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 solution of Dextrose (glucose) in water, intended for intravenous administration. It is supplied in a 500ml polypropylene bag and contains 5 grams of dextrose per 100ml of solution. This isotonic solution is commonly used in hospital and clinical settings for fluid replenishment, hydration, and as a vehicle for the administration of other intravenous medications.

• Composition: Each 100ml contains 5g of Dextrose anhydrous (or equivalent) in Water for Injection.
• Osmolarity: Approximately 252 mOsmol/L, making it isotonic with human plasma.
• pH range: Typically between 3.5 and 6.5.
• Administration route: Intravenous (IV) infusion only.

This solution is commonly used to treat:

• Dehydration due to fluid loss
• Hypoglycemia (low blood sugar)
• As a source of carbohydrate calories (170 kcal per liter)
• As a diluent for the administration of compatible intravenous medications

5% Dextrose Injection is widely recognized for its safety and versatility, especially when electrolyte-free fluids or glucose supplementation is required. It is not suitable as the sole treatment for severe electrolyte imbalances or as the only source of nutrition for extended periods.

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

5% w/v Dextrose Injection USP [Medisal] should only be administered by trained healthcare professionals. It is used intravenously and infused directly into the bloodstream via a vein, typically under sterile conditions in a hospital or clinical setting.

• Preparation: Inspect the solution visually for particulate matter and discoloration before administration. Do not use if the solution is cloudy or the bag is leaking.
• Administration route: Administer via IV using aseptic techniques. Connect the IV tubing to the injection port of the bag and prime the line to remove air.
• Infusion rate: The rate and volume of infusion depend on the age, weight, clinical condition, and fluid balance status of the patient.
• Monitoring: Monitor fluid balance, serum glucose, and electrolytes regularly during therapy. Adjust infusion rate based on patient response and laboratory findings.

Special considerations:

• Do not add incompatible drugs to the solution.
• Use with caution in patients with diabetes mellitus or impaired renal function.
• Avoid prolonged use without electrolyte supplementation, as it may lead to hyponatremia or hypokalemia.

Always adhere to institutional protocols or the prescribing physician's directions for administration and dosage.

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

5% w/v Dextrose Injection USP [Medisal] functions primarily as a source of fluid and carbohydrate energy. The active ingredient, dextrose (a form of glucose), is a monosaccharide that plays a central role in cellular metabolism and energy production.

• Energy supply: Once infused, dextrose is rapidly metabolized by the body to produce energy (ATP), which is essential for cellular function and vital processes.
• Hydration: The solution helps restore fluid balance in the body, particularly in dehydrated patients or those requiring maintenance fluids.
• Glucose metabolism: Dextrose is absorbed by the cells with the help of insulin. It is metabolized through glycolysis and the citric acid cycle to produce energy.

Secondary effects:

• Prevention of ketosis: By providing carbohydrates, 5% dextrose inhibits the catabolism of fats, thereby preventing the formation of ketone bodies.
• Protein-sparing effect: Glucose reduces the need for protein breakdown for energy, preserving muscle and tissue proteins.

In clinical settings, its action makes it suitable for:

• Managing hypoglycemia
• Supporting patients on nil-by-mouth (NPO) status
• Serving as a carrier for drugs requiring IV administration

It is important to monitor patients for fluid overload or electrolyte imbalance during infusion, especially in those with compromised renal or cardiac function.

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

While 5% Dextrose Injection itself has a low potential for pharmacological interaction, its clinical usage can still result in complications when used alongside certain drugs or in specific clinical scenarios.

• Drug compatibility: Dextrose solution is often used as a vehicle for IV medications. However, it may be incompatible with certain drugs including:
  • Ampicillin
  • Phenytoin
  • Diazepam
  • Chloramphenicol
• Electrolyte interactions: Prolonged use of dextrose alone can dilute serum electrolytes, especially sodium and potassium, potentially leading to:
  • Hyponatremia
  • Hypokalemia
• Insulin and hypoglycemic agents: Caution is advised when administering to diabetic patients or those on insulin/oral hypoglycemics, as it may cause significant elevations in blood glucose levels.
• Fluid-sensitive conditions: In patients with heart failure, renal impairment, or liver cirrhosis, interactions with other fluid-retaining medications (e.g., corticosteroids) can increase the risk of fluid overload.

Best practices:

• Use an in-line filter when infusing medications mixed with 5% dextrose.
• Consult compatibility charts or pharmacist before drug admixture.
• Avoid simultaneous administration with blood products via the same line due to hemolysis risk.

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

The dosage of 5% Dextrose Injection USP [Medisal] depends on various patient-specific factors, including age, weight, fluid and electrolyte needs, glucose tolerance, and clinical condition. It is crucial that administration is directed and monitored by healthcare professionals.

• General adult dosage:
  • Usual maintenance rate: 25–125 mL/hour
  • Total daily volume: Typically 1.5 to 3 liters, depending on hydration and nutritional requirements
• Pediatric dosage:
  • Dosage calculated per body weight (e.g., 100–150 mL/kg/day)
  • Infusion rates must be carefully controlled to avoid fluid overload or hyperglycemia
• Geriatric dosage:
  • Lower infusion rates may be necessary due to decreased renal function
  • Monitor fluid balance, cardiac function, and electrolytes closely

Special considerations:

• Infusion rate must be adjusted in diabetic patients to avoid hyperglycemia
• May be combined with electrolyte solutions or medications, if compatible
• Always use an infusion pump to ensure accurate flow rate
• Discontinue or adjust dosage if signs of fluid overload or electrolyte disturbances occur

The dosage should always be individualized and based on comprehensive clinical assessment and ongoing laboratory monitoring.

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

While 5% Dextrose Injection is generally safe and well-tolerated, especially when administered properly, adverse effects can still occur. These may result from incorrect dosage, underlying conditions, or prolonged use.

• Common side effects:
  • Injection site irritation or inflammation (phlebitis)
  • Local pain or redness at infusion site
  • Swelling due to infiltration or extravasation
• Metabolic disturbances:
  • Hyperglycemia, particularly in diabetics or insulin-resistant individuals
  • Hyponatremia due to dilution of serum sodium
  • Hypokalemia in prolonged use without electrolyte supplementation
• Fluid overload:
  • Pulmonary edema
  • Peripheral edema
  • Congestive heart failure exacerbation in susceptible patients
• Rare but serious:
  • Allergic reactions (e.g., rash, pruritus, bronchospasm – rare)
  • Hemolysis if administered with incompatible substances or through improper technique

Monitoring: Patients receiving large volumes or long-term infusions should have regular monitoring of:

• Blood glucose
• Electrolytes (sodium, potassium)
• Fluid balance and weight

Report any signs of intolerance or complications immediately to the medical team.

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

5% Dextrose Injection USP [Medisal] should not be used in certain clinical scenarios due to the risk of adverse effects or worsening of the patient’s condition. Contraindications may be absolute or relative depending on the situation.

• Absolute contraindications:
  • Known hypersensitivity to dextrose or any component of the formulation
  • Severe hyperglycemia or diabetic coma (without insulin)
  • Intracranial or intraspinal hemorrhage (where glucose-induced edema is dangerous)
• Relative contraindications (use with caution):
  • Uncontrolled diabetes mellitus
  • Renal failure or oliguria/anuria (risk of fluid overload)
  • Congestive heart failure
  • Severe electrolyte imbalance (especially hyponatremia)
  • Hypokalemia if not co-administered with potassium

Drug incompatibility: It should not be used as a diluent for drugs that are incompatible with dextrose or have specific stability concerns.

Clinical caution: Avoid use in patients at risk of cerebral edema or those requiring hypotonic fluids unless clinically justified and closely monitored.

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

Proper storage of 5% Dextrose Injection is critical to maintaining its sterility, stability, and therapeutic effectiveness. As with all intravenous solutions, this product must be handled under strict aseptic conditions.

• Storage conditions:
  • Store below 25°C (77°F); avoid freezing
  • Protect from excessive heat and light
  • Keep in original packaging until ready to use
• Stability:
  • The solution is stable until the expiry date if stored correctly
  • Once the bag is opened or punctured, use immediately and discard any unused portion
• Visual inspection:
  • Do not use if the solution is cloudy, discolored, or contains visible particulates
  • Discard if the bag shows signs of damage or leakage
• Handling precautions:
  • Use only sterile equipment when preparing for administration
  • Avoid multiple entries into the bag to prevent contamination

Follow institutional policies and manufacturer’s recommendations for disposal of unused solution and used containers.