5% dextrose

Class	Crystalloid fluid
Chemistry	Isotonic disaccharide solution
Routes of administration	IV only, though theoretically also orally
Absorption	100% oral bioavailability; well absorbed
Solubility	pKa = 12.9; good water solubility; in solution the dextrose is in an non-ionised state
Distribution	VOD =0.6L/kg, distributed widely into total body water (thus: 8% remains intravascular, 26% becomes interstitial fluid and 66% becomes intracellular)
Metabolism	Metabolised extensively by all body tissues, but especially by the liver
Elimination	Metabolites are water and CO2, which are eliminated by the kidneys and lungs, respectively
Time course of action	"Half-life" of the volume expansion effect is perhaps 15-20 minutes in healthy volunteers. Dextrose itself
Target receptor	GLUT family of glucose transporter proteins
Mechanism of action	Expands the extracellular fluid volume and changes the biochemistry of the body fluids
Clinical effects	Volume expansion: - by 8% of the infused volume, after 15-20 minutes - below the circulatory reflex activation threshold Change in osmolality: - approximately 2.5%, i.e. same as from the ingestion of tap water - sensed by OVLT osmosensor; leads to decreased vasopressin release and subsequent diuresis Change in biochemistry: - dilutional sodium drop (~4 mmol/L) - this will be noticed by sodium conservation systems such as the angiotensin and aldosterone systems - decrease in bicarbonate and base excess (also up to 3 mmol/L) because this is a fluid with zero SID Metabolic changes: - the dextrose will be metabolised to produce enrgy, with a total gain of 198 calories
Literature reference	Griffel and Kaufman (1992)
CICM details of understanding	Level 1
Mentioned around Deranged Physiology	Solutions of dextrose: 5%, 10% and 50% concentrations; also Response to 1L of 5% dextrose. Affiliated with Control of blood glucose and therefore Pharmacology of insulin preparations and glucagon.
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