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 used primarily as a source of carbohydrate (caloric energy) and to treat severe hypoglycemia or insulin shock. This formulation contains 50 grams of dextrose (anhydrous) per 100 mL of solution, making it a highly concentrated glucose source administered intravenously.

• Form: Intravenous infusion (Solution for infusion)
• Packaging: 500ml plastic bag
• Active Ingredient: Dextrose (anhydrous), a simple sugar chemically identical to glucose
• Osmolarity: Hypertonic, which means it draws water out of cells and into the bloodstream

This solution is commonly used in emergency and critical care settings to:

• Correct dangerously low blood sugar levels
• Provide rapid energy during metabolic crises
• Serve as a caloric supplement in parenteral nutrition

How to use 50% w/v DEXTROSE INJECTION USP

The administration of 50% w/v Dextrose Injection USP should always be performed by a healthcare professional in a controlled setting, such as a hospital or emergency care unit. Due to its hypertonicity, improper use can lead to serious complications.

• Route: Intravenous (IV) only; should never be administered intramuscularly or subcutaneously
• Method: Can be infused slowly via peripheral or central vein; may require dilution depending on clinical indication
• Equipment: Use sterile IV sets and ensure compatibility with other medications or fluids

General precautions during administration include:

• Monitor blood glucose levels closely before, during, and after infusion
• Check for signs of extravasation (leakage into surrounding tissue) due to risk of tissue damage
• Assess hydration status and serum electrolytes regularly

Important: This product should be used cautiously in patients with impaired renal function, diabetes mellitus, or fluid overload conditions. Administration must be adjusted based on the patient’s metabolic requirements and fluid balance.

Mode of Action 50% w/v DEXTROSE INJECTION USP

The primary pharmacological action of 50% Dextrose Injection lies in its role as a readily available source of glucose. Dextrose, a monosaccharide, is vital for cellular metabolism, particularly in the brain and muscles.

• Rapid Absorption: Once administered intravenously, dextrose enters systemic circulation and is immediately available for cellular uptake.
• Energy Source: It provides an instant supply of energy by entering glycolysis and Krebs cycle pathways to generate ATP (adenosine triphosphate).
• Glycogen Restoration: In cases of hypoglycemia, dextrose helps replenish liver glycogen stores and correct energy deficits.
• Osmotic Effect: The hypertonic nature of 50% Dextrose increases intravascular osmolarity, drawing water into the blood vessels and raising plasma volume temporarily.

This action is particularly useful in emergency management of:

• Severe insulin-induced hypoglycemia
• Coma of unknown origin (suspected hypoglycemia)
• Alcohol-induced hypoglycemia

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

Dextrose Injection may interact with other medications or physiological states, affecting its efficacy or increasing the risk of complications. Below are key interactions to be aware of:

• Insulin: Co-administration increases glucose uptake, potentially leading to hypoglycemia if not properly monitored.
• Diuretics: Loop and thiazide diuretics may increase the risk of hyperglycemia or electrolyte imbalance when combined with dextrose infusions.
• Corticosteroids: These may reduce glucose tolerance and cause persistent hyperglycemia when used alongside dextrose.
• Cardiac Glycosides (e.g., Digoxin): Hypokalemia resulting from dextrose-induced insulin release can enhance the toxicity of digoxin.
• Parenteral Nutrition Components: Dextrose may interact with amino acids, lipids, or electrolytes in multi-nutrient infusions; compatibility must be checked.

Caution: Always inform the healthcare provider about any ongoing medications or supplements, especially in patients receiving chemotherapy, antidiabetics, or electrolyte-altering drugs.

Dosage of 50% w/v DEXTROSE INJECTION USP

The dosage of 50% Dextrose Injection USP must be individualized according to the patient's clinical condition, age, body weight, and severity of hypoglycemia. Always follow institutional protocols or the physician’s prescription.

• Adults (Severe Hypoglycemia): Typically, 25–50 mL (12.5–25 g) of 50% dextrose may be administered slowly via IV push over 3–5 minutes.
• Pediatrics: Not routinely used due to the risk of hyperosmolarity; diluted dextrose concentrations (e.g., 10%) are preferred.
• In Total Parenteral Nutrition (TPN): Infused slowly and titrated based on caloric requirements; usually diluted with other nutrients.

Monitoring Parameters:

• Blood glucose levels (before and after administration)
• Serum electrolytes (especially potassium and sodium)
• Hydration status and signs of fluid overload

Note: Rapid administration or overdose can result in hyperglycemia, osmotic diuresis, or phlebitis. Use with caution and under strict medical supervision.

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

While 50% Dextrose Injection is generally safe when used appropriately, it can cause adverse effects, particularly when administered rapidly or in excessive doses.

• Local Reactions:
  • Thrombophlebitis
  • Injection site pain or inflammation
  • Extravasation injuries (necrosis, cellulitis)
• Systemic Effects:
  • Hyperglycemia
  • Hypokalemia due to insulin release
  • Fluid overload or pulmonary edema (especially in renal/cardiac-compromised patients)
• Metabolic Abnormalities:
  • Lactic acidosis (rare)
  • Electrolyte disturbances such as hyponatremia

Patients should be monitored for these effects and managed accordingly. Discontinue use immediately if signs of hypersensitivity, confusion, or respiratory distress occur.

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

This product is contraindicated in certain conditions where glucose metabolism is impaired or its administration may worsen the underlying issue.

• Uncontrolled Diabetes Mellitus: Risk of severe hyperglycemia and ketoacidosis
• Hyperosmolar states: Such as severe dehydration or hypernatremia
• Intracranial or Intraspinal Hemorrhage: Can increase intracranial pressure
• Delirium Tremens with Dehydration: Risk of electrolyte imbalance and worsening of symptoms
• Hypersensitivity to Dextrose: Rare but may manifest as rash, urticaria, or anaphylaxis

Precautions:

• Use cautiously in patients with renal impairment or heart failure
• Monitor for rebound hypoglycemia after infusion
• Avoid extravasation, which can lead to severe tissue damage

Storage of 50% w/v DEXTROSE INJECTION USP

Proper storage is essential to maintain the sterility and stability of the product.

• Temperature: Store below 25°C (77°F); do not freeze
• Light Protection: Keep away from direct sunlight and UV exposure
• Packaging Integrity: Use only if the plastic bag is intact and free from leaks or discoloration
• Expiration Date: Always check and adhere to the labeled expiry date

Additional Recommendations:

• Once opened or spiked, the solution should be used immediately or discarded
• Do not mix with incompatible drugs or solutions without verifying compatibility
• Discard any unused portion to prevent microbial contamination

Proper storage ensures both safety and efficacy of the medicine, especially in critical care scenarios.