk and are essential for infant nutrition. Use is generally considered safe during lactation when clinically indicated, with no expected adverse effects on the breastfed infant.

Infant Risk: Low risk (L1)
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Pediatric Use

Pediatric patients, especially neonates and infants, have a higher proportion of total body water and immature renal function, making them more susceptible to fluid and electrolyte imbalances. Dosing must be highly individualized based on weight, age, clinical condition, and frequent monitoring of fluid status, electrolytes, and glucose.

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Geriatric Use

Geriatric patients may have age-related decreases in renal function, cardiac reserve, and altered fluid regulation, increasing their susceptibility to fluid overload, electrolyte imbalances (especially hyperkalemia), and hyperglycemia. Close monitoring of fluid status, electrolytes, and glucose is crucial, and lower infusion rates may be necessary.

Clinical Information

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Clinical Pearls

  • This solution is a maintenance fluid, not typically used for rapid volume resuscitation unless specifically indicated and monitored.
  • Always verify the correct concentration of potassium chloride before administration to prevent medication errors.
  • Monitor serum potassium levels closely, especially in patients with renal impairment, those on ACE inhibitors/ARBs, or potassium-sparing diuretics.
  • Monitor blood glucose levels, particularly in diabetic patients or those with stress-induced hyperglycemia.
  • Assess fluid status frequently (I&O, daily weights, physical exam) to prevent fluid overload or dehydration.
  • Administer via a controlled infusion device to ensure accurate delivery rate.
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Alternative Therapies

  • Oral rehydration solutions (for mild dehydration)
  • Other intravenous fluid combinations tailored to specific electrolyte or fluid deficits (e.g., Lactated Ringer's, Plasma-Lyte)
  • Specific electrolyte replacement (e.g., oral potassium supplements, IV potassium phosphate)
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Cost & Coverage

Average Cost: Varies widely by volume and manufacturer per bag (e.g., 1000 mL)
Generic Available: Yes
Insurance Coverage: Tier 1 (Generic)
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General Drug Facts

If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. 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 correct 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 call your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it occurred.