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 that contains 5 grams of dextrose per 100 milliliters of water. It is supplied in a 1000ml polypropylene bag for use via intravenous infusion. This solution is commonly used in clinical settings to provide fluid replacement, calorie supplementation, and as a vehicle for drug delivery.

• Composition: Each 1000ml contains 50 grams of Dextrose (Glucose) dissolved in Water for Injection.
• Osmolarity: Approximately 252 mOsmol/L, making it an iso-osmotic solution.
• pH Range: Typically between 3.2 and 6.5, making it safe for IV administration.
• Purpose: Used primarily for hydration, calorie supplementation, and dilution of other medications.
• Classification: Parenteral fluid and electrolyte replenishment solution.

5% Dextrose Injection is suitable for patients who require intravenous fluid therapy and those unable to consume food orally, offering a temporary energy source and aiding in the prevention of dehydration and electrolyte imbalance.

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

5% Dextrose Injection USP [Medisal] should be administered by a healthcare professional in a clinical setting. Its use should be based on the patient’s fluid, electrolyte, and energy requirements.

• Administration route: Intravenous infusion through a sterile, pyrogen-free set under aseptic conditions.
• Flow rate: Determined by clinical condition, age, body weight, and overall fluid requirement of the patient.
• Inspection before use: Examine the bag for cloudiness, particulate matter, or damage. Do not use if the solution is not clear or if the bag is compromised.
• Preparation: Attach infusion set, ensuring proper priming to remove air before connecting to the patient’s IV line.
• Compatibility: Can be used as a diluent for medications but always check compatibility with added drugs.
• Monitoring: Regular monitoring of blood glucose, electrolytes, and fluid status is essential during prolonged use.

Use only under medical supervision. Improper administration or excessive dosage can lead to fluid overload, electrolyte imbalance, or hyperglycemia, particularly in diabetic or renal-compromised patients.

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

Dextrose acts as a carbohydrate source and fluid replenisher when administered intravenously. Its mechanism of action is primarily metabolic and osmotic in nature.

• Energy provision: Dextrose (a form of glucose) is rapidly absorbed into the bloodstream and utilized by cells as a primary energy source through glycolysis and the citric acid cycle.
• Hydration: The solution provides free water that helps maintain and restore fluid balance, especially in cases of dehydration or fluid loss due to fever, vomiting, or diarrhea.
• Glycogen storage: After cellular uptake, excess glucose is stored as glycogen in the liver and muscles, supporting energy reserves.
• Osmotic activity: Being iso-osmotic, the solution helps avoid shifts in intracellular and extracellular fluids, making it suitable for maintenance fluid therapy.
• Drug delivery vehicle: Acts as a solvent for IV medications that require dilution prior to administration.

This dual action of providing energy and supporting fluid volume makes 5% Dextrose Injection a fundamental component in intravenous therapy regimens across various clinical conditions.

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

Although 5% Dextrose Injection is generally safe, it may interact with certain medications and medical conditions. These interactions can affect the safety and effectiveness of both the Dextrose solution and the concomitant drugs.

• Insulin and Oral Hypoglycemics: Concomitant administration may increase the risk of hypoglycemia due to enhanced glucose uptake by cells.
• Corticosteroids: These may lead to sodium retention and fluid overload when used with IV fluids like Dextrose.
• Diuretics: Potassium-wasting diuretics may result in electrolyte imbalance when used alongside Dextrose solutions.
• Other IV Medications: Incompatibility may occur with certain drugs such as amphotericin B or phenytoin when mixed directly. Always check compatibility before admixture.
• Conditions like Diabetes Mellitus: Use with caution; monitor blood glucose levels to avoid hyperglycemia.
• Renal Impairment: May exacerbate fluid overload or electrolyte disturbances in patients with compromised kidney function.

Always consult with a pharmacist or physician before combining Dextrose Injection with other IV medications to ensure chemical and physical compatibility.

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

The dosage of 5% Dextrose Injection depends on the individual patient's fluid and carbohydrate requirements, age, body weight, and clinical condition. The infusion should be administered under close medical supervision.

• Adults: Typical infusion rate is 30–40 mL/kg/day. For a 70 kg adult, this equals approximately 2100–2800 mL/day.
• Pediatrics: Dosage is generally based on weight and age; around 100 mL/kg/day in neonates and infants, adjusted based on hydration and glucose needs.
• Maximum rate: Should not exceed the renal glucose excretion rate—typically < 0.5 g/kg/hr to avoid hyperglycemia.
• Infusion duration: Continuous infusion over several hours. Rate adjustments are based on blood glucose levels, electrolyte status, and urine output.
• Special populations: Elderly patients, renal-impaired, or those with cardiac conditions require cautious dosing to prevent fluid overload.

Always calculate dosage on an individual basis and reassess regularly, especially in long-term therapy or patients with comorbidities.

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

Although generally well tolerated, 5% Dextrose Injection may cause side effects, particularly when used inappropriately or for prolonged periods. Monitoring is essential to detect and address adverse reactions promptly.

• Common Side Effects:
  • Local site reactions such as redness, swelling, or pain at the injection site.
  • Mild hyperglycemia, especially in diabetic or insulin-resistant patients.
• Serious Side Effects:
  • Fluid overload or pulmonary edema, particularly in patients with renal or cardiac insufficiency.
  • Hyponatremia due to dilutional effects, especially with prolonged infusion.
  • Hypokalemia if not supplemented concurrently with potassium.
  • Hyperglycemia leading to glycosuria and metabolic acidosis in insulin-deficient states.
• Rare Effects:
  • Anaphylactic reactions (very rare).
  • Venous thrombosis or phlebitis at the site of infusion.

Patients should be observed closely during therapy, with regular monitoring of glucose, electrolytes, and fluid balance to mitigate the risk of adverse effects.

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

There are specific clinical scenarios in which the administration of 5% Dextrose Injection is contraindicated. These should be carefully evaluated before use.

• Uncontrolled diabetes mellitus: Can exacerbate hyperglycemia and lead to complications such as diabetic ketoacidosis.
• Intracranial or intraspinal hemorrhage: Dextrose solutions may increase cerebral edema due to hypotonic fluid shift.
• Severe dehydration with low sodium levels: This fluid lacks electrolytes and may worsen hyponatremia.
• Hyperosmolar non-ketotic coma: Glucose-containing fluids may worsen osmolarity.
• Fluid overload states: Including congestive heart failure, pulmonary edema, or severe renal insufficiency.
• Known hypersensitivity: To dextrose or any component of the solution (rare but possible).

Always review the patient’s full medical history and current condition to rule out contraindications before initiating therapy.

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

Proper storage is essential to maintain the safety, sterility, and effectiveness of 5% Dextrose Injection USP.

• Temperature: Store at controlled room temperature between 15°C and 25°C (59°F to 77°F).
• Do not freeze: Freezing can compromise the integrity of the polypropylene bag and potentially cause precipitation of contents.
• Protection from light: Although not highly light-sensitive, storage in a cool, dark place is recommended for optimal stability.
• Packaging integrity: Do not use if the bag is damaged, leaking, or if the solution is cloudy or contains particulates.
• Shelf life: Check the expiration date on the bag. Do not use beyond the expiry date.

Once opened, the solution should be used immediately or discarded as per hospital protocols. Do not store partially used bags for future use to avoid microbial contamination.