Dextrose 20%
Indications
Dextrose 20% is used for:
Parenteral Nutrition and Hydration, Hypoglycemia, Hyperkalaemia
Adult Dose
As directed by a physician. Dosage should be adjusted to meet the requirements of each individual patient.Dosage is dependent upon the age, weight and clinical condition of the patient as well as laboratory determinations
Child Dose
As directed by a physician. Dosage should be adjusted to meet the requirements of each individual patient.Dosage is dependent upon the age, weight and clinical condition of the patient as well as laboratory determinations
Renal Dose
Administration
Contra Indications
Known allergy to corn or corn products. Diabetic coma with hyperglycaemia. Use of hypertonic solutions in patients with intracranial or intraspinal haemorrhage. Patients with delirium tremens and dehydration. Anuria, hepatic coma, or glucose-galactose malabsorption syndrome.
Precautions
Overt or known subclinical DM. Patients with carbohydrate intolerance. IV admin of dextrose may result in hypokalaemia, hypophosphataemia and hypomagnesemia. Prolonged infusion of isotonic dextrose solutions may cause water intoxication. Production of insulin may be adversely affected by prolonged parenteral nutrition with dextrose solutions. Rapid admin of hypertonic dextrose solutions may result in hyperglycaemia and hyperosmolar syndrome. Monitor for signs of mental confusion or loss of consciousness. Monitor blood and urinary glucose regularly. Caution when used in very low birth weight infants. Abrupt withdrawal may lead to rebound hypoglycaemia. Risk of thrombosis when hypertonic (>10%) solutions are administered through peripheral veins. Caution when used parenterally in pregnant women.
Pregnancy-Lactation
Pregnancy Category: C
Maternal and fetal hyperglycemia may occur during labor and delivery; monitor
Lactation: Excretion in milk unknown; use with caution
Interactions
Adverse Effects
Side effects of Dextrose 20% :
Venous thrombosis, phlebitis, hypovolemia, hypervolemia, dehydration, oedema, fever, mental confusion, unconsciousness, hyperosmolar syndrome, hyperglycaemia, hypokalaemia, acidosis, hypophosphataemia, hypomagnesemia, polyuria, glycosuria, ketonuria, nausea, diarrhoea, polydipsia, vein irritation, tissue necrosis, pulmonary oedema, tachypnoea.
Mechanism of Action
Dextrose is a monosaccharide that is used as a source of calories and water for hydration. It helps to reduce loss of body protein and nitrogen. It also promotes glycogen deposition in the liver. When used with insulin, it stimulates the uptake of potassium by cells, especially in muscle tissue, thus lowering serum potassium levels.