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 solution of Dextrose (also known as glucose) in water, used primarily for intravenous administration. It contains 20 grams of glucose in every 100 ml of water, and this particular packaging comes in a 1000ml plastic infusion bag. It is classified as a hypertonic solution, which is especially useful in clinical settings for supplying energy, managing hypoglycemia, or serving as a diluent for compatible medications.

• Generic Name: Dextrose
• Concentration: 20% w/v
• Form: Solution for Intravenous Infusion
• Volume: 1000ml per plastic bag
• Therapeutic Use: Caloric supply, treatment of hypoglycemia, dehydration, or as part of parenteral nutrition
• ATC Code: B05BA03

This infusion is commonly used in hospitals under the supervision of healthcare professionals to maintain glucose levels or treat glucose deficiencies when oral intake is not feasible. It can also be used as a component of total parenteral nutrition (TPN) therapy.

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

The use of 20% Glucose IV Infusion must always be under the supervision of qualified medical personnel. It is administered via a sterile intravenous line and is typically used in inpatient or clinical settings.

• Route of Administration: Intravenous infusion through a suitable vein
• Rate of Infusion: Depends on patient’s age, clinical condition, and glucose tolerance
• Infusion Equipment: Use sterile, pyrogen-free infusion sets; preferably with an inline filter
• Preparation: Inspect the solution for clarity and container integrity before use. Do not use if discolored or particulate matter is visible.
• Compatibility: May be mixed with other IV medications but only under guidance from a pharmacist or doctor

Always monitor blood glucose and fluid balance during infusion. The infusion should be discontinued or modified if signs of fluid overload, electrolyte imbalance, or hyperglycemia develop. Avoid extravasation by ensuring correct venous access and secure catheter placement.

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

The primary mode of action of 20% Glucose IV Infusion lies in its role as a source of readily metabolizable carbohydrate—glucose (dextrose). Upon administration:

• Metabolic Function: Glucose enters systemic circulation and is transported into cells via insulin-dependent and -independent pathways. Inside the cells, glucose undergoes glycolysis, yielding ATP, which fuels vital physiological functions.
• Hypertonic Action: The 20% solution is hypertonic compared to plasma, promoting fluid shift from intracellular to extracellular compartments, temporarily expanding plasma volume.
• Caloric Support: Provides 200 kcal per 1000 ml, helping to meet energy requirements in patients unable to eat orally.
• Prevents Ketosis: Supplying glucose reduces the need for fat breakdown, thus preventing ketone body accumulation, especially in fasting or starved patients.

Overall, this infusion is used to maintain energy balance, support metabolic needs during illness, and manage conditions like hypoglycemia or dehydration.

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

While generally safe under supervision, 20% Glucose IV Infusion can interact with other medications or medical conditions. Awareness of potential interactions is crucial:

• Insulin: Co-administration may require dose adjustments as insulin facilitates glucose uptake, potentially increasing the risk of hypoglycemia.
• Diuretics (e.g., Furosemide): May affect electrolyte balance and fluid volume, requiring careful monitoring when used together.
• Potassium Supplements: Hyperglycemia from excess glucose may cause intracellular shift of potassium, requiring potassium monitoring and dose adjustment.
• Corticosteroids: May antagonize insulin effects and raise blood glucose levels, reducing the effectiveness of glucose therapy.
• Alcohol: Can affect blood glucose regulation and increase the risk of hypoglycemia during glucose infusion.

Always review the patient’s medication history before starting therapy. Incompatibilities can occur if mixed in the same line or bag without proper compatibility studies.

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

Dosage should always be individualized, based on clinical parameters such as age, weight, fluid balance, and glucose requirements.

• Adults: Typically administered at 0.5 to 1.0 g/kg/hour, not exceeding 5-6 mg/kg/min to avoid hyperglycemia or fluid overload.
• Children: Dose ranges from 10 to 20 ml/kg/day; close monitoring of blood glucose and electrolytes is necessary.
• Elderly: Use with caution due to the risk of fluid overload and compromised renal function.
• Patients with renal or cardiac impairment: Require lower volumes and slower rates due to risk of fluid retention or overload.

Frequent monitoring of serum glucose, electrolytes, and renal function is essential during therapy. Modify or discontinue infusion based on laboratory results and clinical response.

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

While generally well tolerated when properly administered, several adverse effects can occur:

• Hyperglycemia: Elevated blood glucose levels, especially in diabetic or insulin-resistant patients
• Electrolyte Imbalances: May dilute plasma electrolytes like sodium or potassium, particularly with large volumes
• Phlebitis: Local vein inflammation at the site of infusion due to the hypertonic nature of the solution
• Fluid Overload: Especially in patients with renal, cardiac, or hepatic insufficiency, leading to pulmonary edema or heart failure
• Hypokalemia: Excess glucose may induce intracellular potassium shifts, leading to low serum potassium levels
• Infection: Risk at the catheter insertion site if aseptic techniques are not strictly followed

Immediate cessation of infusion and medical attention are necessary if symptoms of allergic reaction, circulatory overload, or metabolic disturbances occur.

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

The infusion is contraindicated in specific clinical situations where glucose administration may exacerbate the underlying condition:

• Hyperglycemia: Should not be used in patients with uncontrolled diabetes mellitus without insulin co-administration
• Hypokalemia: May worsen potassium deficit unless potassium supplementation is also administered
• Fluid Retention or Overload: Conditions such as heart failure, renal insufficiency, or pulmonary edema
• Allergy or hypersensitivity: To dextrose or any component of the infusion bag
• Intracranial or intraspinal hemorrhage: Risk of exacerbating cerebral edema

Thorough assessment of the patient's metabolic status, renal and cardiac function, and volume status is essential before initiating therapy.

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

Proper storage conditions are crucial for maintaining the safety, efficacy, and sterility of the infusion solution.

• Temperature: Store below 25°C. Do not freeze.
• Light Protection: No special protection from light is required, but store in a dry place away from direct sunlight
• Packaging: Keep in original plastic bag until use. Do not use if bag is damaged or solution is discolored.
• Expiry: Use within the expiration date printed on the packaging. Do not use after expiry even if the solution appears clear.
• Post-Opening: Single-use only. Discard any unused portion. Do not store for reuse.

Always handle the bag using aseptic techniques and inspect for leaks before use. Follow institutional protocols for storage and disposal of IV fluids.