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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