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 hypertonic solution containing 20 grams of glucose (dextrose monohydrate) per 100 ml of sterile water for injection. The 2000 ml plastic bag provides 400 grams of dextrose. This intravenous solution is used in hospitals for providing immediate energy, managing hypoglycemia, supplementing parenteral nutrition, and serving as a vehicle for drug delivery.

• Generic name: Dextrose (D-glucose)
• Concentration: 20% w/v (hypertonic)
• Volume: 2000 ml (2 liters)
• Purpose: Caloric supplementation, emergency glucose supply, drug diluent

Because it is a high-volume hypertonic solution, it is typically administered via a central venous catheter in clinical settings, especially in intensive care, surgery recovery, or nutrition therapy. The large bag volume ensures prolonged glucose delivery without frequent replacement, especially important in long-term parenteral support.

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

This solution should only be used under strict medical supervision due to its high concentration and volume. Proper technique is essential to avoid complications.

• Administration Route: Intravenous (IV), preferably via central venous line due to hyperosmolarity
• Preparation Steps:
  • Inspect the bag for leaks, particulates, or discoloration
  • Ensure sterile connection to an appropriate IV set
  • Label with patient details and intended infusion rate
• Infusion Guidelines:
  • Administer slowly using an infusion pump
  • Rate adjusted based on clinical indication and patient tolerance
  • Frequent monitoring of blood glucose, electrolytes, and hydration status
• Do Not:
  • Administer via bolus or intramuscular injection
  • Mix with incompatible medications in the same line

Due to the risk of vein irritation and fluid overload, this formulation should be infused cautiously and never through small peripheral veins.

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

Dextrose (glucose) is a monosaccharide that serves as a vital energy source for all cells. When administered intravenously, it enters the bloodstream immediately and is distributed to tissues where it is metabolized to produce ATP through glycolysis and oxidative phosphorylation.

• Cellular Energy:
  • Uptake into cells is insulin-mediated (especially in muscle and fat tissue)
  • Used in glycolysis and citric acid cycle to generate ATP
• Clinical Utility:
  • Corrects hypoglycemia quickly
  • Supports metabolic needs during fasting or stress
  • Reduces protein catabolism by serving as an alternate energy source
• Additional Actions:
  • Promotes glycogen storage in liver and muscles
  • Osmotic properties support fluid movement in parenteral nutrition

This mode of action is especially beneficial for critically ill patients requiring non-enteral energy supplementation.

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

Despite being a basic carbohydrate, intravenous glucose may interact with various drugs and physiological systems, especially in large volumes.

• Insulin:
  • Significantly lowers blood glucose levels
  • Must be co-administered in diabetic patients or during total parenteral nutrition (TPN)
• Diuretics (e.g., furosemide):
  • May potentiate electrolyte disturbances, especially potassium and magnesium loss
• Electrolyte Supplements:
  • Potassium often added to avoid hypokalemia due to insulin response
• Drugs with Limited Solubility:
  • Some medications are incompatible with dextrose solutions (e.g., phenytoin, amphotericin B)
• Alcohol and Corticosteroids:
  • May alter glucose metabolism, requiring careful monitoring

Always consult compatibility charts and pharmacist guidance before mixing or co-administering with other IV drugs.

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

The dose of 20% glucose depends on the patient’s metabolic needs, body weight, glucose tolerance, and therapeutic goals. It must be carefully calculated to avoid hyperglycemia and fluid overload.

• Typical Use: Caloric support in patients unable to take oral nutrition, management of hypoglycemia, or part of TPN regimen
• Adults:
  • Caloric dose: 3–5 mg/kg/min (adjusted to maintain euglycemia)
  • Volume and rate are individualized based on daily fluid and caloric requirements
• Children:
  • Dosing must be weight-based and closely monitored
  • Excess glucose may cause rebound hypoglycemia or osmotic diuresis
• Maximum Infusion Rate:
  • Should not exceed 0.5 g/kg/hour unless insulin is administered concurrently

Close monitoring of blood glucose, serum electrolytes, and hydration status is essential during therapy.

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

While generally safe under supervision, 20% Glucose IV infusion may produce side effects, especially with rapid administration or prolonged use.

• Metabolic:
  • Hyperglycemia, glycosuria
  • Hypokalemia (especially if insulin is administered)
  • Osmotic diuresis leading to dehydration
• Vascular:
  • Phlebitis, thrombosis, and vein irritation
  • Extravasation may cause tissue damage
• Fluid Overload:
  • Pulmonary edema in susceptible patients (e.g., heart failure, renal insufficiency)
• Others:
  • Headache, restlessness, or confusion due to blood sugar fluctuations
  • Rare allergic reactions: fever, rash, or chills

Regular monitoring and prompt intervention can significantly reduce these risks.

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

Certain conditions contraindicate the use of 20% glucose infusion, either due to the solution’s high glucose content, osmolarity, or fluid volume.

• Absolute Contraindications:
  • Known allergy to dextrose
  • Severe hyperglycemia (e.g., diabetic ketoacidosis without insulin)
  • Intracranial or intraspinal hemorrhage (risk of exacerbating cerebral edema)
• Relative Contraindications:
  • Congestive heart failure (risk of fluid overload)
  • Severe renal impairment (reduced clearance)
  • Uncorrected electrolyte imbalances (particularly low potassium or magnesium)

Each patient should be carefully evaluated prior to administration, particularly in acute care settings.

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

Proper storage maintains the efficacy and sterility of the product.

• Temperature: Store below 25°C
• Protection: Keep away from sunlight and freezing conditions
• Packaging Integrity:
  • Use only if the plastic bag is intact, clear, and free of particulates
  • Do not use if the solution is discolored
• After Opening:
  • Use immediately after opening
  • Discard any unused portion; do not re-sterilize
• Shelf Life: Refer to product label for expiry date

Always follow institutional protocols for storage, handling, and disposal of medical solutions.