Core pharmacology

Class Group

Crystalloid

Legacy Cicm Level

Level 1

Introduction

intravenous fluid with 50g glucose in litre of sterile water.

Hypotonic solution

Indications Uses

1. Maintenance fluid and caloric supply in cases of hypoglycaemia or starvation
2. Fluid replacement along with Insulin in DKA/HHS states
3. Fluid replacement in hypernatremic/ hyperosmolar states

Presentation

500 or 1000mls of 5% glucose in a collapsible plastic flask or bag

Mechanism of action

Glucose replacement
Immediately taken up into ISF and Intracellular spaces

Adverse Effects Toxicity

Fluid overload (less than dextrose)
Cerebral edema
Hyperglycaemia
Electrolyte imbalances (hypokalemia,Mg,P)
Extravasation/ Vein irritation / tissue necrosis
Severe dehydration if given in diabetics without insulin

Absorption

IV. BA 100%

Distribution

ICF 670mls
ECF 330mls (with ISF 250mls and plasma 80mls).

Metabolism

Dextrose is taken into cells and potentially metabolized by multiple pathways, depending on:
- Nutritional state
- Catabolic or anabolic state
- Insulin resistance/DM

Excretion

Water is excreted via kidney

Special Points

pH 3.5-6.5
Osm 278

Dextrose penetrates the cells so easily, it cannot contribute to tonicity