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 intravenous solution composed of 20 grams of dextrose per 100 ml of water for injection. In a 500 ml plastic bag, this corresponds to 100 grams of dextrose. It is used primarily for rapid energy supplementation, correction of hypoglycemia, and as a carbohydrate source in parenteral nutrition.

• Generic Name: Dextrose (D-glucose)
• Concentration: 20% w/v (20g/100ml)
• Presentation: 500 ml sterile, flexible plastic bag
• Type: Hypertonic intravenous solution

This solution is most often administered in clinical settings under the supervision of healthcare professionals. It is useful for:

• Emergency treatment of hypoglycemia
• Providing calories in patients unable to eat or absorb nutrients orally
• Correcting catabolic states during fasting, illness, or trauma
• As a vehicle for delivering compatible IV medications

Due to its hypertonicity, this solution should be administered cautiously to avoid complications such as vein irritation or fluid imbalances.

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

20% Glucose Infusion should only be administered intravenously by trained healthcare personnel. Its usage requires strict monitoring due to its high osmolarity and potent glucose load.

• Administration Method: Intravenous infusion via large peripheral vein or central venous catheter
• Preparation Steps:
  • Visually inspect for particulates or discoloration prior to use
  • Ensure the plastic bag is intact and not leaking
  • Use sterile technique and compatible IV set
• Infusion Guidelines:
  • Use an infusion pump to control the rate precisely
  • Adjust rate according to blood glucose monitoring
  • Monitor for local site reactions like phlebitis or infiltration
• Do Not:
  • Inject intramuscularly or subcutaneously
  • Use simultaneously with blood in the same IV line

This product should be used only when clearly indicated, with frequent assessments to prevent complications such as hyperglycemia or fluid overload.

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

Dextrose (glucose) is a monosaccharide and the primary source of energy for cellular metabolism. When administered intravenously, it rapidly enters the bloodstream, bypassing gastrointestinal absorption, and is taken up by body cells for energy production.

• Cellular Uptake:
  • Glucose is transported into cells via insulin-dependent and independent mechanisms
  • Inside cells, it undergoes glycolysis, producing ATP
• Metabolic Benefits:
  • Provides immediate energy in conditions like hypoglycemia
  • Spares protein by serving as an alternate energy source during catabolism
  • Helps replenish glycogen stores in liver and muscle
• Additional Effects:
  • Promotes fluid retention due to its hyperosmolar nature
  • Facilitates the delivery of other IV medications when used as a vehicle

This rapid availability of energy is critical in emergency and supportive care, particularly for patients unable to consume food or those undergoing stress or trauma.

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

Though glucose is naturally occurring, its IV administration can interact with several drugs and physiological processes, especially when used in large volumes or in certain patient populations.

• Insulin:
  • Increases glucose uptake into cells, requiring careful dosage adjustment
  • Concurrent administration often necessary in diabetic patients
• Diuretics:
  • May exacerbate electrolyte disturbances (e.g., hypokalemia)
• Electrolyte Solutions:
  • Dextrose can dilute electrolytes and may require supplementation (especially potassium)
• Drugs Requiring Specific Vehicles:
  • Incompatible with some IV drugs (e.g., diazepam, phenytoin)
• Alcohol:
  • May mask symptoms of hypoglycemia and influence glucose metabolism

Always verify compatibility before co-infusing with other medications and consult with pharmacy services when using it as a diluent.

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

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The dosage of 20% glucose infusion depends on the clinical context, patient's weight, glucose metabolism, and other concurrent therapies. Because this is a hypertonic solution, it must be used cautiously.

• For Hypoglycemia:
  • Adults: 25–50 ml bolus (5–10g dextrose), repeat as needed based on glucose monitoring
  • Children: 0.5–1 g/kg/dose, with monitoring and gradual titration
• Parenteral Nutrition:
  • Administered continuously via central line to avoid vein irritation
  • Rate: generally 3–5 mg/kg/min, titrated based on caloric needs and glucose levels
• Maximum Rate:
  • Should not exceed 0.5 g/kg/hour without insulin
  • High rates increase risk of hyperglycemia and osmotic diuresis

Always adjust the dose according to patient-specific factors and perform regular monitoring of blood glucose, renal function, and fluid status.

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

Although generally safe under medical supervision, 20% glucose infusion may cause a range of adverse effects, particularly with prolonged use or rapid infusion.

• Metabolic:
  • Hyperglycemia and glycosuria
  • Osmotic diuresis leading to dehydration and electrolyte loss
  • Hypokalemia due to insulin-mediated shift of potassium into cells
• Vascular:
  • Thrombophlebitis or vein irritation due to high osmolarity
  • Risk of thrombosis with peripheral infusion
• Fluid Balance:
  • Risk of fluid overload in patients with renal or cardiac dysfunction
• Others:
  • Headache, dizziness, fatigue due to fluctuating glucose levels
  • Rare hypersensitivity reactions like rash or fever

Prompt recognition and management of these effects are crucial to ensure patient safety during therapy.

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

This medication should not be used in patients with conditions that may be worsened by hypertonic glucose or excess fluid.

• Absolute Contraindications:
  • Severe hyperglycemia (uncontrolled)
  • Hypersensitivity to dextrose or any excipient in the solution
  • Intracranial or intraspinal hemorrhage (can worsen cerebral edema)
• Relative Contraindications:
  • Congestive heart failure or fluid-restricted conditions
  • Severe renal impairment (risk of fluid retention)
  • Thiamine deficiency (may precipitate Wernicke's encephalopathy)

Always evaluate the patient’s complete clinical profile and lab results before initiating therapy.

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

Proper storage ensures the safety, potency, and sterility of the infusion solution until administration.

• Storage Conditions:
  • Store at room temperature (below 25°C)
  • Do not freeze or expose to direct sunlight
• Packaging Integrity:
  • Inspect for any leaks, cloudiness, or particulates before use
  • Do not use if the plastic bag is damaged
• Expiry:
  • Check the expiration date on the label
  • Discard any unused solution after opening

Maintain the product in its original packaging until ready for use and follow institutional protocols for disposal of medical waste.