glucose + magnesium chloride hexahydrate + potassium chloride + sodium acetate trihydrate + sodium chloride + sodium gluconate: clinical use

Prescribing considerations

• Assess fluid, electrolyte, glucose and acid–base requirements before selection.
• Use particular caution with cardiac, pulmonary or renal impairment, diabetes, hyperosmolar states, hypocalcaemia, myasthenia gravis, head injury or conditions causing sodium retention.
• It is not intended as primary treatment for severe metabolic acidosis, severe potassium deficiency or hypomagnesaemia.
• Account for the risk of fluid overload, hyperglycaemia, hyperkalaemia, hyponatraemia and metabolic alkalosis.
• A positive Bio-Rad Platelia Aspergillus EIA result may be false positive and requires confirmation.

Contraindications and cautions

• Hyperkalaemia
• Renal failure
• Heart block
• Metabolic or respiratory alkalosis
• Hypochlorhydria
• Uncompensated diabetes or other known glucose intolerance
• Hyperosmolar coma, hyperglycaemia or hyperlactataemia
• Hypersensitivity to an active substance or excipient

Monitoring

• Clinical fluid balance and signs of overhydration
• Blood glucose
• Serum and, where appropriate, urine electrolytes
• Acid–base status
• Infusion site and delivery equipment
• Closer glucose and electrolyte surveillance in neonates and children

Clinical pharmacology

A hyperosmotic electrolyte-and-glucose solution that expands extracellular fluid. Glucose provides carbohydrate, while acetate and gluconate are metabolised to bicarbonate and contribute an alkalinising effect.

Formulation and product differences

• The formulation contains glucose, sodium, potassium, magnesium, chloride, acetate and gluconate.
• It is hyperosmotic and should not be administered through a peripheral vein.
• It contains no calcium.
• It is supplied as a clear, single-use solution; partially used bags must not be reconnected.
• Compatibility and stability must be established before adding another medicine, and solutions containing additives should generally be used immediately.