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 composed of 25 grams of anhydrous dextrose dissolved in 100 milliliters of sterile water for injection, supplied in a 500ml plastic bag. It is primarily used to provide a concentrated source of glucose, which serves as a key energy substrate in clinical settings.

• Purpose: It is indicated for patients who require rapid correction of hypoglycemia, nutritional supplementation when oral intake is inadequate or impossible, and as part of fluid and electrolyte management in various medical conditions.
• Composition: Contains anhydrous dextrose, a simple sugar that is metabolized by the body to provide immediate energy.
• Formulation: The solution is clear, colorless, and free of visible particulates, making it safe for intravenous administration.
• Clinical Use: Used in hospitals for parenteral nutrition, treatment of dehydration, and as a diluent or vehicle for compatible intravenous medications.
• Indications: Correction of hypoglycemia, maintenance of blood glucose levels during fasting, provision of calories for metabolic needs, and treatment of certain fluid imbalances.

How to use 25% w/v DEXTROSE INJECTION USP

Administration of 25% Dextrose Injection requires careful clinical judgment and monitoring to ensure safety and efficacy.

• Route: Administered strictly via intravenous infusion. Do not use intramuscularly or subcutaneously to avoid tissue irritation and necrosis.
• Preparation: Inspect the solution visually to ensure it is clear and free of particles. Confirm compatibility if mixing with other intravenous drugs.
• Infusion Rate: Adjust the infusion rate based on the patient's condition, blood glucose levels, and fluid status to avoid complications such as hyperglycemia or fluid overload.
• Monitoring: Continuously monitor blood glucose, electrolytes, and overall fluid balance during administration.
• Dosing: Dosage should be individualized depending on patient age, weight, clinical condition, and specific therapeutic needs.
• Emergency Use: For acute hypoglycemia, bolus intravenous administration under strict medical supervision is appropriate.

Mode of Action 25% w/v DEXTROSE INJECTION USP

The pharmacological effect of 25% Dextrose Injection is based on its provision of glucose, an essential energy substrate.

• Energy Source: Dextrose is rapidly absorbed into the bloodstream and taken up by cells, where it undergoes glycolysis to produce ATP, the primary energy currency of cells.
• Blood Glucose Regulation: The infusion elevates blood glucose levels, correcting hypoglycemia and providing energy to metabolically active tissues such as the brain and muscles.
• Osmotic Effect: Being hypertonic, it draws fluid from intracellular compartments into the vascular system, aiding in rehydration and maintenance of circulatory volume.
• Supportive Role: Helps maintain caloric intake in patients who cannot consume adequate nutrition orally or enterally.

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

Dextrose injection can interact with various medications, necessitating careful monitoring.

• Insulin and Oral Hypoglycemics: These drugs lower blood glucose, so concurrent administration with dextrose requires dose adjustments to avoid hypo- or hyperglycemia.
• Diuretics: May exacerbate electrolyte imbalances, especially potassium disturbances when used alongside dextrose solutions.
• Warfarin: Hyperglycemia may alter the metabolism of warfarin, potentially affecting anticoagulation control.
• Corticosteroids and Catecholamines: Both may raise blood glucose levels, increasing the risk of hyperglycemia when combined with dextrose infusions.
• Intravenous Drugs: Always verify compatibility before mixing other drugs with dextrose solutions to avoid precipitation or inactivation.

Dosage of 25% w/v DEXTROSE INJECTION USP

The dosage of 25% Dextrose Injection should be individualized based on the patient's clinical needs, age, weight, and metabolic status.

• Adults: Maintenance doses generally range from 100 to 250 ml administered over several hours, depending on caloric and fluid requirements.
• Emergency Hypoglycemia: Rapid intravenous bolus doses of 25 to 50 ml may be administered under close supervision.
• Children: Dose calculations are typically weight-based and carefully titrated to avoid rapid fluctuations in blood glucose.
• Adjustment: Dosage must be modified according to blood glucose measurements, electrolyte status, and renal or cardiac function.
• Parenteral Nutrition: Often combined with amino acids and lipids for comprehensive nutritional support in critically ill patients.

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

While generally well tolerated, 25% Dextrose Injection may cause some adverse effects, especially if improperly administered.

• Local Reactions: Pain, irritation, or thrombophlebitis at the infusion site due to hyperosmolarity.
• Hyperglycemia: Excessive infusion can cause high blood sugar, leading to symptoms such as thirst, increased urination, headache, and in severe cases, diabetic ketoacidosis.
• Fluid Overload: Risk of pulmonary edema or heart failure in susceptible individuals if administered too rapidly or in excess.
• Electrolyte Imbalances: Shifts in potassium and sodium levels can cause arrhythmias or neurological symptoms.
• Allergic Reactions: Rare but may include rash, itching, or anaphylaxis.
• Other: Nausea, dizziness, or headache may occur in some patients.

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

Administration of this solution is contraindicated or should be used with caution in the following situations:

• Uncontrolled Hyperglycemia: Patients with markedly elevated blood glucose or diabetic ketoacidosis should not receive hypertonic dextrose.
• Severe Dehydration: Without prior electrolyte correction, hypertonic solutions may worsen imbalance.
• Allergy: Known hypersensitivity to dextrose or any component of the formulation.
• Intracranial Hemorrhage: Risk of increased intracranial pressure due to osmotic effects.
• Severe Renal or Cardiac Disease: Risk of fluid overload and electrolyte disturbances.

Storage of 25% w/v DEXTROSE INJECTION USP

Proper storage ensures the integrity and sterility of the dextrose solution:

• Temperature: Store at controlled room temperature between 20°C and 25°C (68°F to 77°F). Avoid freezing.
• Protection: Keep in original packaging to protect from light and contamination.
• Handling: Do not shake the bag vigorously to prevent foaming and contamination.
• Inspection: Before use, inspect for cloudiness, discoloration, or particulate matter. Do not use if these are present.
• Expiration: Use before the expiry date indicated on the packaging.
• Environment: Store in a clean, dry place away from incompatible substances and extreme temperatures.