d-glucose


dextrose (d-glucose)

BD Glucose, Glutose, Insta-Glucose

Pharmacologic class: Monosaccharide

Therapeutic class: Carbohydrate caloric nutritional supplement

Pregnancy risk category C

Action

Prevents protein and nitrogen loss; promotes glycogen deposition and ketone accumulation (through osmotic diuretic action)

Availability

Injection: 2.5%, 5%, 10%, 20%, 25%, 30%, 40%, 50%, 60%, 70%

Oral gel: 40%

Tablets (chewable): 5 g

Indications and dosages

Insulin-dependent hypoglycemia

Adults and children: Initially, 10 to 20 g P.O., repeated in 10 to 20 minutes if needed based on blood glucose level; or 20 to 50 ml by I.V. infusion or injection of 50% solution given at 3 ml/minute. Maintenance dosage is 10% to 15% solution by continuous I.V. infusion until blood glucose level reaches therapeutic range.

Infants and neonates: 2 ml/kg of 10% to 25% solution by slow I.V. infusion until blood glucose level reaches therapeutic range

Calorie replacement

Adults and children: 2.5%, 5%, or 10% solution given through peripheral I.V. line, with dosage tailored to patient's need for fluid or calories; or 10% to 70% solution given through large central vein if needed (typically mixed with amino acids or other solution)

Off-label uses

• Varicose veins

• Insulin-secreting islet-cell adenoma

Contraindications

• Hypersensitivity to drug

• Hyperglycemia, diabetic coma

• Hemorrhage

• Heart failure

Precautions

Use cautiously in:

• renal, cardiac, or hepatic impairment; diabetes mellitus.

Administration

• Use aseptic technique when preparing solution. Bacteria thrive in high-glucose environments.

See Infuse concentrations above 10% through central vein.

• Don't infuse concentrated solution rapidly, because doing so may cause hyperglycemia and fluid shifts.

See Never stop infusion abruptly.

Adverse reactions

CNS: confusion, loss of consciousness

CV: hypertension, phlebitis, venous thrombosis, heart failure

GU: glycosuria, osmotic diuresis

Metabolic: hyperglycemia, hypervolemia, hypovolemia, electrolyte imbalances, hyperosmolar coma

Respiratory: pulmonary edema

Skin: flushing, urticaria

Other: chills, fever, dehydration, injection site reaction, infection

Interactions

Drug-drug. Corticosteroids, corticotropin: increased risk of fluid and electrolyte imbalances

Drug-diagnostic tests. Glucose: increased level

Patient monitoring

See Monitor infusion site frequently to prevent irritation, tissue sloughing, necrosis, and phlebitis.

• Check blood glucose level at regular intervals.

• Monitor fluid intake and output.

• Weigh patient regularly.

• Assess patient for confusion.

Patient teaching

• Teach patient how to recognize signs and symptoms of hypoglycemia and hyperglycemia.

• Provide instructions on glucose self-monitoring.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

d-glu·cose (G, Glc),

(glū'kōs), Dextrose; a dextrorotatory monosaccharide (hexose) found in the free state in fruits and other parts of plants, and combined in glucosides, disaccharides (often with fructose in sugars), oligosaccharides, and polysaccharides; it is the product of complete hydrolysis of cellulose, starch, and glycogen. Free glucose also occurs in the blood, where it is a principal energy source for use by body tissues (normal human concentration, 70-110 mg per 100 mL); in diabetes mellitus, it appears in the urine. The epimers of d-glucose are d-allose, d-mannose, d-galactose, and l-idose. Dextrose should not be confused with the l-isomer, which is sinistrose. Synonym(s): cellohexose

glu·cose

(glū'kōs) A dextrorotatory monosaccharide found in a free form in fruits and other parts of plants, and in combination in glucosides, glycogen, disaccharides, and polysaccharides (starch cellulose); the chief source of energy in human metabolism, the final product of carbohydrate digestion, and the principal sugar of the blood; insulin is required for the use of glucose by cells; in diabetes mellitus, the level of glucose in the blood is excessive, and it also appears in the urine.
Synonym(s): d-glucose.