25% w/v DEXTROSE INJECTION USP Infusion/Solution for

What is 25% w/v DEXTROSE INJECTION USP

25% w/v Dextrose Injection USP is a sterile, non-pyrogenic solution of anhydrous dextrose in water intended for intravenous administration. It contains 25 grams of dextrose per 100 ml of water, making it a hypertonic glucose solution. Packaged in a 100ml plastic infusion bag, this preparation is typically used in clinical settings to manage severe hypoglycemia, provide rapid caloric supplementation, or serve as a vehicle for drug dilution.

• Generic Name: Dextrose (Anhydrous)
• Concentration: 25% w/v
• Form: Intravenous infusion/solution
• Volume: 100ml per plastic bag
• Therapeutic Class: Caloric agent, antiketogenic, parenteral nutrient

It is often used in emergency and intensive care scenarios when rapid glucose supplementation is required. Because of its hypertonicity, this solution must be administered with caution and under strict medical supervision.

How to use 25% w/v DEXTROSE INJECTION USP

This solution must be administered intravenously by qualified healthcare professionals, using aseptic techniques. The administration route and rate depend on the patient’s condition and clinical indication.

• Route of Administration: Intravenous infusion or slow IV injection
• Infusion Site: Preferably via central vein due to high osmolarity
• Rate of Administration: Should be individualized and typically controlled by infusion pumps
• Precautions: Ensure catheter patency; avoid extravasation, which can cause tissue damage
• Preparation: Do not use if solution is cloudy or if container is damaged
• Monitoring: Frequent monitoring of blood glucose, serum electrolytes, and fluid status is essential

The infusion must be stopped immediately if the patient develops signs of fluid overload, phlebitis, or metabolic disturbances. Never administer simultaneously with blood through the same IV line.

Mode of Action 25% w/v DEXTROSE INJECTION USP

Dextrose (anhydrous), the active ingredient in this solution, is a monosaccharide that serves as a rapid source of energy for cells. The mode of action includes:

• Metabolic Fuel: Dextrose is quickly absorbed and metabolized by cells through glycolysis, generating ATP necessary for cellular function.
• Plasma Volume Expansion: Being hypertonic, it draws fluid from intracellular compartments to the extracellular space, which can transiently expand plasma volume.
• Prevention of Ketosis: Adequate glucose suppresses fat metabolism, thereby reducing ketone body formation in fasting or malnourished states.
• Hyperosmotic Agent: Facilitates osmotic diuresis and can help manage intracranial pressure when used in specific settings under close monitoring.

The 25% concentration provides 250 kcal per 100 ml, making it a potent energy source in small volumes. It acts quickly, making it ideal for emergencies like severe hypoglycemia or dextrose-responsive metabolic crises.

25% w/v DEXTROSE INJECTION USP Interactions 25% w/v DEXTROSE INJECTION USP

Although dextrose is generally considered safe, it can interact with various drugs and physiological states, especially in critically ill patients.

• Insulin: Co-administration may require careful monitoring as insulin promotes intracellular uptake of glucose, increasing the risk of hypoglycemia.
• Corticosteroids: May counteract glucose-lowering effects and increase blood glucose levels.
• Diuretics (e.g., thiazides, furosemide): Can alter fluid and electrolyte balance, requiring additional monitoring when used with glucose infusions.
• Phenytoin: High glucose concentrations may impair phenytoin absorption when co-infused.
• Potassium-Sparing or Wasting Agents: Dextrose may cause transient hypokalemia; adjust potassium supplementation accordingly.

Avoid mixing with incompatible drugs in the same IV line unless confirmed safe. Always assess total fluid intake, caloric load, and metabolic conditions before administration.

Dosage of 25% w/v DEXTROSE INJECTION USP

Dosing of 25% Dextrose Injection depends on the patient’s glucose requirements, body weight, clinical status, and therapeutic objective. Overdose can cause serious metabolic imbalances.

• Adults: Commonly used in doses ranging from 20 to 50 ml (5 to 12.5 g of dextrose) given slowly IV over 3 to 5 minutes to treat acute hypoglycemia.
• Children: Typically administered at 0.5 to 1 g/kg IV; lower concentrations (e.g., 10%) are often preferred to minimize the risk of venous irritation.
• Neonates: Use with extreme caution; typically a 10% dextrose solution is preferred. 25% is rarely used unless diluted.
• Maximum Rate: Should not exceed 0.5 g/kg/hour unless under close ICU monitoring.

Tailor dosage carefully based on blood glucose levels. Repeat blood glucose tests within 15–30 minutes of administration to guide further treatment.

Possible side effects of 25% w/v DEXTROSE INJECTION USP

Although dextrose solutions are widely used and generally well-tolerated, several side effects can occur, particularly with hypertonic solutions like 25%.

• Hyperglycemia: Elevated blood glucose levels, especially in diabetic patients or those with insulin resistance.
• Electrolyte Imbalance: Can cause dilutional hyponatremia or hypokalemia due to insulin-mediated intracellular shifts.
• Phlebitis: Local vein inflammation due to the high osmolarity of the solution.
• Tissue Necrosis: If extravasation occurs, it can cause local tissue damage or necrosis.
• Osmotic Diuresis: High glucose load may lead to excessive urine output and dehydration.
• Infection Risk: If aseptic technique is compromised, there's a risk of local or systemic infection.

Monitor for symptoms like swelling, pain at infusion site, sudden rise in blood glucose, or changes in mental status. Stop infusion if adverse reactions occur.

25% w/v DEXTROSE INJECTION USP Contraindications 25% w/v DEXTROSE INJECTION USP

Use of 25% Dextrose Injection is contraindicated in several clinical scenarios due to the risk of worsening existing conditions.

• Uncontrolled Diabetes Mellitus: May exacerbate hyperglycemia and cause serious complications.
• Hyperosmolar States: Such as hyperosmolar hyperglycemic syndrome (HHS) or diabetic ketoacidosis (DKA) without concurrent insulin therapy.
• Intracranial Hemorrhage: Hypertonic solutions may increase intracranial pressure, worsening outcomes.
• Fluid Overload Conditions: Including pulmonary edema, congestive heart failure, or renal failure.
• Allergy: Known hypersensitivity to dextrose or any of the solution components.

Contraindications should be evaluated carefully before administration, especially in critically ill patients or those with impaired glucose metabolism.

Storage of 25% w/v DEXTROSE INJECTION USP

Proper storage is essential to maintain the sterility and efficacy of the solution. Always follow the manufacturer’s storage instructions.

• Temperature: Store below 25°C. Do not freeze.
• Protection from Light: No special protection required, but best stored away from direct sunlight.
• Container Integrity: Do not use if the plastic bag is leaking, damaged, or the solution appears cloudy or discolored.
• Shelf Life: Use before the expiration date printed on the label. Discard after expiration.
• Post-Opening: Single-dose use only. Discard any unused portion immediately after opening.

Follow hospital protocols for the storage and disposal of IV fluids. Maintain a sterile environment to prevent contamination during preparation and administration.