Dextrose

Pronunciation

(DEKS trose)


U.S. Brand Names

B-D™ Glucose [OTC]; Dex4 Glucose [OTC]; Enfamil® Glucose; Glutol™ [OTC]; Glutose™ [OTC]; Insta-Glucose® [OTC]



Synonyms

Anhydrous Glucose; D5W; D10W; D25W; D30W; D40W; D50W; D60W; D70W; Dextrose Monohydrate; Glucose; Glucose Monohydrate; Glycosum



Generic Available

Yes



Use

Oral: Treatment of hypoglycemia

5% and 10% solutions: Peripheral infusion to provide calories and fluid replacement

25% (hypertonic) solution: Treatment of acute symptomatic episodes of hypoglycemia in infants and children to restore depressed blood glucose levels; adjunctive treatment of hyperkalemia when combined with insulin

50% (hypertonic) solution: Treatment of insulin-induced hypoglycemia (hyperinsulinemia or insulin shock) and adjunctive treatment of hyperkalemia in adolescents and adults

10% solutions: Infusion after admixture with amino acids for nutritional support

Pregnancy Risk Factor

C/A (oral)



Contraindications

Hypersensitivity to corn or corn products; diabetic coma with hyperglycemia; hypertonic solutions in patients with intracranial or intraspinal hemorrhage; patients with delirium tremens and dehydration; patients with anuria, hepatic coma, or glucose-galactose malabsorption syndrome



Warnings/Precautions

Hypertonic solutions (>10%) may cause thrombosis if infused via peripheral veins; administer hypertonic solutions via a central venous catheter. Rapid administration of hypertonic solutions may produce significant hyperglycemia, glycosuria, and shifts in electrolytes; this may result in dehydration, hyperosmolar syndrome, coma, and death especially in patients with chronic uremia or carbohydrate intolerance. Excessive or rapid dextrose administration in very low birth weight infants has been associated with increased serum osmolality and possible intracerebral hemorrhage.

Use with caution in patients with diabetes. Hyperglycemia and glycosuria may be functions of the rate of administration of dextrose; to minimize these effects, reduce the rate of infusion; addition of insulin may be necessary. Administration of potassium free I.V. dextrose solutions may result in significant hypokalemia, particularly if highly concentrated dextrose solutions are used; monitor closely and/or add potassium to dextrose solutions for patients with adequate renal function. Abrupt withdrawal of dextrose solution may be associated with rebound hypoglycemia. An unexpected rise in blood glucose level in an otherwise stable patient may be an early symptom of infection. Do not use oral forms in unconscious patients

Parenteral dextrose solutions contain aluminum which may accumulate to toxic levels with prolonged administration particularly in patients with impaired renal function. Patients with impaired renal function including premature neonates who receive aluminum at >4-5 mcg/kg/day accumulate aluminum at levels associated with CNS and bone toxicity.

Adverse Reactions

Frequency not defined. Most adverse effects are associated with excessive dosage or rate of infusion.

Note:

Cardiovascular: Venous thrombosis, phlebitis, hypovolemia, hypervolemia, dehydration, edema

Central nervous system: Fever, mental confusion, unconsciousness, hyperosmolar syndrome

Endocrine & metabolic: Hyperglycemia, hypokalemia, acidosis, hypophosphatemia, hypomagnesemia

Genitourinary: Polyuria, glycosuria, ketonuria

Gastrointestinal: Polydipsia, nausea, diarrhea (oral)

Local: Pain, vein irritation, tissue necrosis

Respiratory: Tachypnea, pulmonary edema

Drug Interactions

Corticosteroids



Stability

Stable at room temperature; protect from freezing and extreme heat; store oral dextrose in airtight containers



Mechanism of Action

Dextrose, a monosaccharide, is a source of calories and fluid for patients unable to obtain an adequate oral intake; may decrease body protein and nitrogen losses; promotes glycogen deposition in the liver. When used in the treatment of hyperkalemia (combined with insulin), dextrose stimulates the uptake of potassium by cells, especially in muscle tissue, lowering serum potassium.



Pharmacodynamics/Kinetics

Onset of action: Treatment of hypoglycemia: Oral: 10 minutes

Maximum effect: Treatment of hyperkalemia: I.V.: 30 minutes

Absorption: Rapidly from the small intestine by an active mechanism

Metabolism: Metabolized to carbon dioxide and water

Time to peak, serum: Oral: 40 minutes

Dosage

Hypoglycemia: Doses may be repeated in severe cases

I.V.:

Infants

6 months: 0.25-0.5 g/kg/dose (1-2 mL/kg/dose of 25% solution); maximum: 25 g/dose

Infants >6 months and Children: 0.5-1 g/kg/dose (2-4 mL/kg/dose of 25% solution); maximum: 25 g/dose

Adolescents and Adults: 10-25 g (40-100 mL of 25% solution or 20-50 mL of 50% solution)

Oral: Children >2 years and Adults: 10-20 g as single dose; repeat in 10 minutes if necessary

Treatment of Hyperkalemia: I.V. (in combination with insulin):

Infants and Children: 0.5-1 g/kg (using 25% or 50% solution) combined with regular insulin 1 unit for every 4-5 g dextrose given; infuse over 2 hours (infusions as short as 30 minutes have been recommended); repeat as needed

Adolescents and Adults: 25-50 g dextrose (250-500 mL D10W) combined with 10 units regular insulin administered over 30-60 minutes; repeat as needed or as an alternative 25 g dextrose (50 mL D50W) combined with 5-10 units regular insulin infused over 5 minutes; repeat as needed

Note: More rapid infusions (<30 minutes) may be associated with hyperglycemia and hyperosmolality and will exacerbate hyperkalemia; avoid use in patients who are already hyperglycemic

Administration

Oral: Must be swallowed to be absorbed (see Warnings)

Parenteral: Not for SubQ or I.M. administration; dilute concentrated dextrose solutions for peripheral venous administration to a maximum concentration of 12.5%; in emergency situations, 25% dextrose has been used peripherally; for direct I.V. infusion, infuse at a maximum rate of 200 mg/kg over 1 minute; continuous infusion rates very with tolerance and range from 4.5-15 mg/kg/minute; hyperinsulinemic neonates may require up to 15-25 mg/kg/minute infusion rates

Monitoring Parameters

Blood and urine sugar, serum electrolytes, I & O, caloric intake



Reference Range

Normal blood sugar:

Children 0-2 years: 60-105 mg/dL

Children >2 years and Adults: 70-110 mg/dL

Additional Information

Each g of I.V. dextrose contains 3.4 kcal; glucose monohydrate 1 g is equal to 1 g anhydrous dextrose; osmolarity of 10% dextrose is 505 mOsm/L and 25% dextrose is 1330 mOsm/L. Normal body fluid osmolarity is 310 mOsm/L.



Dental Health: Effects on Dental Treatment

No significant effects or complications reported



Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions



Mental Health: Effects on Mental Status

None reported



Mental Health: Effects on Psychiatric Treatment

None reported



Dosage Forms

Gel, as 40% dextrose:

Glutose™: 40% (15 g, 45 g)

Insta-Glucose®: 40% (30 g)

Infusion, as 2.5% dextrose: 1000 mL

Infusion, as 5% dextrose: 25 mL, 50 mL, 100 mL, 150 mL, 250 mL, 500 mL, 1000 mL

Infusion, as 10% dextrose: 3 mL, 5 mL, 250 mL, 500 mL, 1000 mL

Infusion, as 20% dextrose: 500 mL, 1000 mL

Infusion, as 25% dextrose: 10 mL

Infusion, as 30% dextrose: 500 mL, 1000 mL

Infusion, as 40% dextrose: 500 mL, 1000 mL

Infusion, as 50% dextrose: 50 mL, 500 mL, 1000 mL, 2000 mL

Infusion, as 60% dextrose: 500 mL, 1000 mL

Infusion, as 70% dextrose: 70 mL, 500 mL, 1000 mL, 2000 mL

Solution, oral:

Enfamil® Glucose: 5% (90 mL) [5 g dextrose/100 mL]; 10% (90 mL) [10 g dextrose/100 mL]

Glutol™: 55% (180 mL) [100 g dextrose/180 mL]

Tablet, chewable:

B-D™ Glucose: 5 g

Dex4 Glucose: 4 g

International Brand Names

Apir Glucosado Isotonico® (ES); Apir Glucosalino® (ES); Apiroflex Glucosada® (ES); Biberon Glucosa B Martin® (ES); Biberon Glucosado Pharma® (ES); Clear-Flex Glucose® (CH); Dekstroz Sudaki® (TR); Dekstroz® (TR); Dextrosa® (EC); Dextrosa Fresenius® (ES); Dextrose 50% Injection® (GB); Dextrose® (RO, RU, TR); Dextrose Vioser® (RO); Dextroz Sudaki® (TR); Dianeal® (CH, NO); Euro-Collins® (TR); Flebobag® (ES); Flebobag Glucosa Grifols® (ES); Fleboplast Glucosa Grif® (ES); Glucanet® (PT); GLUCO® (AU); Glucolin® (AR); Glucosa Baxter® (ES); Glucosa Bieffe Medital® (ES); Glucosa Biomendi® (ES); Glucosa Braun® (ES); Glucosa® (CL); Glucosada Fresenius® (ES); Glucosada Grifols® (ES); Glucosada Ife® (ES); Glucosado Bieffe® (ES); Glucosado Braun® (ES); Glucosado Farmacelsia® (ES); Glucosado Hiper Freseniu® (ES); Glucosado Isotonic Braun® (ES); Glucosado Vitulia® (ES); Glucosa Mein® (ES); Glucos Baxter Viaflo® (DK, FI); Glucos B.Braun® (DK, FI); Glucose-1-phosphat "Fresenius"® (AT); Glucose-1-Phosphat Leopold® (CZ); Glucose Aguettant® (FR, RO); Glucose Baxter® (AT, CH); Glucose-Baxter® (LU); Glucose Bioluz® (FR); Glucose Bioren® (CH); Glucose Braun® (AT, CH, DE, DK, HU, LU, PL); Glucose-Clintec® (LU); Glucose Cooper® (FR); Glucose Fresenius® (AT, CH, FR); Glucose® (GB, RO); Glucose INFOsint® (CH); Glucose-Infusionslösung® (DE); Glucose Injection® (AU, GB); Glucose Lavoisier® (FR); Glucose-Lösung ACS Dobfar Info (CH); Glucose-Lösung Berlin-Chemie® (DE); Glucose-Lösung® (DE); Glucose-Lösungen INFO® (CH); Glucose-Lösung Grifols® (DE); Glucose Maco Pharma® (CH); Glucose Mayrhofer® (AT); Glucose Medipharm® (AT); Glucose pfrimmer® (DE); Glucose Sad® (DK); Glucose-Salvia® (LU); Glucose solution for injections® (RU); Glucos. Fresenius Kabi® (DK, FI); Glucosi Infundibile® (RO); Glucosio® (IT); Glucosi® (SI, YU); Glucosmon® (ES); Glucos® (NO); Glucosol® (AT); Glucosteril® (DE, FI, LU, RO, RU); Glucosum "Bichsel"® (CH); Glucosum® (HR, HU, PL, SI); Glucosum Streuli® (CH); Glucotem Sport® (AR); Glucotide® (AR); Glucoza® (HR, RO); Glucoza Renaudin® (RO); Glukose isotonisk SAD® (DK); Glukose® (NO); Glukose SAD® (DK); GlükÓ[z-1-foszfát "Fresenius"® (HU); Glukoza Braun® (PL, SI); Glukoza® (HR, PL, SI, YU); GlükÓ[z Bieffe® (HU); GlukÓ[z® (HU); Injectio Glucosi® (PL); Intramed Dextrose Injection® (ZA); Intravenska raztopina® (SI); 1/3 Isodeks® (TR); Isodex® (HU); Kadeks® (TR); Ka-En® (ID); Meinvenil Glucosa® (ES); Min-I-Jet® (GB); Nutrosa® (AR); Plast Apyr Glucosado® (ES); Solucion de Dextrosa Richmond® (AR); Soluciones Parenterales® (AR, CL); Solucion Glucosada® (AR); Solution of Glucose® (RU); Traubenzuckerlösung Fresenius® (AT); Venofusin Glucosa® (ES)



Review Date: 1969-12-31 Reviewed By: Keywords: ,
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