Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/drugs/1581
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Dextrose (Injection, Solution)
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When possible, glucose concentrations of greater than 12%
should be administered by central vein to reduce the risk for phlebitis and
thrombosis. 25% Dextrose Injection, USP is administered only by slow intravenous injection. The dosage and constant
infusion rate of intravenous dextrose must be selected with caution, particularly
in neonates and low birth weight infants, because of the increased risk of
hyperglycemia/ hypoglycemia. In the neonate, an injection of 250 to 500 mg
(1 to 2 mL)/kg/dose (5 to 10 mL of 25% dextrose in a 5 kg infant)
is recommended to control acute symptomatic hypoglycemia (tremors, convulsions,etc.). Larger or repeated single doses (up to 10 or
12 mL of 25% dextrose) may be required in severe cases or older infants. A
specimen for blood glucose determination should be taken before injecting
the dextrose. In such emergencies, dextrose should be administered promptly
without awaiting pretreatment test results. Subsequent
continuous intravenous infusion of 10% dextrose injection may be needed to
stabilize blood glucose levels. Further treatment should be guided by evaluation
of the underlying disorder. Parenteral drug products
should be inspected visually for particulate matter and discoloration prior
to administration, whenever solution and container permit. See PRECAUTIONS.
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| dailymed-instance:descripti... |
25% Dextrose Injection, USP is a sterile, nonpyrogenic, hypertonic
solution of dextrose in water for injection administered by intravenous injection
to restore blood glucose levels in hypoglycemia and as a source of carbohydrate
calories. Each milliliter (mL) of fluid contains dextrose, hydrous, 250 mg
which delivers 3.4 kcal/gram (0.85 kcal/mL). The solution has an osmolarity
of 1.39 mOsmol/mL (calc.). pH is 4.5 (3.2 to 6.5). May contain hydrochloric
acid and sodium hydroxide for pH adjustment. The solution
contains no bacteriostat, antimicrobial agent or added buffer (except for
pH adjustment) and is intended only for use as a single-dose injection. When
smaller doses are required the unused portion should be discarded with the
entire unit. 25% Dextrose Injection, USP is a dextrose
(glucose) and nutrient (carbohydrate) replenisher. Dextrose,
USP is chemically designated D-glucose monohydrate, (CHO���HO), a hexose sugar freely soluble in water. It
has the following structural formula: The
syringe is molded from a specially formulated polypropylene. Water permeates
from inside the container at an extremely slow rate which will have an insignificant
effect on solution concentration over the expected shelf life. Solutions in
contact with the plastic container may leach out certain chemical components
from the plastic in very small amounts; however,biological testing was supportive
of the safety of the syringe material.
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| dailymed-instance:clinicalP... |
When administered intravenously, this solution restores blood
glucose levels in hypoglycemia and provides a source of carbohydrate calories.
Carbohydrate in the form of dextrose may aid in minimizing liver glycogen
depletion and exerts a protein-sparing action. Dextrose injection undergoes
oxidation to carbon dioxide and water. 25% Dextrose
Injection, USP provides a concentrated solution sufficiently nonirritating
for slow intravenous injection to infants for terminating acute symptomatic
episodes of hypoglycemia in the neonate and in older infants (fasting blood
glucose below 40 mg/100 mL). Values as low as 20 mg/100 mL are not uncommon
in normal asymptomatic infants the first few days of life (longer in premature
infants). Symptoms of hypoglycemia in the newborn and
small infants may be difficult to evaluate and convulsions often are the first
or only recognized manifestation of depressed blood glucose levels. Because
of widely varied etiology, the precise cause may be difficult to establish.
Hypoglycemia (deficient blood glucose) due to organic or functional hyperinsulinism,
may be only temporarily abated by administration of dextrose (glucose) and
may rebound to hypoglycemia levels as release of additional insulin is evoked.
In addition to various other causes, an idiopathic form of hypoglycemia in
infancy has been described, as well as occasional transitory hypoglycemia
in the neonatal period which disappears in later infancy. Fetal hyperinsulinism
in response to maternal hyperglycemia of diabetic mothers has been observed.
Occasionally convulsions associated with severe hypoglycemia are observed
in infants of diabetic mothers. Since glucose is the
only sugar utilized for metabolic requirements of human neural tissue, it
is essential to restore deficient blood glucose levels from any cause in order
to prevent or correct central nervous system dysfunction.
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A concentrated dextrose solution should not be used when
intracranial or intraspinal hemorrhage is present.
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| dailymed-instance:supply |
25% Dextrose Injection, USP is supplied in single-dose containers
as follows: Store at controlled room temperature 15��to 30��C
(59��to 86��F). [See USP.] July, 2004 HOSPIRA, INC. LAKE FOREST, IL 60045
USA
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| dailymed-instance:precautio... |
Frequent monitoring of serum glucose concentrations is required
when intravenous dextrose is given to pediatric patients, particularly neonates
and low birth weight infants. Do not administer unless the solution is clear
and seal is intact. Discard unused portion. Solutions
containing dextrose should be used with caution in infants of diabetic mothers
except as may be indicated in neonates who are hypoglycemic. Care
should be exercised to insure that the needle is well within the lumen of
the vein and that extravasation does not occur. If thrombosis should occur
during administration, the injection should be stopped and corrective measures
instituted. Concentrated dextrose solutions should not
be administered subcutaneously or intramuscularly.<br/>Carcinogenesis, Mutagenesis, Impairment of Fertility:: Studies with 25% dextrose solutions in polypropylene syringes
have not been performed to evaluate carcinogenic potential, mutagenic potential
or effects on fertility.<br/>Pregnancy Category C.: Animal reproduction studies have not been conducted with
dextrose. It is also not known whether dextrose can cause fetal harm when
administered to a pregnant woman or can affect reproduction capacity. Dextrose
should be given to a pregnant woman only if clearly needed.
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| dailymed-instance:overdosag... |
In the event of overdosage (hyperglycemia) during therapy,
re-evaluate the patient and institute appropriate corrective measures. See
WARNINGS and PRECAUTIONS.
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| dailymed-instance:genericMe... |
Dextrose monohydrate
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| dailymed-instance:fullName |
Dextrose (Injection, Solution)
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| dailymed-instance:adverseRe... |
Hyperosmolar syndrome, resulting from excessively rapid administration
of concentrated dextrose may cause mental confusion and/or loss of consciousness. Reactions
which may occur because of the solution or the technique of administration
include febrile response, infection at the site of injection, venous thrombosis
or phlebitis extending from the site of injection and extravasation. If
an adverse reaction does occur, discontinue the infusion, evaluate the patient,
institute appropriate therapeutic countermeasures, and save the remainder
of the fluid for examination if deemed necessary.
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| dailymed-instance:warning |
25% Dextrose Injection, USP is hypertonic and may cause phlebitis
and thrombosis at the site of injection. Significant
hyperglycemia and possible hyperosmolar syndrome may result from too rapid
administration. The physician should be aware of the symptoms of hyperosmolar
syndrome, such as loss of consciousness.
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| dailymed-instance:indicatio... |
25% Dextrose Injection is indicated in the treatment of acute
symptomatic episodes of hypoglycemia in the neonate or older infant to restore
depressed blood glucose levels and control symptoms. Other drugs, such as
epinephrine and glucagon, should be considered in patients unresponsive or
intolerant to dextrose (glucose). Oral feeding of dextrose may be necessary
in infants with frequently recurring hypoglycemic episodes or to prevent recurrences
due to hyperinsulinemia. 25% Dextrose Injection also
provides a minimal source of carbohydrate calories.
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Dextrose
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