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 hypertonic intravenous solution containing 50 grams of dextrose per 100 mL of water for injection, commonly used to manage acute hypoglycemia and provide a concentrated source of energy. This formulation in a 2000ml plastic bag is typically reserved for situations requiring large-volume glucose replacement in controlled settings, such as hospitals or intensive care units.

• Active Ingredient: Dextrose (anhydrous), a naturally occurring monosaccharide (simple sugar).
• Indications:
  • Severe hypoglycemia
  • Parenteral nutrition support
  • Management of insulin or oral hypoglycemic drug overdose
  • To supply calories in patients who cannot ingest food orally
• Classification: Hypertonic carbohydrate solution

This solution must be administered under medical supervision due to its high osmolarity and the potential for serious complications if misused.

How to use 50% w/v DEXTROSE INJECTION USP

Proper administration of 50% Dextrose Injection USP is critical to avoid complications such as hyperglycemia or thrombophlebitis. This medication should be given intravenously and typically under continuous monitoring.

• Route of Administration: Intravenous (IV) infusion via a central line or large vein due to its hypertonic nature.
• Preparation and Handling:
  • Inspect the solution visually for particulate matter or discoloration before administration.
  • Use aseptic technique during preparation and administration.
  • Do not mix with incompatible medications unless compatibility is confirmed.
• Administration Tips:
  • Administer slowly to prevent rapid fluid and glucose shifts.
  • Monitor blood glucose levels frequently.
  • Adjust the infusion rate based on patient response and metabolic needs.
• Monitoring:
  • Blood glucose
  • Electrolytes (especially potassium and sodium)
  • Fluid balance and renal function

Always follow the medical provider’s guidance and institutional protocols for infusion therapy.

Mode of Action 50% w/v DEXTROSE INJECTION USP

50% Dextrose Injection USP works by providing a rapid source of glucose, which is vital for cellular metabolism and energy production. It is especially useful in reversing acute hypoglycemia and supporting high-energy demands in critically ill patients.

• Primary Action: Supplies glucose directly to the bloodstream, bypassing the digestive system.
• Cellular Mechanism:
  • Dextrose enters cells via glucose transporters (GLUT), primarily GLUT1 and GLUT4.
  • Once inside the cell, glucose undergoes glycolysis, producing ATP (adenosine triphosphate), the energy currency of cells.
• Additional Effects:
  • Helps replenish liver and muscle glycogen stores
  • Supports brain function, which is heavily dependent on glucose
  • Counteracts hypoglycemia-induced symptoms like confusion, weakness, or seizures

The hypertonic nature of this solution causes fluid to move from the intracellular space to the extracellular compartment, requiring careful monitoring to avoid fluid and electrolyte imbalance.

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

Drug interactions with 50% Dextrose Injection USP are typically related to its effects on glucose and fluid balance. Although dextrose itself is not highly reactive, its use can influence the pharmacodynamics of other medications.

• Insulin and Antidiabetic Medications:
  • Concurrent use can cause a rapid drop in blood glucose levels, requiring close monitoring and dose adjustments.
• Corticosteroids and Diuretics:
  • May increase blood glucose and reduce potassium, exacerbating electrolyte imbalances.
• Potassium Chloride:
  • Often co-administered to counteract hypokalemia induced by glucose-insulin shifts.
• Medications Affected by Electrolyte Changes:
  • Cardiac glycosides (e.g., digoxin) may be more toxic in the setting of electrolyte disturbances.
• Incompatibilities in IV Mixtures:
  • Do not mix with blood products or medications incompatible with dextrose-containing solutions.

Always consult pharmacy compatibility charts and check for known incompatibilities when adding medications to IV fluids.

Dosage of 50% w/v DEXTROSE INJECTION USP

Dosing of 50% Dextrose Injection USP is highly individualized, based on the patient’s clinical status, age, weight, and the severity of hypoglycemia or energy needs. Large-volume (2000ml) preparations are typically used in specific parenteral nutrition plans or as part of ongoing ICU support.

• Adults (Emergency Hypoglycemia):
  • Typically 25-50 mL of 50% dextrose solution IV push (12.5–25g glucose)
  • Repeat doses may be administered as necessary with close glucose monitoring
• Infusion in Parenteral Nutrition:
  • Dose based on total daily caloric requirements (usually 3–5 mg/kg/min in adults)
  • Infusion rate calculated to prevent glucose overload or osmotic diuresis
• Pediatric Dosing:
  • Usually not recommended for routine use in neonates due to hypertonicity
  • Diluted solutions are preferred for pediatric populations
• Maximum Infusion Rate:
  • Should not exceed the renal glucose excretion capacity to avoid glucosuria or osmotic diuresis

Dosing must be managed under strict medical supervision to avoid complications such as hyperglycemia, electrolyte imbalance, and fluid overload.

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

While 50% Dextrose Injection USP is generally safe when administered correctly, its hypertonic nature can cause several adverse effects if not carefully managed.

• Common Side Effects:
  • Irritation or pain at the injection site
  • Flushing or warmth during rapid infusion
  • Mild hyperglycemia
• Serious Side Effects:
  • Thrombophlebitis: Especially if administered via a peripheral vein
  • Severe hyperglycemia: Can lead to dehydration, ketoacidosis, or osmotic diuresis
  • Hypokalemia: Due to insulin-mediated cellular uptake of potassium
  • Pulmonary edema or fluid overload: In patients with cardiac or renal impairment
  • Local tissue necrosis: If extravasation occurs

Immediate medical attention is necessary if signs of allergic reactions, difficulty breathing, or signs of fluid overload occur.

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

There are several clinical situations where 50% Dextrose Injection USP should not be used due to the risk of worsening the underlying condition or causing harm.

• Absolute Contraindications:
  • Uncontrolled diabetes mellitus
  • Severe dehydration without electrolyte correction
  • Intracranial or intraspinal hemorrhage (risk of worsening cerebral edema)
  • Known hypersensitivity to dextrose
• Relative Contraindications:
  • Thiamine deficiency (e.g., in chronic alcoholics) without concurrent thiamine supplementation
  • Severe hyperosmolar states or hyperglycemia
  • Patients with anuria or severe renal failure (fluid overload risk)

Medical history, ongoing medications, and comorbid conditions must be evaluated before administering concentrated glucose solutions like this.

Storage of 50% w/v DEXTROSE INJECTION USP

Proper storage of 50% Dextrose Injection USP ensures the product remains sterile, effective, and safe for use.

• Storage Conditions:
  • Store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15–30°C (59–86°F)
  • Protect from excessive heat and freezing
• Container Care:
  • Keep in original plastic bag until use to prevent contamination
  • Inspect for leaks, cloudiness, or particulate matter prior to use
• Handling Instructions:
  • Use only clear, colorless solutions
  • Do not reconnect partially used bags
  • Do not use after expiry date

Adherence to these storage guidelines helps maintain the integrity and sterility of the solution, reducing the risk of patient complications.