5% dextrose

5% Dextrose Solution (D5W) is a type of intravenous therapy that provides water, glucose, and calories to the body. It is a sterile, nonpyrogenic solution for fluid replenishment and caloric supply in single dose containers for intravenous administration. It contains no antimicrobial agents. The nominal pH is 4.0 (3.2 to 6.5).

Composition

5% Dextrose Solution is a hypertonic solution of dextrose in water. It contains 50 grams of dextrose monohydrate per liter of water, which is equivalent to a 5% concentration. The osmolarity of D5W is approximately 252 mOsmol/L, making it isotonic with the body's blood plasma when it is prepared. However, once administered, it becomes hypotonic as the dextrose is quickly metabolized, leaving free water to be absorbed by the body.

Uses

D5W is used in the medical field for several purposes:

• As a source of water and calories for patients who are unable to consume food or water by mouth.
• To dilute other medications for intravenous administration.
• In the treatment of hypernatremia (high sodium levels in the blood) as it helps to dilute the sodium in the body.
• As a part of the treatment for ketosis or diabetic ketoacidosis when combined with insulin therapy, as it provides necessary glucose to the body.

Administration

D5W is administered intravenously, usually through a vein in the arm. The rate of administration depends on the patient's age, weight, clinical condition, and fluid and electrolyte balance. Care must be taken to monitor the patient's blood glucose levels, especially in those with diabetes mellitus, as the dextrose can cause hyperglycemia.

Precautions

While D5W is generally safe, there are precautions to consider:

• Overuse can lead to water intoxication, especially if the kidneys are not functioning properly, leading to hyponatremia (low sodium levels).
• Patients with a known hypersensitivity to corn or corn products (from which dextrose is derived) should avoid D5W.
• Caution should be exercised in patients with impaired kidney function or in those with conditions that may be exacerbated by fluid overload.

Side Effects

Possible side effects of D5W administration include:

• Hyperglycemia (high blood sugar)
• Hyponatremia (low sodium levels)
• Fluid overload, leading to edema or heart failure
• Vein irritation or phlebitis at the site of infusion

Conclusion

5% Dextrose Solution is a versatile and commonly used intravenous solution in the medical field. Its primary uses include providing hydration, calories, and a medium for diluting medications for IV use. While generally safe, it requires careful monitoring to avoid potential complications.