50% w/v DEXTROSE INJECTION USP Infusion/Solution for

What is 50% w/v DEXTROSE INJECTION USP

50% w/v Dextrose Injection USP is a sterile, non-pyrogenic, hypertonic solution of dextrose (anhydrous) in water for injection. It is typically administered via intravenous (IV) infusion and is used in clinical settings where rapid administration of glucose is required.

• Active Ingredient: Dextrose (anhydrous) 50g per 100mL of solution.
• Form: Infusion/Solution for injection.
• Packaging: Supplied in 50ml plastic bags suitable for IV administration.
• Osmolarity: Approximately 2525 mOsmol/L, indicating its highly hypertonic nature.

This concentrated glucose solution is primarily used to treat:

• Severe hypoglycemia (low blood sugar levels)
• Hyperkalemia (as part of a regimen to shift potassium intracellularly)
• As a carbohydrate source in parenteral nutrition

It should be administered under strict medical supervision due to its hypertonic nature and potential complications such as vein irritation and fluid/electrolyte imbalances.

How to use 50% w/v DEXTROSE INJECTION USP

Proper administration of 50% w/v Dextrose Injection USP is crucial to avoid complications. It must only be administered by trained healthcare professionals in a controlled clinical environment.

• Route of administration: Intravenous (IV) injection, usually through a central vein due to its hypertonicity.
• Technique:
  • Ensure the solution is clear, colorless, and free from particulate matter.
  • Use aseptic technique to attach the IV line.
  • Infuse slowly to prevent hyperglycemia or vein irritation.
• Monitoring during administration:
  • Blood glucose levels
  • Electrolytes, especially potassium and sodium
  • Renal function and fluid balance

In emergencies like hypoglycemic coma, it may be given as a rapid bolus, but generally, it should be diluted or infused slowly. Follow institutional guidelines and individualized protocols when administering.

Mode of Action 50% w/v DEXTROSE INJECTION USP

Dextrose (glucose) is the primary simple sugar used by the body for energy. When administered intravenously, especially in high concentrations like 50%, it rapidly elevates blood glucose levels and serves several critical metabolic and therapeutic roles.

• Energy supply: Acts as a quick source of glucose, the key fuel for cells, particularly the brain and muscles.
• Reversal of hypoglycemia: Immediately increases circulating blood glucose levels in hypoglycemic patients, restoring neurologic function.
• Shifting of potassium: In hyperkalemia, insulin (co-administered with glucose) drives potassium into cells, lowering serum potassium levels.
• Preventing protein catabolism: Supplies adequate calories to reduce muscle protein breakdown in catabolic states.

Its rapid onset and high concentration make it effective in acute scenarios. However, without simultaneous insulin secretion or administration, hyperglycemia can develop quickly.

50% w/v DEXTROSE INJECTION USP Interactions 50% w/v DEXTROSE INJECTION USP

Dextrose itself is a carbohydrate, but its clinical use in hypertonic concentrations can interact with several physiological processes and drugs:

• Insulin: Insulin facilitates cellular uptake of glucose. When given with dextrose in hyperkalemia treatment, the combination drives potassium into cells.
• Corticosteroids and diuretics: May exacerbate fluid retention or alter glucose metabolism, affecting glycemic control.
• Phenytoin: High glucose concentrations may interfere with the absorption or efficacy of phenytoin when co-administered via the same IV line.
• Electrolyte solutions: Care must be taken when combining with other electrolyte-containing fluids, as this may alter fluid balance or electrolyte levels.
• Parenteral nutrition components: When used in TPN (Total Parenteral Nutrition), interactions with amino acids, lipids, and trace elements must be managed carefully.

Always assess compatibility and follow hospital guidelines before mixing or administering alongside other drugs.

Dosage of 50% w/v DEXTROSE INJECTION USP

The dosage of 50% Dextrose Injection USP must be tailored to the patient’s clinical condition, glucose levels, and intended therapeutic outcome.

• In hypoglycemia:
  • Adults: 25-50 mL IV push (12.5–25g of dextrose).
  • Repeat as necessary based on glucose monitoring.
• In hyperkalemia:
  • Typically 25-50 mL of 50% dextrose administered IV along with 5-10 units of regular insulin.
• In parenteral nutrition:
  • Diluted and given as a continuous infusion over several hours.
  • Rate depends on caloric requirements, generally not exceeding 0.5 g/kg/hr in non-stressed patients.

Important: Do not administer rapidly or undiluted in peripheral veins. Always monitor glucose levels closely during and after administration.

Possible side effects of 50% w/v DEXTROSE INJECTION USP

Though generally safe when administered correctly, 50% Dextrose Injection USP can cause side effects, especially with improper use or prolonged administration.

• Local reactions:
  • Pain, phlebitis, and thrombosis at the injection site due to hypertonicity.
  • Tissue necrosis if extravasation occurs.
• Metabolic disturbances:
  • Hyperglycemia
  • Osmotic diuresis and dehydration
  • Electrolyte imbalances (e.g., hypokalemia)
• Systemic effects:
  • Fluid overload, particularly in patients with renal or cardiac dysfunction.
  • Lactic acidosis or hepatic steatosis with excessive or prolonged use.

Regular monitoring of blood glucose, renal function, and electrolytes helps in early detection and management of these side effects.

50% w/v DEXTROSE INJECTION USP Contraindications 50% w/v DEXTROSE INJECTION USP

This solution should not be used in certain clinical scenarios due to the risk of serious complications.

• Known hypersensitivity to dextrose
• Uncontrolled diabetes mellitus – may lead to severe hyperglycemia or diabetic ketoacidosis.
• Hyperosmolar coma without adequate insulin administration
• Anuria or severe renal impairment – increases risk of fluid overload and acidosis.
• Intracranial or intraspinal hemorrhage – hypertonic solutions may exacerbate cerebral edema.
• Delirium tremens if dehydrated – requires simultaneous administration of thiamine to prevent Wernicke’s encephalopathy.

Always evaluate risk-benefit and monitor patients closely when use is necessary in borderline cases.

Storage of 50% w/v DEXTROSE INJECTION USP

Proper storage conditions are critical to preserve the sterility, efficacy, and safety of the solution.

• Temperature: Store at 20°C to 25°C (68°F to 77°F). Excursions permitted to 15°C–30°C.
• Protect from excessive heat and freezing.
• Keep in the original plastic overwrap until ready for use to protect from moisture and contamination.
• Do not use if:
  • Solution is discolored or contains particulate matter.
  • The bag is leaking or has been punctured.
• Do not autoclave or re-sterilize.

Once opened, the product should be used immediately and not stored for later use due to the risk of microbial contamination.