Dexoride

Approved Indications:

• Fluid and Electrolyte Replenishment
  · Treatment of isotonic, hypotonic, or hypertonic dehydration from causes such as diarrhea, vomiting, burns, or surgery
• Maintenance Fluid Therapy
  · In perioperative and critical care settings to sustain fluid volume, electrolytes, and caloric needs
• Hypoglycemia Correction
  · Use of dextrose-containing solutions to prevent or treat mild to moderate hypoglycemia
• Intravenous Diluent
  · Vehicle for IV medication delivery and parenteral nutrition base fluid

Off-label / Clinically Accepted Uses:

• Severe Hyperemesis Gravidarum
  · Managing electrolyte imbalance and caloric deficit
• Combined Fluid-Calorie Maintenance
  · In post-surgical, trauma, or ICU patients needing both hydration and energy

Formulation Examples:

• 0.9% NaCl + 5% Dextrose
• 0.45% NaCl + 10% Dextrose
• 3% NaCl + 5% Dextrose (selective use)

Adults:

• Maintenance – typically 25–35 mL/kg/day, adjusted per fluid balance
• Hypoglycemia / Mild Dehydration – 500–1000 mL over 2–4 hours

Pediatrics:

• Maintenance – ~100 mL/kg/day (10 kg) + 50 mL/kg/day (next 10 kg) + 20 mL/kg/day (>20 kg); adjust sodium/dextrose based on needs

Neonates:

• Lower concentrations preferred; dosed carefully according to body weight and glucose monitoring

Special Populations:

• Renal impairment: reduce volume; monitor electrolytes and fluid status
• Hepatic impairment: monitor glucose tolerance and adjust rate

Administration Route:

• IV infusion via peripheral or central line
• Rate based on patient’s fluid status and comorbidity profile

Sodium and chloride ions restore extracellular fluid volume and osmotic balance, supporting circulatory stability. Dextrose is a rapid source of glucose, preventing catabolism, maintaining blood sugar, and serving as energy during states of inadequate intake. Combined, they correct dehydration, replenish electrolytes, and sustain metabolic needs in patients unable to take oral intake.

• Absorption / Distribution: Immediate systemic availability upon IV infusion; sodium and chloride remain in extracellular fluid; dextrose distributes into total body water
• Metabolism: Dextrose undergoes glycolysis to glucose-6-phosphate, entering cellular metabolic pathways
• Elimination:
  · Sodium and chloride – excreted by kidney under homeostatic control
  · Dextrose – metabolized; unused glucose excreted by kidneys
• Onset: Immediate
• Half-Life: Not defined; dependent on infusion, metabolism, and excretion rates

• Pregnancy: Considered safe; monitor for fluid overload in preeclampsia
• Lactation: Safe; non-teratogenic and no significant entry into breastmilk when used intravenously

• Primary Class: Crystalloid IV Fluid
• Subclass: Electrolyte + Caloric Parenteral Solution

• Known hypersensitivity to components
• Hypernatremia or hyperchloremia
• Hyperglycemia / uncontrolled diabetes
• Volume overload conditions: congestive heart failure, renal failure without precise monitoring
• Anuria without dialysis

• Use caution in patients with heart, liver, or kidney impairment
• Monitor serum electrolytes, glucose, and fluid balance
• Avoid rapid infusion that may cause fluid overload or hyperosmolar states
• Discontinue if signs of pulmonary edema or CHF appear
• Ensure IV access patency and avoid extravasation

Common:

• Phlebitis, infusion pain, transient hyperglycemia, mild electrolyte shifts

Less Common:

• Fluid overload, peripheral or pulmonary edema

Serious (rare):

• Osmotic diuresis, electrolyte derangements (hypernatremia, hyperchloremic acidosis), hyperglycemia-induced osmolarity increases

• Corticosteroids/Mineralocorticoids: May increase sodium retention and fluid balance
• Diuretics/Antihypertensives: Require careful titration to avoid osmolar and electrolyte shifts
• Insulin: Essential when infusing dextrose to manage hyperglycemia
• Lithium: Sodium levels may reduce lithium retention, risking subtherapeutic levels or increased clearance
• Nephrotoxic Medications: Combined use with fluids requires close monitoring

• Fluid Therapy Protocols: Shift toward balanced crystalloid solutions to prevent hyperchloremic acidosis
• Pediatric Guidelines: Emphasis on individualized dosing for glucose + electrolytes
• Obstetrics: Use in hyperemesis gravidarum with monitored electrolyte and glucose correction

• Temperature: Store at 20–25 °C; avoid extremes
• Do Not Freeze: Discard if frozen
• Protect: Light and contamination
• Single-Use Vials: Use once; discard any unused portion
• Inspection: Ensure solution is clear and container intact before use