Solutions

Dextrose Solution (D5W) 5%
Pharmacological Effects
• Provides calories for some metabolic needs. Each 100 mL provides 5 gm of Dextrose. 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 and gonads do not require insulin for glucose metabolism.
• Supplies body water for hydration.
• Spares body protein by providing carbohydrate for metabolism.
• Osmolarity of D5W is 252 mOsm/L. The fluid is isotonic when in the container. After administration, the dextrose is quickly metabolized in the body, leaving only water - a hypotonic fluid.
• The pH range is 3.5 - 6.5.
• Capable of producing diuresis depending on clinical state of the patient.
• Also used as diluent.

Side Effects
• Hyperglycemia. Include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor
• Fluid overload. Swelling of ankles/feet.
• Symptoms of a serious allergic reaction may include: rash, itching, swelling, severe dizziness, trouble breathing.

Contraindications
• Patients at risk for increased intracranial pressure.
• Patients who have an acute neurological dysfunction.
• Hypovolemic states.
• Patients at risk for third-space fluid shifts.
• Elevated blood glucose concentrations.

0.9% Saline Solution
Side Effects
• Metabolic acidosis when administered in sufficiently large quantities.
• Fluid overload. Swelling of ankles/feet.

Contraindications
• heart problems (e.g., congestive heart failure)
• lung problems (pulmonary edema)
• kidney problems
• low levels of potassium (hypokalemia)
• high levels of sodium (hypernatremia)
• swelling (edema)
• allergies.

Hartmann Solution – Sodium Lactate (different from ringer solution, uses bicarbonate)
Side Effects
• Contains Ca++ and this can cause problems if administered with stored blood. Citrate=anticoagulant (Ca++ dissolves citrate causes lost of anti-coagulablity)
• Fluid overload. Swelling of ankles/feet.
• Symptoms of a serious allergic reaction may include: rash, itching, swelling, severe dizziness, trouble breathing.

Contraindications
• Hartmann's solution is said to be contraindicated in patients with diabetes mellitus, as one of the isomers of lactate is gluconeogenic