- PLADEXSAL 1/5

4.3% Dextrose and 0.18% Sodium Chloride Intravenous Infusion B.P.)
 
Therapeutic Class
 

• Crystalloid   solution   with   carbohydrate source.

 
Description and Composition
 
A clear, colorless solution, each 1000 ml. of which contains:
 
Dextrose Monohydrate equivalent
Or Anhydrous Dextrose B.P.                       43.0 grams
Sodium Chloride B.P.                                 1.80 grams
Water for Injections                                     q.s.
 
Pharmacological Effects
 

• Pladexsal 1/5 has an electrolyte composition of sodium and chloride approximately 1/5 and 1/3 of plasma respectively.
• Supplies body water for hydration.
• Provides 810 ml. of Free Water/Liter of solution.
• Provides the following electrolytes in each liter of fluid:

 
Sodium                                    30 mEq.
Chloride                                   30 mEq.
 

• Provides calories for some metabolic needs. Each 100mL provides 5 grams of Dextrose and each gram of Dextrose Monohydrate provides 3.4kCal. Depending on the presence of insulin, glucose enters cells and is broken down to pyruvate. With adequate oxygen, it enters the Kreb's cycle in the mitochondria and is converted into energy (A.T.P.), CO2 and H2O. The brain does not require insulin for glucose metabolism.
• The pH range is 3.5 - 6.5.

 
Indications
 

• Hypovolemic states including dehydration.
• Recommended as an initial solution for rehydration, for the supply of water and electrolytes in neonates and infants.
• Used to supply or replenish water and electrolytes before, during and after surgery particularly in neonates and infants.

• Indicated for the supply or replenishment of water and electrolytes in cases of possible potassium retention such as anuria, oliguria, hyperkalemia, and increased BUN, particularly in neonates and infants.

 
Dosage and Administration
 
The dose is dependent upon the age, weight and clinical condition of the patient. The infusion rate should be adjusted to provide 300-500 ml/hour (about 75-125 drops/minute) for adults and 50-100 ml/hour (about 12-25 drops/minute) for children.
 
In neonates and pre-term babies’ infusion of more than 100 ml/hour should be avoided.
 
Duration of Action and Excretion
 
Passes out of the blood stream quite rapidly, especially when normal renal function and renal blood flow are present.
 
Adverse Effects
 

• Fluid overload.
• Water intoxication may occur if infused rapidly or in large amounts.
• Congestive heart failure.
• Hyperglycemia

 
Contraindications
 

• Congestive heart failure.
• Renal failure.
• Elevated blood glucose concentration.

 
Precautions
 

• Care is required in patients with cardiac failure, renal failure and in cases where salt intake is restricted as the solution contains sodium chloride 1.8 grams/Liter.
• Care is required in diabetics.
• Monitor E.C.G. continuously.
• Frequently monitor blood pressure, pulse rate and respiratory rate.
• Frequently auscultate breath sounds for rales.