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, hypertonic intravenous solution containing 25 grams of anhydrous dextrose per 100 milliliters of water. It is commonly supplied in a 500ml plastic bottle for medical use.

• Purpose: This medication is primarily used to provide a source of calories and fluids for patients who cannot consume food orally or require intravenous supplementation due to illness or surgery.
• Composition: The active ingredient, dextrose (an anhydrous form of glucose), acts as a carbohydrate source, supplying energy to the body's cells.
• Indications: It is indicated for patients with hypoglycemia, dehydration, or as part of parenteral nutrition. It may also be used in cases of insulin shock, to correct electrolyte imbalances, or to dilute other medications for intravenous administration.
• Form: The solution is clear, colorless, and free from visible particles, making it safe for intravenous infusion.
• Clinical Setting: Used extensively in hospitals, clinics, and emergency care to restore blood sugar levels and provide essential hydration and nutrition when oral intake is not possible or inadequate.

How to use 25% w/v DEXTROSE INJECTION USP

Administering 25% Dextrose Injection requires careful clinical assessment and strict adherence to protocols to ensure safety and efficacy.

• Administration Route: This medication is administered intravenously (IV) only. It should never be given by intramuscular or subcutaneous routes due to tissue irritation and potential complications.
• Preparation: Prior to administration, the solution should be inspected for clarity and absence of particles. If mixed with other drugs, compatibility must be verified to avoid precipitation or loss of efficacy.
• Dilution: In some cases, dilution with sterile water or normal saline might be necessary depending on the patient’s fluid and sugar requirements.
• Infusion Rate: The infusion rate must be carefully controlled and adjusted according to patient age, weight, and clinical condition to prevent complications such as hyperglycemia or fluid overload.
• Monitoring: Blood glucose levels, electrolytes, and fluid balance should be regularly monitored during infusion to adjust dosage and avoid adverse effects.
• Use in Emergency: In hypoglycemic emergencies, it can be administered as a bolus injection under close supervision.

Mode of Action 25% w/v DEXTROSE INJECTION USP

The primary mechanism by which 25% w/v Dextrose Injection exerts its therapeutic effect is by supplying glucose directly into the bloodstream.

• Energy Supply: Dextrose is a simple sugar that is rapidly absorbed and metabolized by the body's cells to produce energy (ATP), vital for cellular function, especially in the brain and muscles.
• Metabolic Pathways: Once administered intravenously, dextrose enters glycolysis and the Krebs cycle, leading to ATP generation.
• Blood Glucose Regulation: It increases blood glucose levels promptly, which is crucial in treating hypoglycemia or maintaining energy balance in fasting or critically ill patients.
• Osmotic Effect: Due to its hypertonic nature, it draws water from intracellular to extracellular compartments, helping to correct dehydration and maintain plasma volume.
• Supporting Nutrition: When used as part of parenteral nutrition, it serves as a key carbohydrate source alongside amino acids and lipids.

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

Dextrose infusion can interact with various medications, potentially affecting efficacy and safety.

• Insulin and Hypoglycemics: Dextrose may reduce the effectiveness of insulin and other antidiabetic drugs by increasing blood sugar levels, requiring dose adjustments.
• Diuretics: Concomitant use with diuretics like furosemide can affect electrolyte balance, particularly potassium levels, necessitating close monitoring.
• Warfarin: High glucose levels can alter warfarin metabolism, affecting anticoagulant control.
• Drugs Requiring Dilution: Compatibility must be checked before co-administration with other IV drugs, as dextrose solutions can cause precipitation or inactivation of some medications (e.g., aminoglycosides, amphotericin B in certain solutions).
• Corticosteroids and Catecholamines: These can increase blood glucose levels, potentially intensifying hyperglycemia risks when combined with dextrose infusion.

Dosage of 25% w/v DEXTROSE INJECTION USP

Dosage of 25% Dextrose Injection depends on the patient’s clinical condition, age, weight, and metabolic needs.

• Adults: Typical maintenance or replacement doses range from 100 to 300 ml infused over several hours, adjusted based on blood glucose and fluid status.
• Emergency Use: In hypoglycemic shock, 25-50 ml may be given as a rapid intravenous bolus to quickly restore blood glucose levels.
• Pediatric Use: Dosage is carefully calculated on a weight basis, often between 0.5 to 1 gram/kg of dextrose, administered slowly with continuous monitoring.
• Continuous Infusion: May be used in combination with electrolytes and other nutrients in parenteral nutrition solutions for critically ill patients.
• Adjustment: Dosage should be modified based on blood glucose levels, kidney function, and patient response to avoid hyperglycemia or fluid overload.

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

While generally safe when administered appropriately, 25% Dextrose Injection can cause side effects, especially if given improperly or in excess.

• Local Reactions: Pain, irritation, or phlebitis at the injection site due to hypertonic solution.
• Hyperglycemia: Elevated blood sugar levels may cause symptoms such as increased thirst, frequent urination, headache, and in severe cases, diabetic ketoacidosis.
• Electrolyte Imbalance: Can cause shifts in sodium, potassium, and fluid balance leading to complications like edema, hypokalemia, or hypernatremia.
• Fluid Overload: Excessive administration may lead to pulmonary edema, hypertension, and congestive heart failure, especially in patients with cardiac or renal impairment.
• Allergic Reactions: Rare, but may include rash, itching, or anaphylaxis.
• Other: Headache, dizziness, or nausea may occur in some cases.

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

Certain medical conditions and patient factors contraindicate the use of 25% Dextrose Injection.

• Hyperglycemia: Patients with uncontrolled diabetes or hyperosmolar states should avoid dextrose solutions to prevent exacerbation of hyperglycemia.
• Severe Dehydration Without Electrolyte Replacement: Using hypertonic dextrose alone can worsen electrolyte imbalance.
• Known Allergy: Hypersensitivity to dextrose or any component of the formulation.
• Intracranial or Intraspinal Hemorrhage: Hyperosmolar solutions may worsen cerebral edema or increase intracranial pressure.
• Severe Renal or Cardiac Failure: Due to risk of fluid overload and electrolyte disturbances.

Storage of 25% w/v DEXTROSE INJECTION USP

Proper storage of 25% w/v Dextrose Injection ensures its potency and safety.

• Temperature: Store at controlled room temperature, ideally between 20°C and 25°C (68°F and 77°F). Avoid freezing as it can damage the solution and container.
• Light Protection: Keep the solution in its original packaging to protect from light exposure that could degrade the product.
• Handling: Avoid shaking vigorously to prevent foaming or contamination.
• Expiry: Use before the expiration date indicated on the bottle. Do not use if the solution appears discolored, cloudy, or contains particles.
• Storage Environment: Store in a clean, dry place away from direct heat sources and incompatible substances.