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, hypertonic intravenous solution containing dextrose monohydrate as its active ingredient. It is widely used in clinical settings to provide a rapid source of energy, especially in patients who are unable to take oral nutrition or require immediate correction of hypoglycemia. The solution is supplied in a 250ml polypropylene bottle and serves as both a caloric source and a fluid therapy agent.

Key features include:

• Highly concentrated glucose (50% w/v), making it a potent source of energy for immediate metabolic needs.
• Typically administered via intravenous infusion to quickly elevate blood glucose levels.
• Commonly used in emergency medicine, critical care, and metabolic support for patients with hypoglycemia, dehydration, or as part of parenteral nutrition.
• Often used when oral or enteral feeding is contraindicated or impractical.

Because of its high osmolarity, it must be administered carefully to avoid vein irritation or other complications. This preparation is specifically designed for intravenous use and must be handled under sterile conditions.

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

Administration of 50% W/V Dextrose Injection requires medical supervision and adherence to proper protocols to ensure patient safety and efficacy.

• Route of Administration: Intravenous infusion only. It should never be administered via intramuscular or subcutaneous routes due to tissue irritation and potential damage.
• Preparation: Inspect the solution visually for particulate matter or discoloration before use. Only clear, colorless solutions should be used.
• Dilution: Depending on the clinical situation, dilution with isotonic fluids may be necessary to reduce osmolarity and avoid phlebitis.
• Infusion Rate: The rate of administration depends on patient age, clinical condition, and desired glucose correction speed. Rapid infusion may be used in severe hypoglycemia, but caution is needed to avoid complications.
• Monitoring: Monitor blood glucose levels regularly during and after administration to prevent hyperglycemia or hypoglycemia.
• Compatibility: Avoid mixing with incompatible medications or additives unless compatibility is confirmed.

Always follow institutional protocols and consult healthcare guidelines for specific dosing and administration instructions.

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

Dextrose, chemically identical to glucose, is a simple sugar utilized by the body as a primary energy source. The pharmacological effect of 50% W/V Dextrose Injection is based on its rapid availability of glucose once administered intravenously.

• Rapid Absorption: Delivered directly into the bloodstream, dextrose bypasses the digestive system and is quickly taken up by cells.
• Energy Production: Glucose undergoes glycolysis and enters cellular metabolic pathways to produce ATP, the energy currency of the cell.
• Correction of Hypoglycemia: It raises plasma glucose levels promptly, correcting acute hypoglycemia, which if untreated, can cause neurological damage.
• Osmotic Effect: The hypertonic nature draws water into the intravascular compartment, aiding in fluid resuscitation and volume expansion.
• Supports Metabolism: Serves as a critical energy source in patients who are unable to eat or metabolize carbohydrates.

The mode of action emphasizes both metabolic support and fluid balance, making it invaluable in emergency and critical care.

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

When using 50% W/V Dextrose Injection, awareness of potential drug interactions is important to avoid adverse effects or reduced efficacy.

• Insulin and Hypoglycemic Agents: Co-administration can counteract the glucose-raising effect of dextrose; dosing adjustments may be required.
• Diuretics: Some diuretics like thiazides can increase blood glucose levels, potentially compounding hyperglycemia.
• Corticosteroids: May antagonize glucose control, increasing blood sugar and requiring careful monitoring.
• Sympathomimetics: These drugs can increase blood glucose levels and should be used cautiously with dextrose infusion.
• Other Intravenous Solutions: Mixing with incompatible IV drugs or solutions can cause precipitation or inactivation; always verify compatibility before administration.

Careful review of all concomitant medications and close patient monitoring is essential to manage these interactions effectively.

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

Dosage of this concentrated dextrose injection should be individualized based on the patient’s condition, weight, and clinical response.

• Adults: In hypoglycemic emergencies, an initial bolus of 25-50 ml may be administered intravenously, followed by a maintenance infusion tailored to glucose levels and caloric needs.
• Pediatrics: Dosage must be carefully calculated based on weight and metabolic requirements; typically a smaller bolus is given.
• Continuous Infusion: For patients requiring ongoing glucose supplementation, the infusion rate is adjusted according to blood glucose monitoring and clinical status.
• Adjustment: Monitor blood glucose frequently and adjust dose to avoid hypo- or hyperglycemia.
• Special Cases: Patients with diabetes, renal impairment, or fluid restrictions require close supervision to prevent complications.

All dosing should follow hospital protocols and be guided by healthcare professionals.

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

While generally safe when used correctly, 50% W/V Dextrose Injection can cause side effects, especially if improperly administered or overdosed.

• Local Reactions: Phlebitis, vein irritation, or thrombosis at the injection site due to hypertonicity.
• Hyperglycemia: Excess glucose can cause elevated blood sugar levels, leading to symptoms such as increased thirst, frequent urination, and in severe cases, diabetic ketoacidosis.
• Fluid Overload: Rapid infusion may cause volume overload, pulmonary edema, or heart failure in susceptible patients.
• Electrolyte Imbalance: Shifts in fluids may alter electrolyte levels, causing hypokalemia or other disturbances.
• Allergic Reactions: Rare but possible hypersensitivity reactions including rash, itching, or anaphylaxis.
• Metabolic Complications: Rarely, prolonged use can result in lactic acidosis or fatty liver changes.

Prompt recognition and management of side effects are critical to avoid complications.

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

This medication should not be used in the following conditions:

• Known Hypersensitivity: Allergy to dextrose or any components of the formulation.
• Hyperglycemia: Patients with uncontrolled diabetes mellitus or hyperosmolar states.
• Severe Dehydration: Without appropriate fluid replacement, as hypertonic dextrose may worsen dehydration.
• Intracranial or Intraspinal Hemorrhage: Due to risk of worsening cerebral edema from fluid shifts.
• Severe Renal or Cardiac Failure: Risk of fluid overload and electrolyte imbalance.
• Use Caution in Patients with: Conditions such as peripheral vascular disease or thrombophlebitis where hypertonic solutions may exacerbate symptoms.

Contraindications should be carefully reviewed before initiating therapy.

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

Proper storage is essential to preserve the integrity and safety of the injection:

• Store at controlled room temperature, between 20°C and 25°C (68°F to 77°F).
• Protect from light by keeping in original packaging until use.
• Do not freeze, as freezing can cause crystallization and compromise sterility.
• Inspect container before use; discard if damaged or if the solution is cloudy or contains particles.
• Use the solution immediately after opening; discard any unused portion to avoid contamination.
• Keep out of reach of children and store away from incompatible substances such as strong oxidizers.

Adhering to storage guidelines helps maintain product quality and patient safety.