10% w/v GLUCOSE INTRAVENOUS INFUSION B.P. Infusion/Solution for

What is 10% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

10% w/v Glucose Intravenous Infusion B.P. is a sterile, non-pyrogenic solution of dextrose (glucose) in water. It is commonly used in clinical settings as a source of carbohydrates and fluid replenishment. This solution is administered intravenously and is especially useful in situations where oral intake of nutrients is not possible or is insufficient.

• Generic Name: Dextrose
• Concentration: 10% w/v (weight/volume)
• Form: Intravenous infusion solution
• Packaging: 2000ml plastic infusion bag
• Classification: Carbohydrate caloric agent, Parenteral nutrition

The 10% glucose solution provides approximately 100g of glucose per liter, supplying energy and promoting an anabolic state in patients. It is widely used in hospitals for patients requiring additional calories, fluid resuscitation, or those undergoing surgery, trauma recovery, or prolonged fasting.

This solution is manufactured to meet the standards of the British Pharmacopoeia (B.P.), ensuring its safety and efficacy for intravenous use. It is free from any antimicrobial agents and should only be used under strict aseptic conditions in a healthcare setting.

How to use 10% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

This infusion should only be administered by a qualified healthcare provider. It is delivered directly into the bloodstream via an intravenous (IV) line, allowing rapid and efficient absorption of glucose into the body.

• Administration Route: Intravenous (IV) infusion
• Method: Controlled infusion using an IV set and infusion pump or gravity drip
• Monitoring: Regular monitoring of blood glucose, fluid balance, and electrolyte levels is essential

The infusion rate and volume are tailored according to individual patient needs, taking into account factors such as age, weight, metabolic demands, and underlying medical conditions. The infusion must be adjusted in patients with impaired glucose tolerance, such as those with diabetes mellitus or insulin resistance.

Step-by-step usage guide:

1. Inspect the infusion bag for any visible particles, cloudiness, or leaks. Do not use if the solution is not clear or the container is damaged.
2. Hang the bag on an IV pole and connect to sterile IV tubing.
3. Prime the tubing to eliminate air bubbles before connecting it to the patient’s IV cannula.
4. Start the infusion at a prescribed rate using an infusion pump or manual drip regulator.
5. Continuously monitor the infusion site for signs of inflammation or infiltration.

In pediatric or critically ill patients, precise fluid and glucose administration is essential. Dosage adjustments must be made to avoid fluid overload or hyperglycemia.

Mode of Action 10% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

The mode of action of 10% w/v Glucose Intravenous Infusion B.P. is primarily metabolic. Glucose (dextrose), a simple monosaccharide, serves as a vital energy source for all cells in the body. When administered intravenously, it bypasses the gastrointestinal tract and enters the bloodstream directly, allowing for rapid availability to tissues.

• Cellular Uptake: Once in the blood, glucose is transported into cells via glucose transporter proteins (GLUTs), with insulin facilitating uptake in insulin-dependent tissues such as muscle and adipose tissue.
• Energy Production: Inside the cell, glucose undergoes glycolysis, a metabolic pathway that breaks down glucose into pyruvate, generating ATP (adenosine triphosphate) – the main energy currency of the cell.
• Further Metabolism: Pyruvate may enter the Krebs cycle (citric acid cycle) for more extensive ATP production, or be converted into lactate under anaerobic conditions.

Key roles of IV glucose infusion include:

• Providing calories to support metabolism during catabolic states (e.g., post-surgery, infection, trauma)
• Preventing ketosis and hypoglycemia in patients who cannot consume carbohydrates orally
• Serving as a vehicle for drug delivery or electrolyte solutions when combined in admixtures

In higher concentrations like 10%, the glucose solution offers moderate caloric support (approximately 400 kcal/L). It is often used for short-term nutritional supplementation or fluid therapy in patients who are NPO (nil per os) or on parenteral nutrition regimens.

It’s important to note that the metabolic processing of glucose also generates CO₂ and water, which can impact patients with impaired respiratory function or fluid overload risks. Hence, administration should be carefully monitored.

10% w/v GLUCOSE INTRAVENOUS INFUSION B.P. Interactions 10% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

While 10% Glucose Intravenous Infusion is generally safe and compatible with a range of medications and electrolytes, it can still interact with certain drugs and clinical conditions. Awareness of these interactions is essential to avoid complications.

• Insulin: Co-administration of insulin with glucose infusion is common in diabetic or hyperkalemic patients. Insulin increases cellular uptake of glucose, potentially leading to hypoglycemia if not carefully titrated.
• Electrolytes: Glucose infusions may cause dilutional hyponatremia, especially if given in large volumes without sodium supplementation. It may also lower serum potassium levels due to intracellular shifts, particularly in combination with insulin.
• Diuretics (e.g., furosemide): May enhance the risk of electrolyte imbalances when used with glucose infusions.
• Drugs in admixture: Not all IV medications are compatible with 10% glucose solutions. Incompatible drugs may precipitate or degrade. Always consult compatibility charts before mixing.

Clinical considerations:

• In patients receiving drugs that influence glucose metabolism (e.g., corticosteroids, thiazide diuretics), glucose infusion may exacerbate hyperglycemia.
• Parenteral nutrition: When used with amino acids or lipid emulsions, careful planning of caloric intake and osmolarity is needed.

Regular monitoring of blood glucose, serum electrolytes, and renal function is recommended when glucose infusion is used concurrently with other pharmacologic agents, especially in critically ill or diabetic patients.

Dosage of 10% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

The dosage of 10% Glucose IV Infusion should be individualized based on the patient’s clinical condition, fluid and electrolyte requirements, and daily caloric needs. The infusion must be prescribed and administered by a healthcare provider, especially in settings requiring precise glucose control.

• Adults: Typical dosage ranges from 500 ml to 2000 ml per day, depending on the therapeutic goal (hydration, nutrition, or glucose supplementation). The rate of administration is generally between 3–6 mg/kg/min to prevent hyperglycemia.
• Pediatrics: Dosing is weight-based. Commonly used at 5–10 ml/kg/hour in neonates or children under controlled settings. Neonates and infants require close monitoring for hypoglycemia or fluid overload.
• Elderly: Same dosing principles as adults, but with caution due to increased risk of cardiac or renal impairment.

Maximum rate: The glucose oxidation rate in most individuals is approximately 4–7 mg/kg/min. Infusions exceeding this rate may lead to hyperglycemia, hepatic steatosis, or increased CO₂ production.

Administration tips:

• Use infusion pumps to control rate and avoid accidental rapid infusions.
• Do not administer simultaneously with blood products via the same line.
• Monitor blood glucose frequently, particularly in diabetic, septic, or post-operative patients.

Always adjust the dosage based on clinical status, glucose tolerance, fluid status, and lab parameters. Excessive administration without correction of electrolytes can lead to complications such as hyponatremia or hypokalemia.

Possible side effects of 10% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

While generally safe when used appropriately, 10% Glucose IV Infusion may cause side effects, especially when infused rapidly or in large volumes. Most side effects are related to glucose overload, fluid shifts, or electrolyte disturbances.

• Metabolic:
  • Hyperglycemia (elevated blood sugar)
  • Glycosuria (glucose in urine)
  • Electrolyte imbalance (especially hypokalemia, hyponatremia)
  • Metabolic acidosis or alkalosis (depending on underlying condition)
• Infusion-related:
  • Thrombophlebitis at the injection site
  • Local irritation or inflammation
  • Infiltration leading to tissue injury (especially if hyperosmolar)
• Systemic:
  • Fluid overload (especially in patients with heart or kidney failure)
  • Pulmonary edema in severe cases

Allergic reactions are extremely rare but possible, typically related to packaging materials or contamination rather than glucose itself.

Signs to watch for:

• Unexplained swelling, dyspnea, or weight gain (suggests fluid overload)
• Confusion, drowsiness, or seizures (may indicate hypo/hyperglycemia or electrolyte imbalance)

Side effects can usually be avoided with proper infusion technique, dosage control, and routine monitoring of biochemical parameters.

10% w/v GLUCOSE INTRAVENOUS INFUSION B.P. Contraindications 10% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

While 10% Glucose IV Infusion is widely used in clinical settings, there are several conditions in which its use is contraindicated or should be approached with extreme caution. Administering it inappropriately can exacerbate underlying conditions or cause serious metabolic complications.

• Hyperglycemia: Glucose infusions are contraindicated in patients with significant or uncontrolled high blood sugar levels. Administering additional glucose can worsen the condition and increase the risk of diabetic ketoacidosis or hyperosmolar hyperglycemic state.
• Diabetes Mellitus (Uncontrolled): Patients with poorly controlled diabetes should not receive concentrated glucose solutions unless combined with insulin therapy and strict glucose monitoring.
• Hypokalemia: IV glucose promotes intracellular potassium shift, which can worsen existing hypokalemia. In such cases, potassium supplementation must be administered concurrently.
• Severe Dehydration with Electrolyte Imbalance: Administering a glucose-only solution can dilute serum electrolytes further and cause complications such as hyponatremia or seizures, especially in children.
• Anuria or Severe Renal Impairment: Patients with significantly reduced or absent urine output are at risk of fluid overload when receiving glucose infusions, especially without adequate renal clearance.
• Acute Stroke or Intracranial Hemorrhage: Hyperglycemia has been associated with worse outcomes in acute neurological events. Glucose-containing solutions are often avoided during the acute phase unless necessary.
• Congestive Heart Failure or Pulmonary Edema: High-volume glucose infusions can exacerbate fluid overload in patients with cardiac dysfunction.

Special Precautions:

• Use with caution in neonates and elderly patients due to altered glucose tolerance and fluid balance.
• Monitor closely in patients with hepatic impairment, as glucose metabolism may be altered.
• Do not use if the solution is discolored, contains particulates, or if the container is damaged.

Before initiating therapy, a thorough patient assessment including metabolic panel, glucose levels, and renal function is essential. When in doubt, alternatives like balanced electrolyte or mixed nutritional solutions may be safer.

Storage of 10% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

Proper storage of intravenous infusion solutions is critical to maintaining their sterility, effectiveness, and safety. The following guidelines apply specifically to 10% Glucose IV Infusion packaged in 2000 ml plastic bags.

• Storage Temperature: Store at 15°C to 25°C (59°F to 77°F). Avoid extremes of temperature. Do not freeze.
• Humidity & Light: Store in a dry place, away from direct sunlight. Prolonged exposure to light or high humidity can degrade the plastic bag or solution.
• Packaging: Keep the infusion bag inside its protective outer wrap until use. This helps protect from moisture and potential puncture damage.

Handling precautions:

• Inspect the bag before use. Do not use if the solution appears cloudy, discolored, or contains visible particles.
• Do not use if the container is leaking or if seals are damaged.
• Once the outer wrap is removed, the product should be used immediately or stored under aseptic conditions if delay is unavoidable.

After Opening:

• Use the solution within 24 hours once the bag has been opened or accessed.
• Do not reconnect partially used bags to a new IV line or reuse for another patient.

Disposal: Unused portions should be discarded safely, according to hospital protocols and local regulations. Do not pour remaining solution down the drain unless permitted by biohazard guidelines.

Maintaining optimal storage conditions ensures the efficacy of the glucose solution and minimizes the risk of contamination or degradation, protecting patient safety and treatment outcomes.