5% w/v DEXTROSE INJECTION USP [Medisal] Injection

What is 5% w/v DEXTROSE INJECTION USP [Medisal]

5% w/v Dextrose Injection USP [Medisal] is a sterile, non-pyrogenic intravenous solution composed of 5 grams of dextrose (a form of glucose) per 100 ml of water for injection. It is supplied in a 250ml polypropylene bottle, designed for parenteral administration under medical supervision. This formulation is categorized as an isotonic solution, commonly used for fluid and nutrient replenishment in various clinical scenarios.

• Generic name: Dextrose
• Strength: 5% w/v (5 grams of dextrose per 100 ml)
• Route of administration: Intravenous (IV)
• Packaging: 250ml polypropylene bottle, non-reactive and safe for IV use

This solution serves multiple medical purposes including:

• Providing calories as a carbohydrate source
• Treating dehydration when electrolytes are not required
• Acting as a vehicle for drug dilution and administration
• Managing hypoglycemia or insulin-induced low blood sugar

Its clinical utility spans across pediatrics, adult medicine, and critical care settings, especially when managing fluid balance or glucose requirements.

How to use 5% w/v DEXTROSE INJECTION USP [Medisal]

Administration of 5% w/v Dextrose Injection USP [Medisal] should be carried out only by trained healthcare professionals in a controlled setting such as a hospital or clinical facility. The solution is intended for intravenous infusion and should never be administered intramuscularly or subcutaneously.

• Inspect visually: Always check the solution for particulates or discoloration. Do not use if the solution appears cloudy or if the bottle is damaged.
• Dosage and rate: The volume and infusion rate depend on the patient’s age, body weight, clinical condition, and fluid balance. Typically infused slowly to avoid fluid overload or hyperglycemia.
• Route: Administered via IV line using a sterile needle or catheter, often through a central or peripheral vein.
• Compatibility: Can be mixed with compatible IV drugs. However, confirm drug compatibility before mixing.
• Aseptic technique: Use strict aseptic conditions during administration to avoid contamination or infection.

It is essential to monitor:

• Blood glucose levels
• Electrolytes and fluid balance
• Signs of infection or phlebitis at the injection site

Dispose of unused portions properly and never reuse single-dose containers. Over-infusion may lead to complications such as hyperglycemia, hyponatremia, or fluid overload.

Mode of Action 5% w/v DEXTROSE INJECTION USP [Medisal]

The therapeutic effect of 5% Dextrose Injection USP is primarily attributed to its active component, dextrose (D-glucose), a monosaccharide that plays a central role in cellular metabolism. Once infused intravenously, it serves multiple physiological functions depending on the patient's needs.

• Energy source: Dextrose is rapidly absorbed and metabolized by body tissues, providing an immediate and essential source of energy, particularly useful in patients with limited oral intake or during acute illnesses.
• Maintains blood glucose levels: Prevents hypoglycemia in patients receiving insulin or those with conditions like fasting, sepsis, or diabetes.
• Hydration: The water component helps in correcting dehydration and maintaining plasma volume, especially when electrolyte-free fluid replacement is necessary.
• Carrier for other drugs: Acts as a vehicle for delivering IV medications in a diluted, safer form.

Once inside the body:

• Dextrose is transported into cells via insulin-dependent and -independent pathways.
• It undergoes glycolysis and the Krebs cycle to produce ATP, water, and carbon dioxide.
• Excess glucose can be stored as glycogen in the liver or converted into fat.

Because this is an isotonic solution, it doesn’t initially alter plasma osmolarity but may become hypotonic after glucose metabolism, aiding intracellular hydration.

5% w/v DEXTROSE INJECTION USP [Medisal] Interactions 5% w/v DEXTROSE INJECTION USP [Medisal]

While 5% Dextrose Injection is generally considered safe and well-tolerated, potential interactions may arise when used alongside other medications or in patients with metabolic imbalances.

• Insulin: Co-administration may cause rapid glucose uptake, resulting in hypoglycemia. Blood glucose levels should be monitored closely.
• Corticosteroids: These may antagonize the hypoglycemic effects of dextrose, potentially altering glucose tolerance.
• Diuretics: Especially thiazide diuretics may exacerbate fluid and electrolyte imbalances, increasing the risk of hyponatremia when large volumes of dextrose solutions are infused.
• Phenytoin: High concentrations of dextrose may reduce the solubility of phenytoin in IV formulations, affecting drug stability.
• Electrolyte Imbalances: In patients with conditions like SIADH or renal failure, dextrose infusion can worsen hyponatremia or fluid overload.

Drug compatibility:

• Always confirm the compatibility of drugs before mixing with 5% Dextrose.
• Some antibiotics, chemotherapy agents, and biologics may not be stable in dextrose-containing solutions.

Additionally, when used in patients with diabetes mellitus, dextrose-containing solutions must be administered with caution and under close glucose monitoring to prevent complications.

Dosage of 5% w/v DEXTROSE INJECTION USP [Medisal]

Dosage should always be individualized based on the patient's clinical status, age, weight, and hydration or caloric needs. It should be prescribed and supervised by healthcare professionals.

• Adults: Typically infused at rates of 30 to 40 ml/kg/day, depending on caloric requirements and fluid balance. For a 70kg adult, this equates to approximately 2–3 liters/day, adjusted as needed.
• Pediatrics: Doses are usually weight-based and more carefully controlled to avoid fluid overload. Maintenance fluids may be calculated using the Holliday-Segar method (e.g., 100 ml/kg for the first 10 kg).
• Geriatrics: Infusion rates may be reduced due to decreased renal function or risk of heart failure.

Special considerations:

• For hypoglycemia: Administered as a bolus or slow infusion, depending on severity.
• As a drug diluent: Used in small amounts depending on the medication’s concentration and compatibility.

Monitoring is crucial to avoid over-infusion, especially in patients with renal impairment, cardiovascular disease, or diabetes. Dextrose metabolism and fluid output should guide adjustments.

Possible side effects of 5% w/v DEXTROSE INJECTION USP [Medisal]

Although generally safe, 5% Dextrose Injection can cause side effects, particularly when administered in large volumes or without proper monitoring. Side effects can range from mild to life-threatening depending on patient-specific factors.

• Metabolic effects:
• Hyperglycemia
• Hypoglycemia (after abrupt cessation or insulin co-administration)
• Electrolyte imbalances such as hyponatremia or hypokalemia
• Fluid overload:
• Peripheral edema
• Pulmonary edema (in susceptible individuals)
• Congestive heart failure symptoms
• Infusion-related effects:
• Phlebitis or irritation at the injection site
• Local inflammation or redness
• Infection if aseptic technique is not observed
• Allergic reactions (rare):
• Rash, itching, or urticaria
• Anaphylactic reactions (extremely rare)

Prompt discontinuation and supportive treatment should be initiated if serious adverse effects occur. Frequent monitoring of blood glucose, fluid status, and electrolytes helps prevent most side effects.

5% w/v DEXTROSE INJECTION USP [Medisal] Contraindications 5% w/v DEXTROSE INJECTION USP [Medisal]

Use of 5% Dextrose Injection is contraindicated in certain patient groups and clinical situations due to the risk of worsening underlying conditions or inducing complications.

• Hypersensitivity: Known allergy to dextrose or any component of the solution.
• Hyperglycemia: Should not be used in patients with uncontrolled diabetes or hyperosmolar states.
• Intracranial or intraspinal hemorrhage: Use of hypotonic solutions may increase cerebral edema.
• Delirium tremens with dehydration: May require electrolyte-containing solutions instead of dextrose-only fluids.
• Water intoxication or hyponatremia: Risk of worsening serum sodium dilution and cerebral complications.
• Anuria or severe renal impairment: Increased risk of volume overload and electrolyte disturbances.

Always review the patient’s medical history, renal and hepatic function, and ongoing treatments before initiating therapy.

Storage of 5% w/v DEXTROSE INJECTION USP [Medisal]

Proper storage of 5% Dextrose Injection ensures both safety and effectiveness of the product until its expiration date.

• Temperature: Store between 15°C to 25°C (59°F to 77°F).
• Protect from freezing: Do not allow the solution to freeze, as this can compromise sterility and stability.
• Light protection: While not always light-sensitive, store in original packaging until use to prevent contamination or degradation.
• Inspect before use: Do not use if the solution is discolored, contains particulates, or the bottle is damaged.
• After opening: For single-use only. Discard any unused portion immediately after use.

Keep out of reach of children and dispose of according to institutional guidelines or pharmaceutical waste protocols.