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 intravenous infusion solution containing 25 grams of anhydrous dextrose per 100 milliliters of water. Supplied in a 1000ml plastic bag, it is a hypertonic glucose solution commonly used in clinical settings to provide a concentrated source of carbohydrates directly into the bloodstream.

• Composition: Contains anhydrous dextrose dissolved in sterile water, providing 25% weight/volume concentration.
• Form: Clear, colorless, sterile solution intended for intravenous infusion.
• Indications: Used for treatment of hypoglycemia, parenteral nutrition support, maintenance of caloric intake in patients unable to eat, and as a vehicle for intravenous medications.
• Purpose: Provides an immediate and efficient energy source to cells, particularly critical in patients who require rapid correction of blood glucose levels or nutritional support.
• Application Settings: Widely used in hospitals, intensive care units, and emergency settings.

How to use 25% w/v DEXTROSE INJECTION USP

Administration of 25% Dextrose Injection should be performed under medical supervision, with careful attention to dosing, rate, and patient monitoring.

• Route of Administration: Administer intravenously via a suitable vein; do not inject intramuscularly or subcutaneously.
• Preparation: Inspect the solution for clarity and absence of particulates before use. Confirm compatibility if mixing with other drugs.
• Infusion Rate: Adjust infusion speed based on clinical condition and blood glucose levels. Rapid infusion may cause hyperglycemia or fluid overload.
• Monitoring: Continuously monitor blood glucose, fluid balance, and electrolytes to avoid complications.
• Dosage Adjustment: Dose must be individualized based on patient age, weight, metabolic demands, and clinical status.
• Emergency Use: In acute hypoglycemia, a bolus may be given under strict supervision, followed by maintenance infusion.

Mode of Action 25% w/v DEXTROSE INJECTION USP

The therapeutic effect of 25% Dextrose Injection is due to its provision of glucose, a fundamental energy substrate for cellular metabolism.

• Energy Supply: Dextrose is metabolized in cells via glycolysis to generate ATP, essential for cellular functions and survival.
• Blood Glucose Correction: Increases circulating glucose levels rapidly, correcting hypoglycemia and preventing neurological impairment.
• Osmotic Effect: Being hypertonic, it draws water from intracellular compartments into the vascular space, aiding plasma volume expansion.
• Supportive Nutrition: Supplies calories for patients unable to meet energy requirements orally or enterally.
• Metabolic Role: Facilitates synthesis of glycogen and fatty acids when in excess, contributing to energy storage.

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

Dextrose solution may interact with various medications, influencing their effects or causing adverse reactions.

• Insulin and Oral Hypoglycemic Agents: These lower blood glucose levels and require dose adjustments to prevent hypo- or hyperglycemia when used with dextrose.
• Diuretics: Potassium-wasting diuretics can cause electrolyte imbalances exacerbated by glucose infusion.
• Warfarin: Changes in blood glucose may affect warfarin metabolism and anticoagulant effect.
• Corticosteroids and Sympathomimetics: Both can elevate blood glucose, increasing hyperglycemia risk when combined with dextrose infusion.
• Intravenous Medications: Always check compatibility before co-administration to avoid precipitation or reduced efficacy.

Dosage of 25% w/v DEXTROSE INJECTION USP

The dosage depends on patient-specific factors such as age, weight, clinical condition, and therapeutic goals.

• Adults: Maintenance doses typically range from 200 ml to 500 ml infused over several hours based on caloric and fluid needs.
• Hypoglycemia Treatment: Rapid intravenous bolus doses (e.g., 50 ml) may be administered for immediate blood glucose correction, followed by maintenance infusion.
• Pediatrics: Dosage must be carefully calculated per body weight and titrated according to blood glucose monitoring.
• Adjustments: Modify dosage and infusion rate based on ongoing assessment of blood glucose, hydration status, and electrolyte balance.
• Parenteral Nutrition: Often used as part of a comprehensive nutritional regimen with amino acids and lipids in critically ill patients.

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

Adverse effects can occur, especially if administered improperly or without appropriate monitoring.

• Local Reactions: Pain, inflammation, or thrombophlebitis at the infusion site due to hyperosmolarity.
• Hyperglycemia: Excessive dosing can cause elevated blood glucose, resulting in symptoms such as polyuria, polydipsia, headache, and, in severe cases, diabetic ketoacidosis.
• Fluid Overload: Rapid or excessive infusion may lead to pulmonary edema, heart failure, or hypertension, particularly in susceptible individuals.
• Electrolyte Imbalances: Shifts in potassium, sodium, and other electrolytes may cause arrhythmias or neurological symptoms.
• Allergic Reactions: Rare hypersensitivity reactions including rash, itching, or anaphylaxis.
• Other: Nausea, dizziness, or headache may be observed in some patients.

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

The solution should not be used in the following situations:

• Uncontrolled Hyperglycemia: Patients with very high blood sugar levels or diabetic ketoacidosis should avoid hypertonic dextrose until glucose levels are controlled.
• Severe Dehydration: Without correction of electrolytes, hypertonic solutions may exacerbate dehydration or imbalance.
• Known Hypersensitivity: Allergy to dextrose or any component of the solution.
• Intracranial Hemorrhage or Increased Intracranial Pressure: Osmotic shifts may worsen cerebral edema.
• Severe Renal or Cardiac Dysfunction: Risk of fluid overload and electrolyte disturbances is increased.

Storage of 25% w/v DEXTROSE INJECTION USP

Proper storage conditions help maintain solution integrity and safety:

• Temperature: Store at room temperature (20°C to 25°C), avoiding freezing.
• Protection: Keep in original packaging to protect from light and contamination.
• Handling: Avoid vigorous shaking; inspect for particulate matter and cloudiness before use.
• Expiry: Use before the expiration date indicated on the packaging.
• Environment: Store in a clean, dry place, away from incompatible substances and extreme temperature fluctuations.