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In Patient Pharmacy Lab
Week 5 – Introduction to Drugs and IV Solutions
The following is a list of intravenous fluids, their osmolality and considerations:
Solution
Osmolality
Usage and Limitations
isotonic (252
mOsm/L)
provides free water (hypotonic) to the
extracellular and intracellular spaces,
as the dextrose is quickly metabolized;
promotes renal elimination of solutes;
treats hypernatremia; does not provide
electrolytes; one liter is 170 calories
hypertonic (505
mOsm/L)
osmotic diuretic; provides free water
and 340 calories per liter, but no
electrolytes; hypertonic solutions may
irritate the veins
D20W - 20% Dextrose in
water
hypertonic (1011
mOsm/L)
osmotic diuretic; provides calories, but
no electrolytes; solutions containing
more than 10% dextrose must be
infused in a central line
D50W - 50% Dextrose in
water
hypertonic (1700
mOsm/L)
osmotic diuretic; provides calories, but
no electrolytes
D5 1/4 NS - 5% Dextrose &
0.2NaCl
isotonic (320
mOsm/L)
for daily maintenance of body fluids
when Cl and Na are required; treats
hypernatremia; replaces hypotonic
losses; 170 calories pre liter
D5 1/2 NS - 5% Dextrose &
0.45NaCl
hypertonic (406
mOsm/L)
to promote renal function and
excretion; basically the same as .45NS
except provides 170 calories per liter
D5NS - 5% Dextrose &
0.9NaCl
hypertonic (559
mOsm/L)
to treat fluid volume deficit; for daily
maintenance of body fluids and
nutrition; basically the same as NS,
except provides 170 calories per liter
D10NS - 10% Dextrose &
0.9NaCl
hypertonic (812
mOsm/L)
to replace calories, fluid, sodium and
chloride
D5W - 5% Dextrose in water
D10W - 10% Dextrose in
water
hypotonic (154
mOsm/L)
assists with renal function; provides
free water, Na and Cl.; replaces
normal hypotonic daily fluid lossesassists with daily body fluid needs, but
not with electrolyte replacement or
provision of calories.
isotonic
(308mOsm/L)
replaces NaCl deficit and
restores/expands extracellular fluid
volume; the only solution that may
be administered with blood
products--does not provide free water
that causes hemolysis of red blood
cells
hypertonic (1026
mOsm/L)
raises Na osmolality in the blood;
removes excess intracellular fluid;
infuse slowly; monitor for pulmonary
edema and intravascular volume
overload
isotonic (309
mOsm/L)
replaces K, Na, Cl. and Ca.; does not
contain lactate, which can be harmful
to those who are unable to metabolize
lactic acid; does not provide free water
Lactated Ringer’s Solution
isotonic (273
mOsm/L)
closely resemble the electrolyte
composition of normal blood serum
and plasma; will need additional K;
does not provide calories or free
water; used to treat losses from lower
GI tract and burns.
D5LR - 5% Dextrose in
Lactated Ringers
hypertonic (524
mOsm/L)
same as Lactated Ringers, plus
calories
D10LR - 10% Dextrose in
Lactated Ringers
hypertonic (776
mOsm/L)
same as Lactated Ringers, plus extra
calories
10% Dextran 40 in 5%
Dextrose
isotonic (252
mOsm/L)
plasma expander
10% Dextran 40 in 0.9%NS
isotonic (308
mOsm/L)
plasma expander
1/2 NS - 0.45%NaCl
NS - 0.9% NaCl
3%NS
Ringer’s Solution
hypertonic (1114
mOsm/L)
depressant diuretic effects, provides
calories
8% Amino Acids
hypertonic (950
mOsm/L)
provides protein in varying
percentages; assists with tissue repair
and to correct negative nitrogen
balance
Intralipids 10%
isotonic (280-300
mOsm/L)
provides fatty acids and calories
Intralipids 20%
isotonic (330 - 340
mOsm/L)
provides calories and fatty acids;
contraindicated in patients with liver
damage or altered fat metabolism
5% Alcohol in 5% Dextrose