D5W (Dextrose 5%)

Class
Water solution and carbohydrate source

Pharmacological Effects
1. Provides calories for some metabolic needs. Each 100 mL provides 5 gm of Dextrose. Depending on the presence of insulin,
glucose enters cells and is broken down to pyruvate. With adequate oxygen, it enters the Kreb's cycle in the mitochondria and is
converted into energy (A.T.P.), CO2 and H2O. The brain and gonads do not require insulin for glucose metabolism.
2. Supplies body water for hydration.
3. Spares body protein by providing carbohydrate for metabolism.
4. Osmolarity of D5W is 252 mOsm/L. The fluid is isotonic when in the container. After administration, the dextrose is quickly
metabolized in the body, leaving only water - a hypotonic fluid.
5. The pH range is 3.5 - 6.5.
6. Capable of producing diuresis depending on clinical state of the patient.

Uses
1. Adult I.V. solution to keep vein open.
2. Vehicle for mixing medications for I.V. delivery for all age groups.
3. It may be the primary adult I.V. fluid for medical emergencies, though many services use only L.R. or N.S.

Duration of Action
1. Glucose use depends on metabolic rate. It is stored in the liver and muscle as glycogen.
2. Water use depends on clinical state of patient, body temperature and renal function. Excreted through the skin, lungs, and
kidney.

Side Effects
1. Hyperglycemia.
2. Fluid overload.

Contraindications
1. Patients at risk for increased I.C.P.
2. Patients who have an acute neurological dysfunction.
3. Hypovolemic states.
4. Patients at risk for third-space fluid shifts.
5. Elevated blood glucose concentrations.

Precautions/Information
1. Since the tonicity is low, avoid using in head injury patients.
2. Use sterile technique in venipuncture and equipment assembly, with all venipunctures
3. Do not administer quantity in excess of that required to keep vein open or administer appropriate dose of medication.
4. Do not use solution if outdated, cloudy or the seal is not intact, as with all IV solutions.
5. Monitor E.C.G. continuously.
6. Monitor blood pressure, pulse rate and respiratory rate frequently.
 

Definition
By Mayo Clinic staff

Chronic obstructive pulmonary disease (COPD) refers to a group of lung diseases that block
airflow and make it increasingly difficult for you to breathe.
Emphysema and chronic bronchitis are the two main conditions that make up COPD, but COPD
can also refer to damage caused by chronic asthmatic bronchitis. In all cases, damage to your
airways eventually interferes with the exchange of oxygen and carbon dioxide in your lungs.

COPD is a leading cause of death and illness worldwide. Most COPD is caused by long-term
smoking and can be prevented by not smoking or quitting soon after you start. Damage to your
lungs can't be reversed, so treatment focuses on controlling symptoms and minimizing further
damage.

Lifestyle and home remedies

If you have COPD, you can take steps to feel better and slow the damage to your lungs:

 Control your breathing. Talk to your doctor or respiratory therapist about techniques for
breathing more efficiently throughout the day. Also be sure to discuss breathing positions and
relaxation techniques that you can use when you're short of breath.
 Clear your airways. In COPD, mucus tends to collect in your air passages and can be difficult to
clear. Controlled coughing, drinking plenty of water and using a humidifier may help.
 Exercise regularly. It may seem difficult to exercise when you have trouble breathing, but
regular exercise can improve your overall strength and endurance and strengthen your
respiratory muscles.
 Eat healthy foods. A healthy diet can help you maintain your strength. If you're underweight,
your doctor may recommend nutritional supplements. If you're overweight, losing weight can
significantly help your breathing, especially during times of exertion.
 Avoid smoke. In addition to quitting smoking, it's important to avoid places where others
smoke. Secondhand smoke may contribute to further lung damage.
 Pay attention to frequent heartburn. Constant heartburn can indicate gastroesophageal reflux
disease (GERD), a condition in which stomach acid or, occasionally, bile flows back into your
food pipe (esophagus). This constant backwash of acid can aggravate COPD, but treatments for
GERD can help. Talk to your doctor if you have frequent heartburn.
 See your doctor regularly. Stick to your appointment schedule, even if you're feeling fine. It's
important to steadily monitor your lung function.

http://www.mayoclinic.com/health/copd/DS00916/DSECTION=lifestyle-and-home-remedies

Tests and diagnosis

Spirometer
If you have symptoms of COPD and a history of exposure to lung irritants — especially cigarette
smoke — your doctor may recommend these tests:

 Pulmonary function tests. Spirometry is the most common lung function test. During this test,
you'll be asked to blow into a large tube connected to a spirometer. This machine measures how
much air your lungs can hold and how fast you can blow the air out of your lungs. Spirometry
can detect COPD even before you have symptoms of the disease. It can also be used to track the
progression of disease and to monitor how well treatment is working.
 Chest X-ray. A chest X-ray can show emphysema — one of the main causes of COPD. An X-ray
can also rule out other lung problems or heart failure.
 Arterial blood gas analysis. This blood test measures how well your lungs are bringing oxygen
into your blood and removing carbon dioxide.
 Sputum examination. Analysis of the cells in your sputum can help identify the cause of your
lung problems and help rule out some lung cancers.
 Computerized tomography (CT) scan. A CT scan is an X-ray technique that produces more-
detailed images of your internal organs than those produced by conventional X-rays. A CT scan
of your lungs can help detect emphysema and help determine if you might benefit from surgery
for COPD.

http://www.mayoclinic.com/health/copd/DS00916/DSECTION=tests-and-diagnosis

Risk factors
By Mayo Clinic staff

Risk factors for COPD include:

 Exposure to tobacco smoke. The most significant risk factor for COPD is long-term cigarette
smoking. The more years you smoke and the more packs you smoke, the greater your risk.
Symptoms of COPD usually appear about 10 years after you start smoking. Pipe smokers, cigar
smokers and people exposed to large amounts of secondhand smoke also are at risk.
 Occupational exposure to dusts and chemicals. Long-term exposure to chemical fumes, vapors
and dusts can irritate and inflame your lungs.
 Gastroesophageal reflux disease (GERD). This condition is a severe form of acid reflux — the
backflow of acid and other stomach contents into your esophagus. GERD can make COPD worse
and may even cause it in some people.
 Age. COPD develops slowly over years, so most people are at least 40 years old when symptoms
begin.
 Genetics. A rare genetic disorder known as alpha-1-antitrypsin deficiency is the source of a few
cases of COPD. Researchers suspect that other genetic factors may also make certain smokers
more susceptible to the disease.

http://www.mayoclinic.com/health/copd/DS00916/DSECTION=risk-factors

DUAVENT

Classification
R03AK04 - Salbutamol and other drugs for obstructive airway diseases ; Belongs to the class of
adrenergics and other inhalants used in the treatment of obstructive airway diseases