Acme's Dextrose

• Approved Indications:
• Treatment of hypoglycemia (low blood sugar).
• Source of calories and fluid in intravenous fluid replacement therapy.
• Management of dehydration when oral intake is not possible.
• Prevention and treatment of ketosis.
• Used as a diluent for intravenous drugs.
• Treatment of insulin-induced hypoglycemia.
• Off-label / Clinically Accepted Uses:
• Maintenance of blood glucose levels during surgery or critical illness.
• Nutritional support in parenteral nutrition formulations.
• Fluid and electrolyte replacement in certain metabolic conditions.

• Route: Oral, intravenous (IV), or enteral.
• IV Administration:
• Concentrations range from 5% (D5W) to 70% solutions depending on indication.
• For hypoglycemia: IV bolus of 10–25 g of dextrose (20–50 mL of D50W) administered slowly.
• For fluid maintenance and calorie supply: Continuous infusion rate adjusted per patient’s glucose and fluid needs.
• Oral Administration:
• As glucose tablets or solutions for rapid correction of mild to moderate hypoglycemia.
• Pediatrics:
• Dose varies by age, weight, and clinical condition; hypoglycemia treated with 0.5–1 g/kg IV dextrose bolus.
• Elderly:
• Adjust doses carefully; monitor for fluid overload and glycemic control.
• Special Populations:
• Use caution in patients with diabetes mellitus or fluid restrictions.

Dextrose is a simple sugar (glucose) that serves as a primary energy substrate for cellular metabolism. Upon administration, it rapidly increases plasma glucose concentration, providing immediate energy to cells, especially vital to brain, muscle, and other tissues. In hypoglycemia, dextrose restores normal blood glucose levels, preventing neuroglycopenic symptoms and metabolic complications.

• Absorption:
• Rapidly absorbed from the gastrointestinal tract when administered orally.
• Intravenous administration provides immediate availability in the bloodstream.
• Distribution:
• Distributed widely throughout body water compartments.
• Metabolism:
• Metabolized primarily in cells via glycolysis and the Krebs cycle to produce ATP.
• Half-life:
• Very short plasma half-life as glucose is quickly utilized or stored.
• Elimination:
• Excess glucose is stored as glycogen or converted to fat; no renal excretion of unchanged dextrose under normal conditions.

• Pregnancy: Considered safe; dextrose is a natural nutrient required for fetal development.
• Lactation: Safe for use; glucose is naturally present in breast milk.

• Carbohydrate supplement.
• Caloric agent.
• Intravenous fluid component.

• Known hypersensitivity to dextrose or formulation excipients.
• Hyperglycemia or uncontrolled diabetes mellitus (without appropriate monitoring).
• Intracranial or intraspinal hemorrhage (relative contraindication for hyperosmolar solutions).
• Severe dehydration without volume resuscitation.

• Monitor blood glucose to avoid hyperglycemia.
• Use caution in patients with impaired glucose tolerance or diabetes.
• Risk of fluid overload in patients with cardiac or renal insufficiency.
• Hyperosmolar dextrose solutions can cause phlebitis or tissue necrosis if extravasation occurs.
• Use central venous access for concentrations >10% to reduce vein irritation.

• Common:
• Hyperglycemia.
• Local irritation or phlebitis at IV site.
• Fluid overload.
• Serious/Rare:
• Tissue necrosis from extravasation.
• Electrolyte imbalance (e.g., hypokalemia).
• Hyperosmolar hyperglycemic state.

• May reduce the effectiveness of antidiabetic agents.
• Concurrent corticosteroids or sympathomimetics may increase blood glucose levels.
• Thiazide diuretics may enhance hyperglycemic effect.
• Insulin requirements may increase with dextrose administration.

• Guidelines emphasize monitoring blood glucose during IV dextrose therapy to prevent iatrogenic hyperglycemia.
• Recommendations to use appropriate catheter size and site for hyperosmolar solutions to minimize complications.
• Updated protocols suggest individualized glucose infusion rates in critically ill patients.

• Store at controlled room temperature: 20°C to 25°C (68°F to 77°F).
• Protect from freezing.
• Keep container tightly closed.
• Protect from light where applicable.
• Use within recommended time after opening.