20% w/v GLUCOSE INTRAVENOUS INFUSION B.P. Infusion/Solution for

What is 20% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

20% w/v Glucose Intravenous Infusion B.P. is a sterile, non-pyrogenic, hypertonic solution containing 20 grams of dextrose per 100 ml of water for injection. In a 250 ml plastic bag, this equates to 50 grams of glucose. It is used to provide calories and fluid to patients who require intravenous nutrition or treatment for specific metabolic conditions.

• Generic Ingredient: Dextrose (also known as glucose)
• Concentration: 20% w/v (i.e., 20g per 100 ml)
• Packaging: 250 ml flexible plastic infusion bag
• Type: Hypertonic solution for intravenous administration

This solution is commonly used in hospital settings for:

• Managing severe hypoglycemia when oral glucose is not feasible
• Providing calories as part of parenteral nutrition therapy
• Correcting ketosis and dehydration
• Serving as a carrier for other compatible intravenous drugs

Due to its hyperosmolar nature, 20% glucose is typically administered via a central or large peripheral vein and under strict medical supervision.

How to use 20% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

20% Glucose Infusion is administered intravenously by qualified healthcare professionals. Proper handling, infusion technique, and patient monitoring are essential to ensure safety and effectiveness.

• Administration Route: Intravenous (IV) infusion only
• Preparation:
  • Inspect the plastic bag for leaks, discoloration, or particulates before use
  • Use aseptic technique during administration
  • Connect to a sterile IV set with appropriate filtration
• Infusion Details:
  • Infuse through a large peripheral or central vein due to high osmolarity
  • Use an infusion pump to control the rate accurately
  • Avoid rapid infusion to prevent fluid overload and hyperglycemia
• Monitoring:
  • Check blood glucose and electrolytes before and during infusion
  • Observe for signs of vein irritation or thrombophlebitis
  • Adjust infusion rate based on clinical response and metabolic needs

Do not administer simultaneously with blood products in the same infusion set. Only use under medical supervision.

Mode of Action 20% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

Dextrose is a simple sugar that plays a central role in the body’s metabolism. When administered intravenously, it rapidly enters the bloodstream and is transported to cells, where it serves as a key energy source.

• Cellular Metabolism:
  • Dextrose is absorbed into cells via glucose transporters
  • It undergoes glycolysis to generate ATP — the body’s energy currency
• Primary Effects:
  • Raises plasma glucose levels, reversing hypoglycemia
  • Provides readily available calories in parenteral nutrition
  • Spare body protein by reducing catabolism during fasting or illness
• Secondary Effects:
  • High osmolarity can cause fluid shifts into the vascular space
  • Promotes diuresis if infused in excess

The infusion’s clinical impact depends on the patient’s metabolic state, concurrent illnesses, and infusion rate. The energy yield is approximately 3.4 kcal per gram of dextrose.

20% w/v GLUCOSE INTRAVENOUS INFUSION B.P. Interactions 20% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

Though dextrose is generally safe, its administration can affect or be affected by various medications and physiological states.

• Insulin:
  • Can be co-administered to control blood glucose
  • Increases cellular uptake of glucose, reducing serum levels
• Diuretics:
  • May influence fluid and electrolyte balance when used with hypertonic glucose
• Electrolytes:
  • High glucose may dilute plasma sodium and potassium levels
  • Requires concurrent electrolyte replacement in prolonged use
• Drugs Mixed in IV Solution:
  • Ensure compatibility when used as a diluent (e.g., avoid with phenytoin)
• Alcohol:
  • May alter glucose metabolism and mask hypoglycemia symptoms

Clinicians should consider all concomitant medications and patient-specific factors before initiating glucose infusion therapy.

Dosage of 20% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

The dosage must be tailored to the patient’s needs, including age, weight, blood glucose levels, and clinical condition. Dextrose infusion should be administered cautiously, especially at higher concentrations.

• Adults:
  • Commonly administered in boluses of 25–50 ml for hypoglycemia
  • For nutritional support: 3–5 mg/kg/min IV infusion, adjusted per patient requirements
• Pediatrics:
  • Used with caution, especially in neonates
  • Doses must be carefully calculated (0.5–1 g/kg per dose)
• Infusion Rate:
  • Should not exceed patient’s glucose oxidation rate (approx. 4–7 mg/kg/min)
  • Frequent monitoring required to avoid hyperglycemia and osmotic diuresis

Doses must be carefully adjusted based on ongoing glucose and electrolyte monitoring.

Possible side effects of 20% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

While 20% glucose is generally well-tolerated under supervision, its high concentration may lead to local or systemic side effects, especially with improper use.

• Metabolic Side Effects:
  • Hyperglycemia
  • Glycosuria and osmotic diuresis
  • Electrolyte imbalances (e.g., hypokalemia, hyponatremia)
• Local Reactions:
  • Phlebitis at the injection site
  • Vein irritation or thrombosis
• Systemic Effects:
  • Fluid overload in susceptible individuals (e.g., heart failure, renal dysfunction)
  • Headache, confusion, or fatigue if blood glucose fluctuates sharply
• Allergic Reactions:
  • Rare, but may include rash, fever, or anaphylaxis

Monitoring during infusion helps detect and manage side effects promptly.

20% w/v GLUCOSE INTRAVENOUS INFUSION B.P. Contraindications 20% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

This solution should not be used in certain medical conditions where administration could worsen patient outcomes.

• Absolute Contraindications:
  • Severe hyperglycemia without adequate insulin therapy
  • Hypersensitivity to dextrose
  • Intracranial or intraspinal hemorrhage
• Relative Contraindications:
  • Severe dehydration with electrolyte imbalance
  • Congestive heart failure or renal insufficiency
  • Uncontrolled diabetes mellitus
  • Thiamine deficiency (risk of Wernicke’s encephalopathy)

Use should be guided by a comprehensive assessment of the patient's condition and co-existing comorbidities.

Storage of 20% w/v GLUCOSE INTRAVENOUS INFUSION B.P.

Proper storage is essential to maintain the sterility, efficacy, and safety of this medical product.

• Storage Conditions:
  • Store below 25°C (77°F)
  • Protect from excessive heat and direct sunlight
  • Do not freeze
• Visual Inspection:
  • Check the solution for cloudiness, particulates, or leaks
  • Do not use if the bag is damaged or contents appear abnormal
• Shelf Life:
  • Refer to expiry date printed on the packaging
  • Do not use after expiration
• Handling After Opening:
  • Use immediately after opening to prevent microbial contamination
  • Discard any unused portion

Store in original packaging in a cool, dry place, out of reach of unauthorized personnel.