d-glucose
dextrose (d-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),glu·cose
(glū'kōs)Synonym(s): d-glucose.