Glucose, 10% 250 ml

Glucose increases redox processes in the body, improves the antitoxic function of the liver, enhances myocardial contractile activity, and is a source of easily digestible carbohydrates.

The pharmacodynamic properties of 5% and 10% solutions of dextrose are similar to those of glucose, the main source of energy for cellular metabolism.

The 5% solution of dextrose is an isotonic solution with an osmolarity of about 278 mOsm/L. The caloric intake of a 5% dextrose solution is 200 kcal/L. A 10% dextrose solution is a hypertonic solution with an osmolarity of about 555 mOsm/L. The caloric intake of the 10% dextrose solution is 400 kcal/L.

In parenteral nutrition 5% and 10% solutions of dextrose are administered as a source of carbohydrates (separately or as part of parenteral nutrition if necessary). The 5% and 10% solutions of dextrose make it possible to compensate for fluid deficiencies without the simultaneous administration of ions. Dextrose, entering the tissues, is phosphorylated, turning into glucose-6-phosphate, which is actively involved in many parts of the body’s metabolism.

When dextrose solutions are used to dilute and dissolve parenterally administered medications, the pharmacodynamic properties of the solution will depend on the substance added.

Pharmacokinetics:

Glucose is metabolized by two different pathways: anaerobic and aerobic.

Dextrose breaks down into pyruvic acid or lactic acid (anaerobic glycolysis) and is metabolized to carbon dioxide and water with the release of energy.

When dextrose solution is used to dilute and dissolve parenterally administered medications, the pharmacokinetic properties of the solution will depend on the substance added.

Indications

Active ingredient

Composition

The infusion solution is clear colorless.

1 ml

Dextrose 0.10 g

Auxiliary substances:

sodium chloride 0.00026 g,

Hydrochloric acid solution 0.1 M to pH 3.0 – 4.1,

water d / i to 1 ml.

How to take, the dosage

Dextrose solution for infusion is given intravenously (IV).

The drug is usually injected into the peripheral or central vein. The concentration and dose of the administered solution depend on the age, body weight and clinical condition of the patient.

The drug should be used under regular medical supervision.

Clinical and biochemical parameters, in particular blood glucose concentration and water-salt balance, should be monitored closely.

Interaction

The co-administration of catecholamines and steroids decreases dextrose (glucose) absorption.

Mixing with other medications should be visually checked for incompatibility.

To dilute or dissolve other medications, the drug should only be used if there are instructions for dilution with dextrose solution in the instructions for use for the medication.

In the absence of information on the compatibility of the drug should not be mixed with other medicinal products.

Be sure that any medication is soluble and stable in water within the pH range of the medication before adding it.

After adding a compatible medication to the medication, the resulting solution should be administered immediately.

Drugs with known incompatibilities should not be used.

If dextrose solutions are administered through the same infusion system as for hemotransfusion, there may be a risk of hemolysis and thrombosis.

Special Instructions

Since patients with diabetes mellitus, renal insufficiency or in acute critical condition may have impaired glucose (dextrose) tolerance, their clinical and biological parameters, in particular plasma electrolyte concentration, including magnesium or phosphorus, blood glucose concentration should be monitored particularly carefully. If hyperglycemia is present, the rate of drug administration should be adjusted or short-acting insulin should be prescribed.

Normally, glucose is completely absorbed by the body (normally the kidneys do not excrete it), so the appearance of glucose in the urine may be a pathological sign.

In case of prolonged or high-dose dextrose administration it is necessary to monitor the concentration of potassium in plasma and if necessary to administer additional potassium to avoid hypokalemia.

In episodes of intracranial hypertension, careful monitoring of blood glucose concentration is necessary.

The use of dextrose solutions may lead to hyperglycemia. Therefore, they are not recommended after acute ischemic stroke, because hyperglycemia is associated with increased ischemic brain damage and prevents recovery.

Particular close clinical monitoring is required at the beginning of intravenous administration of the drug.

For rehydration therapy, carbohydrate solutions should be used in combination with electrolyte solutions to avoid electrolyte imbalance (hyponatremia, hypokalemia).

The concentration of glucose and electrolytes in the blood, the water balance and the acid-base state of the body should be monitored.

The solution should be inspected before use. Use only a clear solution without visible inclusions and with no damage to the package. Administer directly after connection to the infusion system.

The solution should be administered using sterile equipment and following aseptic and antiseptic procedures.

The air should be removed from the infusion system with the solution to prevent air embolism.

Do not connect containers in series to avoid air embolism, which can occur due to air being sucked out of the first container before the second container has completed the infusion. Infusing intravenous solutions contained in soft plastic containers under increased pressure to increase the flow rate may result in an air embolism if the remaining air in the container is not completely removed prior to infusion. The use of an intravenous system with a vent may result in an air embolism if the vent is open. Soft plastic containers with such systems should not be used. Added substances can be administered before infusion or during infusion through the infusion site (if a special port for drug administration is available). Addition of other drugs to the solution or violation of the administration technique may cause fever due to possible ingestion of pyrogens. In case of adverse reactions the infusion should be stopped immediately. When adding other drugs before parenteral administration the isotonicity of the resulting solution should be checked. Complete and thorough mixing under aseptic conditions is mandatory. Solutions containing additional substances should be used immediately, their storage is prohibited. When introducing additional nutrients the osmolarity of the resulting mixture should be determined before starting the infusion. The resulting mixture should be administered via a central or peripheral venous catheter depending on the final osmolarity. Compatibility of additionally administered drugs should be assessed before adding them to the solution (similar to the use of other parenteral solutions). It is the responsibility of the physician to assess the compatibility of the additionally administered drugs with the drug. The resulting solution should be checked for discoloration and/or the appearance of precipitate, insoluble complexes or crystals. The instructions for use of the drugs to be added should be consulted. From a microbiological point of view, the diluted drug should be used immediately. Exceptions are dilutions prepared under controlled and aseptic conditions. Otherwise, once the solution has been prepared, the terms and conditions of storage prior to administration are the responsibility of the user. Children Neonates, especially those born prematurely or with low birth weight, have an increased risk of hypo- or hyperglycemia, so during intravenous administration of dextrose solutions, careful monitoring of blood glucose concentration is necessary to avoid long-term adverse effects. Hypoglycemia in newborns may lead to prolonged seizures, coma and brain damage. Hyperglycemia is associated with intraventricular hemorrhage, delayed bacterial and fungal infections, retinopathy of prematurity, necrotizing enterocolitis, bronchopulmonary dysplasia, prolonged hospitalization, and mortality. To avoid a potentially fatal overdose of intravenous drugs in neonates, special attention must be paid to the route of administration. When using a syringe pump for intravenous drug administration to newborns, the solution container should not be left attached to the syringe. When using an infusion pump, all system clamps must be closed before removing the system from the pump or disconnecting it, regardless of the presence of a device in the system that prevents the free flow of fluid. Intravenous infusion devices and other drug administration equipment should be monitored regularly. If the drug contains corn-derived dextrose, use of the drug is contraindicated in patients with known intolerance to corn or corn products because the following manifestations of hypersensitivity are possible: anaphylactic reactions, chills, and fever. For preparations in containers: Containers should be disposed of after a single use. Each unused dose should be disposed of. Do not reassemble partially used containers.

Contraindications

Decompensated diabetes mellitus and non-sugar diabetes; hyperosmolar coma; hemodilution and extracellular hyperhydration, hypervolemia; hyperglycemia and hyperlactatemia; severe renal failure (with oliguria or anuria); decompensated heart failure; generalized edema (including pulmonary and cerebral edema) and cirrhosis with ascites; other known forms of glucose intolerance (e.g., metabolic stress); hypersensitivity to drug components; administration of solution within the first 24 h after head injury; use of the same infusion system as for hemotransfusion because of risk of hemolysis and thrombosis; patients with known intolerance to corn or corn products (when receiving dextrose from corn); contraindications to any drugs added to glucose solution.

Side effects

Unwanted reactions (URs) are grouped by system and organ according to the MedDRA Dictionary and the WHO UR frequency classification:

Very common (?1/10), common (?1/100 to < 1/10), infrequent (?1/1000 to < 1/100), rare (?1/10000 to < 1/1000), very rare (< 1/10000), frequency unknown – (frequency cannot be determined from available data).

Immune system disorders: frequency unknown – anaphylactic reactions, hypersensitivity.

Metabolism and nutrition: frequency is unknown – disorders of water-electrolyte balance (hypokalemia, hypomagnesemia, hypophosphatemia), hyperglycemia, hemodilution, hypervolemia, dehydration.

Vascular disorders: frequency unknown – venous thrombosis, phlebitis.

Skin and subcutaneous tissue: frequency unknown – increased sweating.

Renal and urinary tract: frequency unknown – polyuria.

General disorders and disorders at the injection site: frequency unknown – chills, fever, infection at the injection site, irritation at the injection site, extravasation, pain at the injection site.

Laboratory and instrumental data: frequency unknown – glucosuria.

The undesirable reactions may also be related to the drug that has been added to the solution. The likelihood of other adverse reactions depends on the properties of the specific drug added.

If undesirable reactions occur, the solution should be discontinued.

Overdose

Symptoms:

Prolonged infusion of the drug can lead to hyperglycemia, glucosuria, hyperosmolarity, osmotic diuresis, and dehydration. Rapid infusion may create fluid accumulation in the body with hemodilution and hypervolemia, and if the body’s ability to oxidize glucose is exceeded, rapid administration may cause hyperglycemia. There may also be a decrease in plasma potassium and inorganic phosphate.

When using dextrose infusion solution to dilute and dissolve other medications for intravenous administration, the clinical signs and symptoms of overdose may be related to the properties of the medications used.

Treatment:

If symptoms of overdose occur, suspend administration of the solution, assess the patient’s condition, administer short-acting insulin, and administer supportive symptomatic therapy if necessary.

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