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 containing 50 grams of dextrose monohydrate per 100 mL of water for injection. It is supplied in a 100 mL polypropylene bottle and is intended for intravenous administration.

Key Characteristics:

Concentration: 50% weight/volume (500 mg/mL) Formulation: Dextrose monohydrate in water for injection Packaging: 100 mL polypropylene bottle Route of Administration: Intravenous (IV) only

Primary Uses:

Treatment of Severe Hypoglycemia: Rapid correction of low blood glucose levels in emergency situations. Parenteral Nutrition: Provides a concentrated source of calories in patients unable to consume food orally. Management of Hyperkalemia: Used in conjunction with insulin to lower elevated serum potassium levels. farmacoinc.com This high-concentration dextrose solution is typically used in acute care settings under strict medical supervision due to its hypertonicity and potential for adverse effects if not administered correctly.

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

Administration of this hypertonic solution requires careful attention to technique and patient monitoring.

Preparation:

Inspection: Ensure the solution is clear and free from particulate matter. Do not use if discolored or if the container is compromised. Aseptic Technique: Maintain sterility during preparation and administration to prevent infection.

Administration Guidelines:

Route: Intravenous injection only. Rate: Administer slowly over 3 to 5 minutes to minimize vein irritation and reduce the risk of hyperglycemia. Vein Selection: Preferably use a large, central vein to reduce the risk of thrombophlebitis. Needle Size: Use a large-caliber needle to accommodate the solution's viscosity. Monitoring: Continuously monitor blood glucose levels and watch for signs of fluid overload or electrolyte imbalances.

Special Considerations:

Pediatric Use: Not recommended for neonates or infants due to the risk of vein irritation and tissue damage. Dilution: In certain cases, dilution with compatible fluids may be necessary to reduce osmolarity. Extravasation: Take precautions to avoid leakage into surrounding tissues, which can cause severe tissue necrosis. medicalguidelines.msf.org Proper administration is crucial to ensure therapeutic efficacy and minimize potential complications.

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

Dextrose, a monosaccharide, serves as a rapid source of glucose upon intravenous administration.

Mechanism:

Energy Provision: Dextrose is metabolized to produce ATP, supplying immediate energy to cells. Glycogen Storage: Excess glucose is stored as glycogen in the liver and muscles for future energy needs. Protein Sparing: Provides calories, reducing the need for protein catabolism in energy production. Insulin Release: Elevated blood glucose levels stimulate insulin secretion, facilitating cellular glucose uptake.

Clinical Effects:

Hypoglycemia Correction: Rapidly increases blood glucose levels, alleviating symptoms of hypoglycemia. Hyperkalemia Management: When combined with insulin, promotes the intracellular shift of potassium, lowering serum potassium levels. Nutritional Support: Provides caloric supplementation in patients requiring parenteral nutrition. farmacoinc.com Understanding the pharmacodynamics of dextrose is essential for its effective and safe use in clinical practice.

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

While dextrose is generally well-tolerated, certain interactions may influence its efficacy and safety.

Drug Interactions:

Insulin: Co-administration enhances cellular glucose uptake; dosage adjustments may be necessary to prevent hypoglycemia. Potassium Chloride: Combined use requires careful monitoring of serum potassium levels to avoid hypokalemia. Corticosteroids: May antagonize insulin effects, leading to hyperglycemia. Diuretics: Can cause electrolyte imbalances, necessitating monitoring when used concurrently with dextrose.

Laboratory Interactions:

Blood Glucose Monitoring: Frequent monitoring is essential to adjust therapy and prevent complications. Electrolyte Levels: Regular assessment of electrolytes, especially potassium and phosphate, is important during prolonged use. MedLibrary.org Always consider potential interactions and monitor patients accordingly to ensure safe administration.

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

Dosage should be individualized based on the patient's clinical condition, age, and response to therapy.

Adults:

Hypoglycemia: Administer 20 to 50 mL (10 to 25 g dextrose) intravenously over 3 to 5 minutes. Repeat as necessary based on blood glucose levels. Hyperkalemia: Administer 25 to 50 g dextrose (50 to 100 mL) with 10 units of regular insulin intravenously over 30 to 60 minutes. farmacoinc.com

Children:

Hypoglycemia: Administer 0.5 to 1 g/kg (1 to 2 mL/kg) intravenously over 3 to 5 minutes. Maximum dose: 25 g. Note: Use with caution; dilution may be necessary to reduce osmolarity.

Administration Tips:

Monitoring: Check blood glucose levels before and after administration. Adjustment: Dosage may need to be adjusted in patients with renal or hepatic impairment. Always tailor the dosage to the individual patient's needs and monitor for therapeutic effectiveness and adverse reactions.

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

While generally safe when administered correctly, potential side effects may occur.

Common Side Effects:

Local Reactions: Pain, redness, or swelling at the injection site. Hyperglycemia: Elevated blood glucose levels, especially in diabetic patients. Fluid Overload: Particularly in patients with compromised cardiac or renal function.

Serious Side Effects:

Tissue Necrosis: Due to extravasation; requires immediate medical attention. Electrolyte Imbalances: Hypokalemia, hypophosphatemia, or hypomagnesemia during prolonged use. Allergic Reactions: Rare, but may include rash, itching, or anaphylaxis. Medscape Prompt recognition and management of side effects are essential to prevent complications.

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

Certain conditions preclude the use of this hypertonic solution.

Absolute Contraindications:

Hypersensitivity: Known allergy to dextrose or any component of the formulation. Hyperglycemia: Uncontrolled high blood glucose levels. Intracranial or Intraspinal Hemorrhage: Risk of exacerbating cerebral edema. Severe Dehydration: May worsen hyperosmolar states. FDA Database +4 FDA Database +4 Guideline Central +4

Relative Contraindications:

Diabetes Mellitus: Use with caution; requires close monitoring of blood glucose levels. Renal or Cardiac Impairment: Risk of fluid overload; monitor fluid balance carefully. A thorough assessment of the patient's medical history and current condition is vital before administration.

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

Proper storage of 50% W/V Dextrose Injection, USP (MEDISAL) is essential to maintain its stability, potency, and sterility. Follow these guidelines to ensure safe and effective use:

• Temperature: Store the injection at controlled room temperature, typically between 20°C to 25°C (68°F to 77°F). Avoid exposure to extreme heat or cold, as temperature fluctuations can degrade the solution.
• Light Protection: Keep the product in its original packaging to protect it from light. Excessive light exposure may cause chemical degradation of the dextrose solution.
• Avoid Freezing: Do not freeze the injection. Freezing can cause crystallization of dextrose and compromise the solution’s safety and efficacy.
• Packaging Integrity: Inspect the polypropylene bottle for any signs of damage, leakage, or contamination before use. Do not use if the container is cracked, punctured, or otherwise compromised.
• Storage Area: Store in a clean, dry place away from direct sunlight and away from incompatible substances such as strong oxidizers.
• Shelf Life: Use before the expiration date printed on the label. Do not use expired solutions as their efficacy and sterility cannot be guaranteed.
• After Opening: Use the solution immediately after opening the container. Discard any unused portion to avoid contamination.