Bedside Snapshot

Use It For
Free-water replacement in hypernatremia; re-lowering Na⁺ after overcorrected hyponatremia; drug diluent and carrier; dextrose source in DKA (with saline)
Adult Dose
  • Hypernatremia: per free-water deficit IV, ≤0.5 mEq/L/hr (max 10 mEq/L/24 hr)
  • Re-lowering (specialist-directed): 2–4 mL/kg/hr IV over 4 hr with desmopressin
  • DKA: add dextrose 5–10% when glucose <250 mg/dL
Pediatric Dose
Hypernatremia: per free-water deficit IV, ≤0.5 mEq/L/hr (max 10 mEq/L/24 hr), specialist-guided. DKA: dextrose goes in the saline fluid, not as D5W. Never for boluses or maintenance
Onset / Duration
IV: immediate / volume-based (lasts while infused); the dextrose is metabolized, leaving free water
Do Not Give / Hold If
Significant hyperglycemia; hyponatremia or high risk (SIADH, postop) unless specialist-directed re-lowering; acute brain injury or raised ICP (maintenance or resuscitation); shock or hemorrhage bolus; same line as blood
Watch For
Hyponatremia (headache, vomiting, confusion: STAT Na⁺); hyperglycemia (glucose checks); fluid overload (crackles, falling SpO₂); low K⁺ or phosphate
Reversal / Rescue
No antidote: stop the infusion. Severe symptomatic hyponatremia: 3% saline IV bolus, adults 100 mL over 10 min (up to 3), children 2 mL/kg over 10 min (max 100 mL; Moritz & Ayus 2010); hyperglycemia: insulin
Must Remember
D5W is free water, not volume: only a small fraction per liter stays in the vessels. Never bolus it for shock; never use it as maintenance in children or after brain injury

Indications

ED / ICU / Transport

  • Hypernatremia: free-water replacement. Use it when enteral water is not possible or not enough. When the gut works, enteral water is the better choice because it skips the glucose load.
  • Overcorrected hyponatremia: re-lowering serum sodium (Na⁺) after a rise beyond the 24-hr limit. This is usually done with desmopressin and nephrology input.
  • Diabetic ketoacidosis (DKA): add dextrose to the IV fluids once glucose falls below 250 mg/dL. It lets insulin keep running until the ketoacidosis resolves (see insulin). In euglycemic DKA (glucose <200 mg/dL, e.g. SGLT2 inhibitors or pregnancy), the dextrose-containing fluid starts with the saline and insulin from the outset. D5W alone is not the DKA fluid. It has no sodium.
  • Drug diluent and carrier: for some drugs, D5W is the required or preferred diluent (liposomal amphotericin B, amiodarone infusions). Many premixed infusions also come in D5W, including heparin, milrinone and magnesium sulfate.
  • Interfacility transfer: the bag runs as a free-water infusion, or it carries a drip.

Other Uses

  • Source of water and calories: labeled for adults and children. 1 L gives only 170 kcal. That is not nutrition.
  • Not indicated: not as a shock, hemorrhage or dehydration bolus. Not as maintenance fluid in children or after acute brain injury. Not as the sole maintenance fluid in most adults, because of hyponatremia risk: use a sodium-containing fluid unless there is a specific free-water need. Not for hypoglycemia rescue. It is too dilute: use D10W or D50W.

Composition
ComponentPer LiterComparison to Plasma
Dextrose (hydrous)
50 g (5 g/100 mL; 50 mg/mL)
Normal fasting plasma glucose is about 0.7–1 g/L (70–100 mg/dL)
Calories
170 kcal (3.4 kcal/g)
—
Na⁺ / Cl⁻
0 / 0 mEq
Na⁺ 135–145 mEq/L; Cl⁻ 96–106 mEq/L
K⁺, Ca²⁺, Mg²⁺, buffer
None
—
Osmolarity
252 mOsm/L (calculated)
Serum osmolality 275–295 mOsm/kg
pH
4.0 (Baxter) or 4.3 (ICU Medical); range 3.2–6.5
7.35–7.45
Tonicity
Slightly hypo-osmolar in the bag; hypotonic in the body once the dextrose enters cells
Delivers free water
  • Free water: The body takes up the dextrose and oxidizes it to CO₂ and water. Each liter acts as about 1 L of electrolyte-free water.
  • Where it goes: The water spreads across total body water, and about two-thirds of it goes into cells. Only a small fraction of each liter stays in the plasma. That is why it does not support blood pressure.
  • Why it matters: Water that enters cells dilutes the Na⁺ and swells brain cells. That swelling is the basis of hyponatremic encephalopathy, and the reason to avoid D5W after brain injury.
  • Products: The numbers above are US values. The dextrose is corn-derived. Outside the US, the same fluid is labeled 5% glucose.

Dosing & Administration

Doses vary by protocol; follow local protocols and medical direction.

Available Forms

  • Flexible bags: 50 mg/mL (5 g/100 mL) in 25, 50, 100, 250, 500 and 1,000 mL single-dose bags. 1,000 mL = 50 g dextrose, 170 kcal. The small partial-fill bags are the ones for drug admixture.
  • Premixed drugs in D5W: heparin, milrinone, magnesium sulfate and others. Their volume counts as free water too.
  • Look-alikes: D10W, D50W, D5 in 0.45% or 0.9% sodium chloride, and D5 in lactated Ringer's. Read the full label.

Adult Dosing

IndicationDose & RouteRepeat / MaxNotes
Hypernatremia (chronic or unknown duration)
Restore volume with isotonic crystalloid first if hypovolemic or in shock. Then per free-water deficit, as an IV infusion over 48 hr or more, plus ongoing free-water losses; set and adjust the rate from repeat Na⁺ values
Lower Na⁺ by ≤0.5 mEq/L/hr (max 10 mEq/L/24 hr)
D5W replaces pure water deficits (diabetes insipidus, insensible losses); combined sodium and water losses (GI losses, osmotic diuresis) usually need a sodium-containing hypotonic fluid such as 0.45% saline. Expert-opinion limit; confirm the institutional target. Known acute onset (<48 hr): faster correction per specialist
Overcorrected hyponatremia (re-lowering)
2–4 mL/kg/hr IV over 4 hr, usually with desmopressin IV or subcut (nephrology-directed; dosing varies by protocol: 1–3 mcg every 8–12 hr, or 2–4 mcg every 6–8 hr)
Repeat if Na⁺ is not falling about 1 mEq/L/hr; aim back under the 24-hr limit. Limits differ: US expert panel 10 mEq/L in 24 hr (8 mEq/L if high ODS risk); European 2024 standard no more than 8 mEq/L in any 24 hr. Follow the nephrology plan
ODS = osmotic demyelination syndrome. High risk: starting Na⁺ ≤105 mEq/L, hypokalemia, alcohol use disorder, malnutrition, liver disease
DKA, glucose <250 mg/dL
Add dextrose 5–10% to the IV fluids while the insulin infusion continues
Adjust insulin and dextrose to keep glucose around 200 mg/dL until ketoacidosis resolves
Dextrose is given with sodium-containing fluid; plain D5W adds free water only. Euglycemic DKA (SGLT2 inhibitors, pregnancy): start 5–10% dextrose with the saline and insulin from the outset
Drug diluent or carrier
Volume per the drug label (e.g. liposomal amphotericin B at 1–2 mg/mL in D5W)
Count carrier and flush volume in daily fluid and free-water totals
Amiodarone infusions exceeding 2 hr: D5W in glass or polyolefin bottles

Pediatric Dosing

IndicationDose (per kg) & RouteMax Single / Max TotalNotes
Hypernatremia (specialist-guided)
Per free-water deficit, as an IV infusion, after isotonic resuscitation of any shock
Lower Na⁺ by ≤0.5 mEq/L/hr (max 10 mEq/L/24 hr)
D5W replaces pure water deficits such as diabetes insipidus; hypernatremic dehydration is usually rehydrated with a sodium-containing fluid with dextrose per specialist. Cerebral edema and seizures from rapid correction are reported mainly in infants and children with hypernatremic dehydration; check Na⁺ frequently
DKA
Add 5% dextrose to the sodium-containing rehydration fluid when glucose falls to about 250–300 mg/dL, or sooner if it falls faster than about 90 mg/dL/hr after the initial fluid expansion; the insulin infusion continues
10% or even 12.5% dextrose may be needed to keep insulin running until acidosis resolves
Per the ISPAD 2022 pediatric guideline, which differs from the adult <250 mg/dL rule; plain D5W is not the DKA fluid. Follow the PICU or local DKA protocol
Maintenance IV fluid (28 days–18 yr)
Not recommended: use isotonic fluid with KCl and dextrose per the AAP guideline
—
Hypotonic maintenance fluid raises the risk of hyponatremia
Shock or dehydration bolus
Contraindicated: give isotonic crystalloid boluses
—
See normal saline or lactated Ringer's
Drug diluent or carrier
Volume per the drug label; lower concentrations (e.g. liposomal amphotericin B 0.2–0.5 mg/mL) give infants enough volume
Count carrier volume toward the mL/kg/day total
Use a syringe pump for small volumes

See weight-based dosing.

Preparation & Administration

  • Line: A peripheral IV is acceptable. D5W runs 252 mOsm/L, and the usual peripheral limit is a final osmolarity under about 900 mOsm/L. That limit matters once drugs are added. IV only.
  • Pump: run free-water and re-lowering infusions on a pump with a set rate and volume limit, never by gravity
  • Blood products: never through the same set (pseudoagglutination or hemolysis); with a single line, flush with normal saline before and after the transfusion
  • Air embolism: use a non-vented set (or close the vent), never connect flexible bags in series, avoid pressure bags unless all air is evacuated first, and stop the pump before the bag empties
  • Additives: confirm solubility and stability at pH 3.2–6.5, mix well, inspect for precipitate, use promptly and do not store
  • Tubing: replace the administration set at least every 24 hr, as the manufacturer label says. For blood and lipid lines, follow local policy.
Dosing Notes:
  • Free-water deficit (L): TBW × (Na⁺ ÷ 140 − 1). TBW (total body water) is weight (kg) × 0.6 for men and children, × 0.5 for women and older men, and × 0.45 for older women
  • Expected change per liter of D5W: ΔNa⁺ ≈ −serum Na⁺ ÷ (TBW + 1). Use it as a quick bedside estimate
  • Example: Take a 70 kg man with Na⁺ 160 mEq/L. His TBW is 42 L, so the deficit is about 6 L. Each liter of D5W drops Na⁺ by about 3.7 mEq/L. Keep the fall within 10 mEq/L in 24 hr: no more than about 2.7 L of D5W (about 110 mL/hr), plus measured ongoing losses in the first 24 hr. The full deficit takes 48 hr or more to replace.
  • Estimates only: Urine, stool, drain and insensible losses keep moving. Recheck Na⁺ and recalculate.

Contraindications & Precautions

Contraindications

  • Clinically significant hyperglycemia (label)
  • Known hypersensitivity to dextrose (label)
  • Contraindicated as a resuscitation or maintenance fluid in acute brain injury: TBI, stroke, intracranial hemorrhage, raised ICP. The ESICM guideline makes a strong recommendation against it. For diabetes insipidus after brain injury, free-water replacement is specialist-directed
  • Boluses for shock, hemorrhage or dehydration, in any age (guideline / clinical)

Precautions

  • Hyponatremia risk: young children, older adults, postoperative patients, SIADH, heart or lung failure, diuretics and drugs that cause SIADH. Avoid D5W in these patients. If it cannot be avoided, monitor Na⁺ closely. The exception is deliberate, specialist-directed re-lowering after overcorrection.
  • Diabetes or impaired glucose tolerance: watch for hyperglycemia and hyperosmolar state. CNS disease and renal impairment add risk.
  • Hyperosmolar hyperglycemic state (HHS): start with isotonic crystalloid (0.9% saline or a balanced crystalloid). Reach for hypotonic fluid (0.45% saline, not plain D5W) only if osmolality is not falling despite fluids and insulin. Keep the osmolality fall at 3–8 mOsm/kg/hr. Glucose should fall no more than 90–120 mg/dL/hr. Keep the Na⁺ fall ≤10 mEq/L in 24 hr.
  • Fluid overload risk: heart failure, cirrhosis, renal failure. Whether pulmonary edema follows depends on volume and rate.
  • Severe malnutrition or alcohol use disorder: refeeding syndrome and thiamine deficiency are the risks. Start slowly, give thiamine, and replace K⁺, phosphate and Mg²⁺ per protocol.
  • Corn allergy: the dextrose is corn-derived. Hypersensitivity, including anaphylaxis, is reported.

Hold / Reassess If

  • New headache, nausea, vomiting, confusion or seizure: stop, STAT Na⁺ and glucose
  • Na⁺ falling faster than 0.5 mEq/L/hr in chronic hypernatremia, or below the planned re-lowering target: slow or stop, notify
  • Glucose above the protocol target: reduce the rate, or start or adjust insulin
  • Crackles, edema or a rising oxygen requirement: stop, reassess volume
Never a Resuscitation Fluid: D5W adds almost no circulating volume, and it lowers Na⁺. For shock and dehydration, reach for isotonic crystalloid.

Adverse Effects & Toxicity

Common

  • Hyperglycemia (most common; frequency not established)
  • Dilutional hyponatremia
  • Infusion-site pain, phlebitis, extravasation or vein thrombosis
  • Fluid overload and edema
  • Low K⁺ and phosphate with prolonged use
  • Line or bloodstream infection (device-related)

Serious / Life-Threatening

EffectRecognitionManagement
Acute hyponatremic encephalopathy
Headache, nausea, vomiting, lethargy, seizures; highest risk in children, older adults, postoperative and SIADH patients
Stop D5W; STAT Na⁺; severe symptoms: 3% saline IV bolus. Adults: 100 mL over 10 min, up to 3 boluses, repeated until symptoms resolve or Na⁺ is up 4–6 mEq/L. Children: 2 mL/kg over 10 min (max 100 mL; Moritz & Ayus 2010, Table 8), repeated 1–2 times as needed until symptoms improve, per PICU protocol
Hyperglycemia or hyperosmolar state
Rising glucose, osmotic diuresis, dehydration, confusion
Slow or stop; insulin; replace losses
Cerebral edema from too-rapid hypernatremia correction
Seizure or falling level of consciousness during correction; reported mainly in infants and children with hypernatremic dehydration
Stop free water; recheck Na⁺; neurologic assessment
Pulmonary edema
Dyspnea, crackles, falling SpO₂
Stop; oxygen and ventilatory support; diuretic (furosemide)
Anaphylaxis
Urticaria, angioedema, bronchospasm, hypotension
Stop; IM epinephrine per anaphylaxis protocol
Refeeding syndrome
Low K⁺, phosphate and Mg²⁺, fluid retention, thiamine deficiency in malnourished patients
Slow the glucose load; replace electrolytes; thiamine

Overdose & Toxicity Management

  • Cause: usually a pump or rate error, or free water from carrier lines nobody recognized
  • Signs: watch for hyperglycemia, hyperosmolality, dilutional hyponatremia and fluid overload. Severe hyperglycemia or severe hyponatremia can be fatal.
  • Management: stop the infusion; insulin for hyperglycemia; treat CNS, respiratory and cardiovascular effects; 3% saline for severe symptomatic hyponatremia (weight-based in children: 2 mL/kg, max 100 mL)
  • Antidote: none

Monitoring
ParameterWhen / How OftenTarget / Act If
Laboratory: serum Na⁺ (hypernatremia correction)
Baseline; at least every 4–6 hr during chronic hypernatremia correction; every 1–2 hr when shifts are rapid or symptoms severe
Off the planned trajectory: adjust the rate and notify (sodium)
Laboratory: serum Na⁺ (re-lowering)
Every 1–2 hr during re-lowering after overcorrected hyponatremia, until Na⁺ is back under the 24-hr limit
Not falling about 1 mEq/L/hr: notify for a repeat D5W and desmopressin course; falling below target: stop and notify
Laboratory: glucose
Baseline; hourly on an insulin infusion; regularly in diabetes, neonates and prolonged infusions
Above protocol target: slow or add insulin; low in a neonate: increase glucose delivery (glucose)
Laboratory: serum osmolality (DKA/HHS)
Baseline and with each electrolyte panel during hyperglycemic crisis treatment
HHS: osmolality falling more than 8 mOsm/kg/hr (target 3–8), glucose falling more than 90–120 mg/dL/hr, or Na⁺ down more than 10 mEq/L in 24 hr: slow free water and notify; not falling despite fluids and insulin: notify
Laboratory: K⁺, phosphate, Mg²⁺
Baseline and daily on prolonged infusions; more often with insulin or malnutrition
Low: replace (potassium)
Laboratory: chloride, bicarbonate, renal function
Baseline and daily
Rising creatinine or acid-base change: review fluid plan (chloride, creatinine)
Clinical: neurologic status
Every assessment during dysnatremia treatment
Headache, vomiting, confusion or seizure: stop, STAT Na⁺
Clinical: intake, output and weight
Hourly urine output during correction; daily weight
High urine output (diabetes insipidus, osmotic diuresis): recalculate losses
Clinical: lungs and SpO₂
Every assessment
Crackles, edema or falling SpO₂: stop, reassess volume
Infusion Safety: rate and bag
Start, bag change, handoff
Right fluid (D5W, not D50W or D5NS), pump rate matches order, carrier volumes counted

Interactions & Compatibility

Clinically Significant Interactions

Drug / ClassEffectWhat To Do
Drugs associated with hyponatremia: thiazide and loop diuretics, SSRIs, SNRIs, vasopressin analogs (desmopressin), certain antiepileptic, psychotropic and cytotoxic drugs
Added free water plus impaired water excretion: hyponatremia
Avoid D5W; if unavoidable, monitor Na⁺ closely. Exception: D5W and desmopressin are combined on purpose in specialist-directed re-lowering of overcorrected hyponatremia
Oxytocin
Intrinsic antidiuretic effect: water intoxication (dilutional hyponatremia) with seizures, coma and maternal death is reported with prolonged infusions
Do not use D5W as the oxytocin carrier or maintenance fluid in labor: the label dilutes oxytocin for labor in 0.9% sodium chloride or lactated Ringer's and piggybacks it on an electrolyte solution. Track intake; check Na⁺ for headache, vomiting, confusion or seizure
Insulin
Drives glucose and K⁺ into cells
Expected in DKA; monitor glucose hourly and K⁺
Corticosteroids and other drugs that raise glucose
Additive hyperglycemia
Monitor glucose; adjust rate or insulin

IV Compatibility

  • Blood products: never in the same set; flush with normal saline
  • Phenytoin: avoid adding to dextrose and dextrose-containing fluids (poor solubility, precipitation); dilute in normal saline and flush with saline (phenytoin)
  • Liposomal amphotericin B: dilute only in D5W; never saline; flush an existing line with D5W first or use a separate line
  • Amiodarone: infusions exceeding 2 hr in D5W in glass or polyolefin bottles (amiodarone)
  • Chemotherapy: check each agent's label for dextrose as a diluent
  • Verify with an institutional compatibility resource.

Special Populations
  • Pediatrics: Children face a higher risk of hyponatremic encephalopathy, and of glucose and fluid imbalance. For ages 28 days to 18 years, the AAP recommends isotonic maintenance fluid with KCl and dextrose. Save D5W for calculated free-water therapy. See the Pediatric Dosing table.
  • Neonates: preterm and low-birth-weight neonates are at risk of both hypoglycemia and hyperglycemia. Watch glucose closely. In very-low-birth-weight infants, excess or rapid dextrose raises serum osmolality and the risk of intracerebral hemorrhage.
  • Pregnancy: D5W has been used for decades in labor and delivery. Exposure in general is not expected to cause major birth defects, miscarriage or adverse maternal or fetal outcomes. The trap is oxytocin. During an oxytocin infusion, avoid large volumes of D5W, because oxytocin's antidiuretic effect can cause water intoxication. Use a sodium-containing fluid, and check Na⁺ if symptoms appear.
  • Lactation: not expected to harm a breastfed infant. There are no data on glucose levels in human milk or on milk production.
  • Older Adults: higher risk of hyponatremia, hyponatremic encephalopathy and fluid overload. Start low and titrate cautiously.
  • Renal Impairment: no dose adjustment is established. The risk of fluid overload, electrolyte disturbance and hyperosmolar hyperglycemia runs higher, so choose the rate carefully and monitor closely.
  • Hepatic Impairment: no specific adjustment is established. Liver disease raises the risk of osmotic demyelination when Na⁺ shifts quickly.
  • Obesity / Dosing Weight: no specific adjustment is established. Free-water deficit formulas are estimates, so titrate to measured Na⁺.
  • Diabetes: hyperglycemia is likely. Pair D5W with insulin per protocol, or choose enteral water for hypernatremia.
  • Acute Brain Injury: avoid it as maintenance or resuscitation fluid. That covers TBI, stroke, hemorrhage and raised ICP.

Field & Transport Considerations
  • Scope: Paramedic, RN and critical-care transport (Paramedic/RN/CCT) teams run D5W infusions and drug carriers. Scope varies by state and agency protocol.
  • Storage & Stability: keep it at 25°C (77°F) in the overwrap until use. A brief exposure up to 40°C (104°F) does not harm the product. Avoid excessive vehicle heat. Use admixed bags promptly.
  • Carried Concentration: D5W, D10W and D50W look alike, and so do D5W and D5 with saline or lactated Ringer's. Read the percentage and the salt content.
  • Infusions in Transport: pump only, with volume limit; count carrier, flush and premixed-drip volume as free water; no pressure bags unless all air is evacuated (air embolism); never connect bags in series.
  • Blood in Transport: run blood on its own saline-primed set, never through a D5W line.
  • Handoff Essentials: indication, current rate and total volume given, Na⁺ and glucose trend with times and next draw due, insulin or desmopressin doses, urine output.

Clinical Pearls
Free Water, Not Volume: Only a small fraction of each liter stays in the vessels. The rest moves into the interstitium and cells. The hypotensive patient needs isotonic crystalloid or blood. Not D5W.
Exam Discriminator, Osmolarity vs Tonicity: D5W's calculated osmolarity (252 mOsm/L) is slightly below plasma. Exams often teach it as isotonic, and that is the trap. Once the dextrose is metabolized, it is physiologically hypotonic. It lowers Na⁺ and swells cells.
Hidden Free Water: Drug carriers, flushes and premixed drips in D5W add up to liters a day in the ICU. When Na⁺ drifts down, total every dextrose-water line before you blame the disease.
Gut First for Hypernatremia: Enteral water corrects hypernatremia with no glucose load. When the gut is unavailable, use D5W. And recheck glucose, not just Na⁺.
Too Dilute for Hypoglycemia: D5W holds 5 g per 100 mL, one-tenth the strength of D50W. Treat low glucose with D10W or D50W per the dextrose page. Then run an infusion to prevent a recurrence.
D5W vs Its Cousins:
  • D5W: free water only. No sodium.
  • D5 in 0.45% sodium chloride: free water plus 77 mEq/L Na⁺, so the dextrose comes with sodium (e.g. later in DKA)
  • D5 in 0.9% sodium chloride: isotonic saline with dextrose added
  • D10W: 505 mOsm/L. Twice the glucose, and still no sodium.

Pharmacology

Mechanism of Action

  • Dextrose (D-glucose) enters cells and is oxidized to CO₂ and water. What is left is electrolyte-free water, and it lowers plasma tonicity
  • The water spreads across total body water. About two-thirds enters cells and expands them. Little stays intravascular
  • Glucose supplies 3.4 kcal/g (170 kcal/L). It spares some protein, but it is not nutrition
  • Glucose stimulates insulin, and insulin shifts K⁺, phosphate and Mg²⁺ into cells

Pharmacokinetics

RouteOnsetPeakDuration
IV infusion
Immediate
Depends on rate and glucose use
Volume-based: lasts while the infusion runs
  • Half-life: no meaningful drug half-life. The effect follows rate, volume and the patient's glucose use
  • Metabolism: glycolysis and oxidation. Muscle and fat uptake depend on insulin
  • Elimination: the kidneys excrete the water. Glucose given faster than it is used causes hyperglycemia, glucosuria and osmotic diuresis

Names & Classification
Generic Name
Dextrose Injection, USP 5% (dextrose hydrous in Water for Injection); D5W; 5% glucose outside the US
Brand Names
Generic; US makers include Baxter (VIAFLEX container), ICU Medical and Fresenius Kabi
Pharmacologic Class
Carbohydrate solution (monosaccharide in water)
Therapeutic Class
IV fluid; free-water and calorie source; drug diluent
Controlled Substance
Not controlled
Look-Alike / Sound-Alike
None commonly reported as a named pair; in practice, bags of D5W, D10W, D50W and dextrose-saline combinations look alike

Related

References
  1. Baxter Healthcare Corporation. (2026). Dextrose Injection (5% and 10%), USP: Prescribing information. DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3bb406a9-f5cb-403a-b1bb-5c4facbea3d5
  2. Umpierrez, G. E., Davis, G. M., ElSayed, N. A., et al. (2024). Hyperglycemic crises in adults with diabetes: A consensus report. Diabetes Care, 47(8), 1257–1275. https://doi.org/10.2337/dci24-0032
  3. Spasovski, G. (2024). Hyponatraemia: Treatment standard 2024. Nephrology Dialysis Transplantation, 39(10), 1583–1592. https://doi.org/10.1093/ndt/gfae162
  4. Feld, L. G., Neuspiel, D. R., Foster, B. A., et al. (2018). Clinical practice guideline: Maintenance intravenous fluids in children. Pediatrics, 142(6), e20183083. https://doi.org/10.1542/peds.2018-3083
  5. Oddo, M., Poole, D., Helbok, R., et al. (2018). Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations. Intensive Care Medicine, 44(4), 449–463. https://doi.org/10.1007/s00134-018-5086-z
  6. Glaser, N., Fritsch, M., Priyambada, L., et al. (2022). ISPAD clinical practice consensus guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatric Diabetes, 23(7), 835–856. https://doi.org/10.1111/pedi.13406
  7. Astellas Pharma US. (2024). AmBisome (amphotericin B) liposome for injection: Prescribing information. DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f7be6506-4d20-401e-a0ff-02ad7c33158a
  8. Verbalis, J. G., Goldsmith, S. R., Greenberg, A., et al. (2013). Diagnosis, evaluation, and treatment of hyponatremia: Expert panel recommendations. The American Journal of Medicine, 126, S1–S42. https://doi.org/10.1016/j.amjmed.2013.07.006
  9. Moritz, M. L., Ayus, J. C. (2010). New aspects in the pathogenesis, prevention, and treatment of hyponatremic encephalopathy in children. Pediatric Nephrology, 25, 1225–1238. https://doi.org/10.1007/s00467-009-1323-6
  10. Par Pharmaceutical. (2024). Pitocin (oxytocin) injection: Prescribing information. DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=dddcdcc3-cd4d-4573-98ac-9468bea23a8b
  11. Fresenius Kabi USA. (2025). Amiodarone hydrochloride injection: Prescribing information. DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9772ab48-2ef1-4b9f-9a27-794f3e7e5c7a
  12. Hikma Pharmaceuticals USA. (2024). Phenytoin sodium injection, USP: Prescribing information. DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=035a8d4e-2063-4240-83cb-d7eebcabe301

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