Description
Glucose Pharmacodynamics
Participates in various metabolic processes in the body.
Infusion of dextrose solutions partially compensates water deficit. Dextrose entering tissues is phosphorylated into glucose-6-phosphate, which is actively involved in many parts of the body’s metabolism.
5% dextrose solution is isotonic to blood plasma. Hypertonic (10%) solution increases blood osmotic pressure, increases diuresis.
Indications
Hypoglycemia, carbohydrate malnutrition, toxicoinfections, intoxications in liver diseases (hepatitis, liver dystrophy and atrophy, including liver failure), hemorrhagic diathesis, dehydration (vomiting, diarrhea, postoperative period), intoxication, collapse, shock.
Contraindications .
Hypersensitivity, hyperglycemia, hyperlactacidemia, hyperhydration, postoperative dextrose utilization disorders; circulatory disorders that threaten cerebral edema, pulmonary edema, acute left ventricular failure, hyperosmolar coma.
With caution:
Decompensated chronic heart failure, chronic renal failure (oligo-, anuria), hyponatremia, diabetes mellitus.
Pregnancy and lactation:
5% glucose solution may be used as indicated in pregnancy and during lactation.
There is no sufficient clinical data concerning use of 10% glucose solution during pregnancy and lactation, therefore it is possible to use during pregnancy and lactation only in cases when the expected benefits from the drug therapy exceed the possible risk of complications.
Dosage and administration method
- Intravenous drip.
- The 5% solution is administered at a maximum rate of 7 ml (150 calpm)/min (400 ml/h); maximum daily dose for adults is 2 l.
- Intravenously by jetting – 10-50 ml of 5% and 10% solutions.
In adults, the daily dose of administered dextrose should not exceed 4 to 6 g/kg, i.e. about 250-450 g. - In metabolic disorders occurring after operations, injuries or hypoxia, the process of glucose oxidation is disturbed. In such cases, the daily dose is reduced to 200-300 g, while the daily volume of fluid administered should be 30-40 ml/kg.
- Children given parenteral nutrition together with fats and amino acids on the first day should be given glucose at a dose of 6 g glucose/kg/day, and up to 15 g/kg/day thereafter.
- To calculate the glucose dose during the administration of 5% and 10% solutions, the following should be taken into consideration: for children with body weight of 2-10 kg – 100-165 ml/kg/day; for children with body weight of 10-40 kg – 45-100 ml/kg/day.
- Administration rate: in case of intact metabolism the maximum administration rate of dextrose in adults is 0.25-0.5 g/kg/h, in metabolism disorders (decrease of metabolism intensity, e.g. after operations or injuries, in hypoxia) the administration rate is decreased to 0.125-0.25 g/kg/h. In children, dextrose infusion rate should not exceed 0.5 g/kg/h, which is about 10 ml/min for 5% solution, or 200 drops/min (20 drops = 1 ml).
- For more complete absorption of dextrose administered in large doses, short-acting insulin at the rate of 1 IU of insulin per 4-5 g of dextrose is administered simultaneously with it.
- Patients with diabetes are administered dextrose under control of its content in blood and urine.
