Dextrose solutions I.V. can cause fluid or solute overload resulting in dilution of serum electrolyte concentrations, overhydration, congested states, or pulmonary edema.
Hypertonic dextrose solutions, even when given intravenously, have a tendency to cause venous thrombosis. Proper technique for intravenous injection should therefore be employed to avoid vein damage. For example: It is suggested that a needle of the smallest practicable bore be used; that the injection be made as slowly as conditions permit; that the bevel of the inserted needle be kept as far away as possible from the wall of the vein (usually the superior vena cava or other equally large vein); blood flow in the punctured vein be increased by the application of heat to that extremity; that the solution itself be warmed to body temperature, or at least to room temperature, before use; and that the tourniquet be removed as soon as the needle is in the vein and before any solution is injected.
Dextrose-containing solutions should be used with caution in patients with subclinical or overt diabetes mellitus or carbohydrate intolerance.
Rapid administration of hypertonic solutions may produce significant hyperglycemia or hyperosmolar syndrome, especially in patients with chronic uremia or carbohydrate intolerance.
There is currently no manufacturer warning information available for this drug.
Dextrose Injection, 50%, is used in parenteral hyperalimentation. It is a hypertonic solution and, when administered intravenously, cause cellular dehydration. It has been employed to promote diuresis by increasing the osmotic pressure of the glomerular filtrate. Its hypertonic property makes it valuable in the following special clinical uses, which may be summarized as follows:
a) For its concentrated food value in patients in whom more dilute solutions are contraindicated by actual or impending edema, such as exist in surgical as well as nonsurgical patients.
b) 50%: Used in the treatment of insulin hypoglycemia (hyperinsulinemia or insulin shock) to restore blood glucose levels.
For reduction of increased cerebrospinal pressure and/ or cerebral edema due to delirium tremens or acute alcoholic intoxication. Increased cerebrospinal fluid pressure may be depressed for two to four hours after intravenous injection of 50 mL of 50% dextrose solution.
Dextrose is α-D (+) Glucopyranose, C6H12O6, a sugar usually obtained by the hydrolysis of starch. It has the following structural formula:
Dextrose, USP, contains one molecule of water of hydration or is anhydrous.
Dextrose Injection, USP, a fluid and nutrient replenisher, is a sterile aqueous solution of dextrose and is available in the following
concentration:
50% – containing 500 mg of dextrose monohydrate per mL; osmolarity (calc.): 2500 mOsmol/ L.
This preparation is for intravenous use and contains no antimicrobial preservatives. It is intended as a single dose vial; once the unit is assembled and used, any remaining portion of the solution must be discarded with the entire unit.
