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 containing dextrose (anhydrous) in water for injection. It is available in a 500ml plastic bottle and is used primarily as a source of carbohydrate calories in patients who require parenteral nutrition. This high-concentration solution is typically administered via intravenous infusion under medical supervision.

• Composition: Each 100 ml of solution contains 50g of Dextrose (anhydrous).
• Form: Infusion/Solution for intravenous use.
• Primary Use: Provides immediate energy through glucose supply in clinical settings like hypoglycemia, coma, or total parenteral nutrition.
• Therapeutic Category: Caloric agent and fluid replenisher.

Because of its high osmolarity, this solution must be administered through a large vein to prevent irritation or damage to smaller veins. The 50% concentration is reserved for situations where rapid glucose supplementation is critical or when fluid restriction is necessary.

How to use 50% w/v DEXTROSE INJECTION USP

50% Dextrose Injection USP should only be used under the supervision of a qualified healthcare provider. Its use depends on the patient's clinical condition and intended therapeutic goals.

• Route of Administration: Intravenous (IV) infusion.
• Preparation: The solution is ready to use and does not require dilution unless specifically directed by a physician. However, due to its hypertonicity, it may sometimes be diluted with compatible IV fluids.
• Administration Guidelines:
  • Administer slowly to avoid venous irritation.
  • Use a central venous catheter for prolonged infusion due to the solution's high osmolarity.
  • Monitor blood glucose levels before and during infusion.
• Special Considerations:
  • Ensure aseptic technique is used during administration.
  • Do not use if the solution is discolored or contains particulate matter.
  • Infuse using a volumetric pump to precisely control the rate.

In emergency cases such as hypoglycemia, the solution may be administered more rapidly but should be followed by close monitoring to avoid rebound hyperglycemia.

Mode of Action 50% w/v DEXTROSE INJECTION USP

The pharmacological action of 50% Dextrose Injection USP is centered around the rapid delivery of glucose into the bloodstream, providing immediate energy and restoring blood glucose levels.

• Primary Mechanism:
  • Dextrose (glucose) is absorbed directly into the systemic circulation upon IV administration.
  • It enters cells via insulin-regulated transporters and is utilized in glycolysis to produce ATP.
  • The rapid metabolism of glucose generates energy essential for cellular processes.
• Systemic Effects:
  • Quick elevation of blood glucose levels in cases of hypoglycemia.
  • Replenishment of glycogen stores in the liver and muscles.
  • Reduction in protein catabolism when used in parenteral nutrition.
• Metabolic Pathway:
  • Dextrose is metabolized via glycolysis and the Krebs cycle to produce ATP, CO₂, and water.
  • Excess glucose can be stored as glycogen or converted to fat.

This mode of action makes it a vital agent in emergency care, especially in cases of insulin overdose, fasting hypoglycemia, or nutritional support in patients unable to ingest food.

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

Although dextrose itself has minimal direct drug interactions, administering it in a clinical setting can affect the pharmacokinetics of certain medications or the patient's metabolic state.

• Insulin:
  • Concomitant use can enhance glucose uptake, potentially leading to hypoglycemia if not carefully monitored.
• Diuretics (e.g., Furosemide):
  • May alter fluid and electrolyte balance; monitor for dilutional hyponatremia or hypokalemia.
• Corticosteroids:
  • Can induce hyperglycemia and reduce insulin sensitivity, counteracting the effects of dextrose.
• Other IV drugs:
  • Ensure compatibility before mixing or co-infusing to avoid precipitation or reduced efficacy.

Always assess a patient's full medication regimen before initiating 50% Dextrose infusion, especially in those on insulin or with compromised renal or hepatic function.

Dosage of 50% w/v DEXTROSE INJECTION USP

The dosage must be individualized based on the patient's clinical status, age, weight, and metabolic needs. It is typically used for rapid correction of hypoglycemia or as part of a parenteral nutrition regimen.

• Adults:
  • Hypoglycemia: 25–50 ml (12.5–25g of dextrose) given IV over 3–5 minutes.
  • Parenteral nutrition: Dosage determined by daily caloric needs; often requires continuous infusion under strict monitoring.
• Children:
  • Doses vary with age and weight; generally, 0.5–1 g/kg body weight.
  • Infusion must be administered slowly with blood glucose monitoring.
• Geriatric Patients:
  • Start at lower doses due to altered glucose metabolism and comorbidities.

Important: Rapid administration of high-concentration dextrose solutions may cause vein irritation or thrombophlebitis. Always monitor for hyperglycemia, electrolyte disturbances, and fluid overload.

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

While 50% Dextrose Injection is generally well tolerated when used appropriately, it may lead to several adverse effects, especially with inappropriate dosage or prolonged use.

• Common Side Effects:
  • Hyperglycemia
  • Thrombophlebitis at the infusion site
  • Local pain, redness, or irritation
• Serious Side Effects:
  • Fluid overload leading to pulmonary edema
  • Electrolyte imbalances such as hypokalemia or hyponatremia
  • Hyperosmolar syndrome, particularly in diabetic or dehydrated patients
• Allergic Reactions (rare):
  • Rash, itching, or difficulty breathing
  • Hypersensitivity reactions to dextrose or plastic container components

Monitoring of blood glucose, serum electrolytes, and fluid status is essential throughout the treatment duration to mitigate these risks.

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

This medication is contraindicated in several clinical conditions where high concentrations of dextrose may worsen the underlying pathology or cause additional complications.

• Absolute Contraindications:
  • Known hypersensitivity to dextrose or any component of the formulation
  • Patients with severe hyperglycemia without concurrent insulin therapy
  • Comatose patients with intracranial or intraspinal hemorrhage
• Relative Contraindications:
  • Severe dehydration without electrolyte correction
  • Thiamine deficiency (may worsen Wernicke’s encephalopathy)
  • Uncontrolled diabetes mellitus
  • Fluid retention disorders such as pulmonary edema or congestive heart failure

Careful assessment and monitoring are crucial before and during treatment, especially in patients with renal, hepatic, or cardiac impairments.

Storage of 50% w/v DEXTROSE INJECTION USP

Proper storage is essential to maintain the sterility, efficacy, and safety of the solution. Always follow manufacturer and institutional guidelines.

• Temperature: Store at 20–25°C (68–77°F); avoid freezing.
• Light Exposure: Protect from direct sunlight and excessive light exposure.
• Container Integrity:
  • Do not use if the plastic bottle is leaking, cloudy, or contains precipitates.
  • Do not re-use partially used containers.
• Shelf Life: Check the expiration date on the label; discard any unused solution after expiration.
• Handling:
  • Use aseptic technique when connecting to IV lines.
  • Do not introduce additives without compatibility checks.

Improper storage may compromise the sterility of the product, increasing the risk of infections or adverse reactions.