Dextrose Injection BP 5%,10%& 50%
COMPOSITION:
100ml of intravenous injection contains 5g of Dextrose.
100ml of intravenous injection contains 10g of Dextrose
100ml of intravenous injection contains 50g of Dextrose
CLINICAL PHARMACOLOGY:
Dextrose is natural sugar, whose presence in the body is essential to life. It is transported into all living cells by facilitated diffusion. After intravenous administration dextrose goes through fast (approximately 20minutes) and slow phases of equilibration. The mean volume of distribution has been shown to be 18.4 ± 3.39L in healthy adults 18 ±4.36L in diabetic adults. Dextrose is metabolized to carbon dioxide and water with the release of energy.
INDICATIONS:
-Treatment of carbohydrate and fluid depletion.
-Treatment of severe hypoglycaemia.
CONTRAINDICATIONS:
Solutions containing dextrose may be contraindicated in patients with known allergies to corn or corn products.
Dextrose 50% solution is contra-indicated in patients with anuria, intra-cranial or intra-spinal haemorrhage and in delirium tremens where there is dehydration.
INTERACTIONS
Dextrose solutions have been reported to be incompatible with the following drugs: cyanocobalamin, kanamycin sulphate, novobiocin sodium and warfarin sodium.
Dextrose solution should not be combined with blood transfusion as clumping of the red blood cells may occur.
WARNINGS/PRECAUTIONS
Dextrose injections or infusions should be used with caution in patients with overt or sub-clinical diabetes mellitus, carbohydrate intolerance, severe under – nutrition, thiamine deficiency, hypophosphataemia, haemodilution, sepsis, trauma, shock, metabolic acidosis and severe d
ehydration. Monitor blood glucose levels in diabetic patients.
It has been suggested that glucose solutions should not be used after acute ischaemic strokes as hyperglycaemia has been implicated in increasing cerebral ischaemic brain damage and in impairing recovery.
KEEP OUT OF THE REACH OF CHILDREN
PREGNANCY AND LACTATION:
Intravenous dextrose infusion to the mother may result in foetal insulin production and
a risk of rebound hypoglycaemia in the neonate. Infusions of dextrose administered during caesarian section and labour should not exceed 5-10mg dextrose/ hour.
SIDE/ADVERSE EFFECTS
Fever, phlebitis, extravasation, andthrombosis,and pain at site of injection. A too rapid administration of dextrose injection may results in hyperglycaemia and glycosuria.
Wernicke’s Encephalopathy may be induced in patients with thiamine deficiency unless thiamine is administered concurrently with the dextrose.
SYMPTOMS OF OVERDOSE AND ANTIDOTE
Accidental overdose will result in hyperglycemia, fluid and electrolyte imbalances. Following overdose, administration of dextrose should be reduced or discontinued and electrolyte balance restored. Further dextrose administration should be undertaken with careful monitoring of blood glucose.
DOSAGE AND ADMINISTRATION
Depends on use and age, weight and clinical condition of the patient. The average normal adult requires 2 to 3 liters of fluid to replace water loss through perspiration and urine.
- Treatment of carbohydrate and fluid depletion.
Non- diabetic adults (including the elderly) and children: 1 to 3 liters daily of 50% dextrose solution, administered at a rate not exceeding 3ml/ minute.
2) Treatment of severe hypoglycaemia
Adults (including the elderly):
20-50ml of 50% dextrose solution by slow injection.
Repeated doses my be required in severe cases
NOTE:
- Do not give Dextrose without saline solutions in blood transfusions: may cause clumping of blood cells.
- Observe closely for signs of overloading where fluid intake is restricted.
- Check infusion site regularly to prevent irritation or extravasations and phlebitis; change site immediately if there is sign of extravasation.
PRESENTATION
Dextrose injection B.P 50% solution is presented in PVC intravenous bag with a total content of 500ml.
STORAGE
Store below 250C