50% W/V DEXTROSE INJECTION, USP (MEDISAL) Injection/Solution for

What is 50% W/V DEXTROSE INJECTION, USP (MEDISAL)

50% W/V Dextrose Injection, USP (MEDISAL) is a sterile, non-pyrogenic, hypertonic solution of Dextrose monohydrate in water for injection. It is used primarily as a source of calories and fluid in clinical settings and is often administered intravenously to manage hypoglycemia and provide parenteral nutrition.

• Composition: Each 50 ml contains 25 grams of dextrose monohydrate.
• Concentration: 50% weight/volume (W/V) – indicating 50 grams of dextrose per 100 ml of solution.
• Formulation: Supplied in a polypropylene bottle to ensure compatibility and prevent leaching of plasticizers.
• Usage: Commonly used in emergency and hospital settings for acute management of severe hypoglycemia, and as part of total parenteral nutrition (TPN).
• Category: Hypertonic carbohydrate solution for intravenous administration.

This formulation is particularly beneficial when rapid glucose elevation is required, such as in diabetic patients experiencing insulin-induced hypoglycemia or in metabolic emergencies requiring immediate energy support.

How to use 50% W/V DEXTROSE INJECTION, USP (MEDISAL)

Administering 50% Dextrose Injection should be done with care, ideally under medical supervision. Its hypertonic nature requires slow intravenous administration to avoid complications.

• Route of Administration: Intravenous (IV) only. Do not administer intramuscularly or subcutaneously.
• Preparation: Inspect the solution for clarity and container integrity before use. Do not use if the solution is discolored or contains particulate matter.
• Administration:
  • Use a vein with adequate blood flow to avoid thrombophlebitis.
  • Administer slowly over several minutes to reduce the risk of hyperglycemia or vein irritation.
  • Can be diluted if necessary or given via a central line in concentrated form.
• Monitoring:
  • Blood glucose levels should be monitored closely before, during, and after administration.
  • Monitor for signs of fluid overload or electrolyte imbalance.
• Special Considerations:
  • Adjust dose and rate of infusion based on patient’s clinical condition and glucose metabolism.
  • Avoid extravasation; it can cause local tissue damage.

Only trained healthcare professionals should administer 50% Dextrose Injection due to its potency and the potential for rapid metabolic shifts.

Mode of Action 50% W/V DEXTROSE INJECTION, USP (MEDISAL)

Dextrose is a simple monosaccharide, chemically identical to glucose, which is the body’s primary source of energy. When administered intravenously, it has immediate metabolic effects.

• Energy Source: Dextrose rapidly enters cells and undergoes glycolysis, producing ATP, the body’s energy currency.
• Hypertonic Effect: The 50% concentration makes this solution hypertonic. It pulls fluid from the intracellular and interstitial spaces into the vascular space, expanding plasma volume temporarily.
• Hepatic Utilization: The liver takes up dextrose and stores excess glucose as glycogen for later use.
• Insulin Response: High glucose levels stimulate insulin secretion, facilitating glucose uptake by muscle and fat tissues.
• Corrects Hypoglycemia: Rapid elevation of blood glucose levels is essential in reversing neuroglycopenic symptoms like confusion, seizures, or coma caused by hypoglycemia.
• Metabolic Precursor: Provides a carbon source for various metabolic pathways, including synthesis of amino acids and fatty acids in critical care nutrition.

Due to its rapid and efficient metabolism, 50% Dextrose Injection is an essential intervention in glucose management and metabolic support.

50% W/V DEXTROSE INJECTION, USP (MEDISAL) Interactions 50% W/V DEXTROSE INJECTION, USP (MEDISAL)

Though primarily a carbohydrate solution, 50% Dextrose Injection may interact with medications, disease states, or body systems in specific scenarios.

• Drug Interactions:
  • Insulin: Co-administration accelerates glucose uptake; essential in controlled glucose infusion for diabetic ketoacidosis.
  • Potassium chloride: Often given alongside dextrose and insulin to manage hyperkalemia.
  • Corticosteroids: May counteract the hypoglycemic effects of dextrose, increasing blood glucose levels.
  • Diuretics (e.g., furosemide): Can cause electrolyte shifts that may be exacerbated by glucose-induced insulin secretion.
• Disease Interactions:
  • Diabetes Mellitus: Requires careful monitoring to avoid hyperglycemia.
  • Renal Impairment: Risk of fluid overload and altered glucose clearance.
  • Congestive Heart Failure (CHF): Excess fluid can worsen symptoms.
• Electrolyte Imbalance: High glucose may trigger insulin-mediated potassium shifts, leading to hypokalemia.

Always consult with a healthcare provider before combining this solution with other medications or infusions to avoid pharmacodynamic or pharmacokinetic interactions.

Dosage of 50% W/V DEXTROSE INJECTION, USP (MEDISAL)

The dosage of 50% Dextrose Injection must be tailored to the patient's clinical condition, age, weight, and therapeutic goals. It is a concentrated solution and should be administered with caution.

• Adults:
  • For Hypoglycemia: 25-50 ml (12.5–25 g) IV bolus as needed.
  • Repeat doses may be given depending on blood glucose response.
• Pediatrics:
  • Generally not recommended in neonates due to high osmolarity.
  • Children: 0.5 to 1 g/kg (1 to 2 ml/kg) IV bolus.
  • Must be diluted to avoid vein irritation or phlebitis.
• Rate of Administration:
  • Administer slowly over 2-5 minutes.
  • Rapid infusion may cause hyperglycemia and fluid shifts.
• Frequency: Based on repeated glucose monitoring.
• Maximum Dosage: There is no absolute maximum, but excessive dosing can lead to hyperglycemia and electrolyte imbalance.

Always monitor blood glucose levels during and after administration. Titrate doses based on clinical need and glucose response.

Possible side effects of 50% W/V DEXTROSE INJECTION, USP (MEDISAL)

Like all intravenous medications, 50% Dextrose Injection can cause side effects, especially when administered rapidly or in large volumes.

• Common Side Effects:
  • Local vein irritation or thrombophlebitis
  • Pain at injection site
  • Warmth or flushing sensation
• Metabolic Effects:
  • Hyperglycemia
  • Glycosuria (glucose in urine)
  • Rebound hypoglycemia if insulin is overcorrected
• Serious Side Effects:
  • Fluid overload, especially in patients with renal or cardiac impairment
  • Electrolyte disturbances like hypokalemia
  • Lactic acidosis in critical illness when glucose metabolism is impaired
• Allergic Reactions: Rare, but include rash, pruritus, or anaphylactoid reactions.

Side effects should be promptly reported and managed. Continuous monitoring during administration helps minimize risks.

50% W/V DEXTROSE INJECTION, USP (MEDISAL) Contraindications 50% W/V DEXTROSE INJECTION, USP (MEDISAL)

This hypertonic solution is not appropriate for all patients. Its use is contraindicated in several medical situations.

• Absolute Contraindications:
  • Known allergy or hypersensitivity to dextrose or any component of the solution
  • Hyperglycemia or uncontrolled diabetes mellitus
  • Delirium tremens in dehydrated patients
• Relative Contraindications:
  • Severe dehydration without concurrent electrolyte replacement
  • Intracranial or intraspinal hemorrhage (risk of worsening cerebral edema)
  • Thiamine deficiency (risk of Wernicke’s encephalopathy in chronic alcoholics)
• Special Caution:
  • Renal or cardiac failure (due to risk of fluid overload)
  • Peripheral administration in small veins (risk of vein damage)

Evaluate patient’s metabolic status before administration. Use only when the benefits clearly outweigh the risks in borderline conditions.

Storage of 50% W/V DEXTROSE INJECTION, USP (MEDISAL)

Proper storage conditions are essential to maintain the safety and efficacy of 50% Dextrose Injection.

• Storage Temperature: Store between 15°C and 30°C (59°F and 86°F).
• Avoid Freezing: Do not allow the solution to freeze, as this may cause crystallization and compromise sterility.
• Light Protection: While light-resistant containers are used, avoid prolonged exposure to direct sunlight.
• Container Integrity: Use only if the container is intact. Do not use if the solution appears cloudy, discolored, or if the seal is broken.
• Single-Use Vial: Discard any unused portion. Do not store after opening.
• Shelf Life: Check expiration date on the packaging. Expired products must be discarded.

Adherence to storage guidelines ensures sterility and maintains the concentration and pH of the dextrose solution, critical for safe administration.