Dextrose 5% Intravenous Infusion

Dextrose is a prescription sterile, nonpyrogenic solution for fluid replenishment and caloric supply for intravenous and/or oral administration and as treatment of low blood sugar.

This infusion has glucose as the main ingredient with a molecular formula of C6H12O6.H20 and a molecular weight of 198.17.

IUPAC ID: D-glucose

It is colorless or an almost colorless clear liquid with a sweet flavor

Pharmacology and toxicity

Glucose is one of the sources of heat and energy for the human body, 16.7kJ heat can be produced from one gram glucose so glucose is usually, be used for the supplement of heat and treatment of hypoglycemia.

When administered together with insulin by phleboclysis, because the synthesis of glycogen must be joined together with potassium, thus the potassium enters into the cell to make the concentration of potassium in plasma is decreased.

Glucose injection can be used for the treatment of hyperpotassemia.

Glucose injection is administered fast intravenously can make tissue to dehydrate so the product can be used as a dehydrating agent.

Moreover, glucose is the main material that can maintain and adjust the osmotic pressure of peritoneum dialysate.

Pharmacokinetics

Glucose administered by phleboclysis usually enters into circulation directly. It is oxidized completely to produce CO2 and water and excreted by the lungs and kidney accompanied by the production of heat.

The available capacity of the common people for glucose is about 6mg/kg/minute.

Indications

It used to supplement energy and body liquid; used for the scarcity of feeding and body liquid. Used by all classes.(such as vomiting, diarrhea) intravenous hyperalimentation, ketosis;
Hypoglycemia
Hyperkalemia
50% glucose could be used as a dehydrant for body tissue.;
Used for the preparation of peritoneal dialysate
Used as medicine diluent;
Used for the test of dose tolerate of glucose administered by phleboclysis
Used for the preparation of GIK

Dosage and administration

The recommended dosage for treatment of carbohydrate and fluid depletion is:

- for adults: 500 ml to 3 litres / 24h

- for babies and children :

- 0-10 kg body weight:	100 ml/kg/24h.
- 10-20 kg body weight:	1000 ml + 50 ml /kg over 10 kg / 24h.
- > 20 kg body weight:	1500 ml + 20 ml / kg over 20 kg / 24h.

The infusion rate depends on the patient's clinical condition.

Heat supplement; when the patients take little food or even cannot take food due to some causes, 25% glucose injection can be administered by phleboclysis, as well as the body fluid was supplied. The dose can be estimated according to the heat energy on demand.

Intravenous hyperalimentation treatment: Glucose is one of the most important sources of energy when used with this method.

For the non-protein heat, the production of heat supplied by glucose and fat is 2:1, and the clinical dosage should be estimated according to heat supplement on demand as per the requirements of fluid supplement, the glucose can be prepared to get the injection with different concentration range 25-50% and the insulin can be added from necessity, the quantity of insulin is one unit vs. 5-10 grams.

Since the administration of high concentration glucose, the solution is irritative for the vein, at the same time the adipose emulsion should be used, the large vein is usually elected to drip by intravenous.

For hypoglycemia, 50% glucose injection with a dose 20-50ml may be administered by the mainline for the serious first.

For ketosis, 5-25% glucose injection is administered by drip for the serious and 100 grams daily can control the disease.

For the isotonic dehydration, 5% glucose injection can be administered by drip.

For hyperkalemia, 10-25% glucose injection, and every 2-4 grams glucose combined with one unit of insulin is administered by drip can reduce the concentration of serum potassium. But this method only leads to the potassium from outside the cell to the inner, and the total potassium in the body remains unchanged. If any actions are not taken to excrete the potassium there still exists the possibility of hyperkalemia.

For tissue dehydration, high concentration glucose injection (usually 50% glucose injection) should be administered fleetly by intravenous injection with a dose of 20-50 ml but the effect may be very temporal. And during the clinical usage, hyperglycemia should be avoided, and this method is seldom used at present.

When used for the adjustment of the osmotic pressure of peritoneum dialysate, 50% dextrose with the dose of 20ml can make the osmotic pressure 1l increase 55mosm per kg H200.

Side effects

Phlebitis may happen when high concentration glucose injection was administered by drip, but the occurrence rate will decrease when administered to the large vein.

Exosmosis of high concentration glucose injection may lead to locality gall

Reactive hypoglycemia: when administered combined with insulin with overdose, reactive hypoglycemia may happen in patients with original hypoglycemia. Tendency and when intravenous hyperalimentation was ceased suddenly.

Hyperglycemia non-ketosis coma: it usually happens when the high concentration was administered or intravenous hyperalimentation treatment was used for the patients with diabetes mellitus, stress condition, with the treatment of high dose glucocorticoids or for the patients who received peritoneal dialysis for the treatment of toxemia

Electrolyte disturbance: glucose is administered singly for long-term may lead to hypokalemia, sodium, and phosphor.

Original cardiac functional insufficiency;

Hyperkalemia, the cases may happen occasionally when the patient with diabetes mellitus is administered with high concentration glucose injection.

Drug interactions

Dextrose has no known severe interactions with other drugs.

Dextrose has no known serious interactions with other drugs.

Dextrose has no known moderate interactions with other drugs.

Mild interactions of dextrose include:

Contraindications

Diabetes ketoacidosis

Hyperglycemia non-ketosis hyperosmotic state;

Attention

High dose glucose during parturition may stimulate the secretion of insulin for the fetus, which can lead to glycopenia.

The product should be administered cautiously in the following cases:

1.Tolerance test of oral glucose for the patients whose stomach has been cut partially may lead to dumping syndrome and hypoglycemia.

2.The patients with periodic paralysis of hypokalemia;

3.Stress conditions or glucocorticoids administration may lead to hyperglycemia;

4.When the product is administered with the patients with dropsy, cardiac and kidney insufficiency and ascites due to cirrhosis, water retention may happen,

So the administration dosage should be controlled; the drip speed should be controlled strictly for the patients with cardiac functional insufficiency.