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PLABOLYTE-40
(5% Dextrose and 3% Potassium Chloride Injection U.S.P.)
Therapeutic Class
Crystalloid solution with a carbohydrate source.
Description and Composition
A clear, colorless solution each 1000 ml. of which contains:
Dextrose Monohydrate U.S.P. 50.0 grams
Potassium Chloride U.S.P. 3.0 grams
Water for Injections q.s.
Pharmacological Effects
- Plabolyte-40 is a maintenance solution with a high amount of potassium in a homogenized form.
- Supplies water and potassium to fulfill daily requirements.
- 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.
- Spares body protein by providing carbohydrate for metabolism.
- Provides the following electrolytes in each liter of fluid:
Potassium 40 mEq.
Chloride 40 mEq.
- Osmolarity of Plabolyte-40 is 333 mOsm/L. The fluid is hypotonic but hyperosmolar.
- The pH range is 3.5 – 6.5.
Indications
- Recommended in conditions that require administration of high amounts of potassium along with dextrose as an energy source.
- Especially useful in late post-operative period to supplement the daily requirements of water, potassium and energy.
Dosage and Administration
The dose is dependent upon the age, weight, and clinical condition of the patient. The rate of infusion should be adjusted to provide 10 mEq/hour of potassium. In urgent situations the rate may be increased to 40 mEq/hour, under cardiac monitoring.
For non-diabetics, the infusion rate of dextrose should not exceed 4mg/kg/minute. At this rate the hepatic glucose production is minimized and peripheral glucose uptake maximized.
Duration of Action and Excretion
- Glucose use depends on metabolic rate. It is stored in the liver and muscle as glycogen.
- Water use depends on clinical state of patient, body temperature and renal function. Excreted through the skin, lungs, and kidneys.
Adverse Effects
- Fluid overload.
- Water intoxication may occur if infused rapidly or in large amounts.
- Hyperglycemia.
- Hyperkalemia.
Contraindications
- Patients with hyperkalemia.
- Renal failure
- Elevated blood glucose concentrations.
Precautions
- To avoid hyperkalemia, it is advisable to use the solution only when the urine output is more than 500 ml/24 hours or more than 20 ml/hour.
- In non-urgent situations the rate of potassium administration should not exceed 10 mEq/hour. In urgent conditions the rate may be increased up to 40 mEq/hour. In this circumstance cardiac monitoring is advisable.
- The solution should be used with care in patients with renal failure, oliguria, or azotemia.
- Care is required in patients with Addisons Disease without hyperkalemia.
- Caution should be exercised in severe burns without hyperkalemia, in cardiac failure and in diabetics.
- Monitoring of serum electrolytes and blood sugar levels is recommended during therapy.
- Since the tonicity is low, avoid using in head injury patients.
- Use sterile technique in venipuncture and equipment assembly.
- Monitor E.C.G. continuously.
- Monitor blood pressure, pulse rate and respiratory rate frequently.
Osmolarity and Tonicity
Hypotonic solution, having a tonicity of 40.
Slightly hyper-osmolar solution (333 mOsm/L)
Caloric Value
170 kCal/Liter
Pharmaceutical Precautions
- Store at room temperature. Protect from sunlight.
- Do not use if bottle is leaking, solution is cloudy or contains foreign matter.
- Discard unused portion.
- Keep all medicines out of the reach of children.
Packaging
- 500ml and 1000ml in Plabottle.
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