Hypertonic Dextrose

Hypertonic Dextrose Uses, Dosage, Side Effects, Food Interaction and all others data.

Hypertonic 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.

Blood glucose is an obligatory energy source in humans involved in various cellular activities, and it also acts as a signalling molecule for diverse glucose-sensing molecules and proteins. Glucose undergoes oxidation into carbon dioxide, water and yields energy molecules in the process of glycolysis and subsequent citric cycle and oxidative phosphorylation. Glucose is readily converted into fat in the body which can be used as a source of energy as required. Under a similar conversion into storage of energy, glucose is stored in the liver and muscles as glycogen. Glucose stores are mobilized in a regulated manner, depending on the tissues' metabolic demands. Oral glucose tablets or injections serve to increase the supply of glucose and oral glucose administration is more effective in stimulating insulin secretion because it stimulates the incretin hormones from the gut, which promotes insulin secretion.

Trade Name Hypertonic Dextrose
Generic Dextrose
Dextrose Other Names Dextrosa, Dextrose, Dextrose solution, Dextrose, unspecified, Glucosa, Glucose, Glucose, liquid, Grape sugar, Liquid glucose
Type Injection
Groups Approved, Vet approved
Therapeutic Class Intravenous fluid preparations, Parenteral Nutritional preparations
Manufacturer
Available Country United States
Last Updated: September 19, 2023 at 7:00 am
Hypertonic Dextrose
Hypertonic Dextrose

Uses

Hypertonic Dextrose is administered as a parenteral nutrition solution in the treatment of carbohydrate depletion and hypoglycaemic coma. Because of its high dextrose content it is used in the treatment of cerebral edema, shock, circulatory collapse, unconsciousness and to correct hyperkalaemia with or without insulin.

Hypertonic Dextrose is also used to associated treatment for these conditions: Arrhythmia, Caloric Deficit, Edema of the cerebrum, Metabolic Alkalosis, Hypoglycemic reaction, Blood Specimen Collection, Electrolyte replacement, Nutritional supplementation, Parenteral Nutrition, Parenteral rehydration therapy, Plasmapheresis, Positive cardiac inotropic effect, Total parenteral nutrition therapy, Urine alkalinization therapy, Fluid and electrolyte maintenance therapy

How Hypertonic Dextrose works

Glucose supplies most of the energy to all tissues by generating energy molecules ATP and NADH during a series of metabolism reactions called glycolysis. Glycolysis can be divided into 2 main phases where the preparatory phase is initiated by the phosphorylation of glucose by a hexokinase to form glucose 6-phosphate. The addition of the high-energy phosphate group activates glucose for subsequent breakdown in later steps of glycolysis and is the rate-limiting step. Products end up as substrates for following reactions, to ultimately convert C6 glucose molecule into two C3 sugar molecules. These products enter the energy-releasing phase where total of 4ATP and 2NADH molecules are generated per one glucose molecule. The total aerobic metabolism of glucose can produce up to 36 ATP molecules. This energy-producing reactions of glucose is limited to D-glucose as L-glucose cannot be phosphorlyated by hexokinase. Glucose can act as precursors to generate other biomolecules such as vitamin C. It plays a role as a signaling molecule to control glucose and energy homeostasis. Glucose can regulate gene transcription, enzyme activity, hormone secretion, and the activity of glucoregulatory neurons. The types, number and kinetics of glucose transporters expressed depends on the tissues and fine-tunes glucose uptake, metabolism, and signal generation in order to preserve cellular and whole body metabolic integrity .

Dosage

Hypertonic Dextrose dosage

The volume and rate of infusion of dextrose solution will depend upon the requirements of the individual patient and the judgement of the physician.

The maximum rate at which dextrose can be infused without producing glycosuria is 0.5 gm/kg/hr.

The usual recommended flow rate for adult is 10-35 drops per minute infused intravenously.

Intravenous-

Hyperkalaemia:

  • Adult: 25-50 g combined with 10 units of regular insulin, administered over 30-60 minutes; may repeat if necessary. Alternatively, 25 g combined with 5-10 units of regular insulin infused over 5 minutes; may repeat if necessary.
  • Child and infants: 0.5-1 g/kg (using 25% or 50% solution) combined with regular insulin (1 unit for every 4-5 g dextrose given); infuse over 2 hr, may repeat if necessary.

Intravenous-

Hypoglycaemia:

  • Adult: 10-25 g (40-100 ml of 25% solution or 20-50 ml of 50% solution). Doses may be repeated in severe cases.
  • Child: ≤6 mth: 0.25-0.5 g/kg/dose; >6 mth: 0.5-1 g/kg/dose. Doses may be repeated in severe cases. Max: 25 g/dose.

Oral-

Hypoglycaemia:

  • Adult: 10-20 g as single dose; may repeat in 10 min if needed.
  • Child: >2 yr: 10-20 g as single dose; may repeat in 10 min if needed.

It should not be administered by SC or IM route. Hypertonic Dextrose should be infused through the largest available peripheral vein.

Side Effects

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.

Toxicity

Oral LD50 value in rats is 25800mg/kg. The administration of glucose infusions can cause fluid and/or solute overloading resulting in dilution of the serum electrolyte concentrations, over-hydration, congested states, or pulmonary oedema. Hypersensitivity reactions may also occur including anaphylactic/anaphylactoid reactions from oral tablets and intravenous infusions.

Precaution

Concentrated dextrose solution should not be infused rapidly or for a long period. It may be hazardous in patients with impaired hepatic or renal function and severe sepsis.

Care should be taken to avoid circulatory overload, particularly in patients with cardiac insufficiency. Caution must be exercised in the administration of these injections to patients receiving corticosteroids or corticotropin. These injections should be used with caution in patients with overt or subclinical diabetes mellitus.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Do not administer unless solution is clear and seal is intact.

Interaction

There is no drug drug interaction and none well documented.

Food Interaction

No interactions found.

Volume of Distribution

The mean volume of distribution after intravenous infusion is 10.6L.

Elimination Route

Polysaccharides can be broken down into smaller units by pancreatic and intestinal glycosidases or intestinal flora. Sodium-dependent glucose transporter SGLT1 and GLUT2 (SLC2A2) play predominant roles in intestinal transport of glucose into the circulation. SGLT1 is located in the apical membrane of the intestinal wall while GLUT2 is located in the basolateral membrane, but it was proposed that GLUT2 can be recruited into the apical membrane after a high luminal glucose bolus allowing bulk absorption of glucose by facilitated diffusion . Oral preparation of glucose reaches the peak concentration within 40 minutes and the intravenous infusions display 100% bioavailability.

Half Life

The approximate half-life is 14.3 minutes following intravenous infusion. Gut glucose half-life was markedly higher in females (79 ± 2 min) than in males (65 ± 3 min, P < 0.0001) and negatively related to body height (r = -0.481; P < 0.0001).

Clearance

The mean metabolic clearance rate of glucose (MCR) for the 10 subjects studied at the higher insulin level was 2.27 ± 0.37 ml/kg/min at euglycemia and fell to 1.51±0.21 ml/kg/ at hyperglycemia. The mean MCR for the six subjects studied at the lower insulin level was 1.91 ± 0.31 ml/kg/min at euglyglycemia.

Elimination Route

Glucose can be renally excreted.

Pregnancy & Breastfeeding use

Pregnancy Category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Contraindication

Concentrated dextrose solution is contraindicated in patients with Glucose-Galactose Malabsorption Syndrome and severe hydration. The infusion of hypertonic dextrose injections is contraindicated in patients having intracranial or intraspinal hemorrhage, in patients who are severely dehydrated, in patients who are anuric, and in patients in hepatic coma. Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products.

Acute Overdose

Reevaluate patient's condition and institute appropriate symptomatic treatment.

Storage Condition

Store at 25°C.

Innovators Monograph

You find simplified version here Hypertonic Dextrose

Hypertonic Dextrose contains Dextrose see full prescribing information from innovator Hypertonic Dextrose Monograph, Hypertonic Dextrose MSDS, Hypertonic Dextrose FDA label

FAQ

What is Hypertonic Dextrose used for?

Hypertonic Dextrose injection is a sterile solution used to provide your body with extra water and carbohydrates. It is used when a patient is not able to drink enough liquids or when additional fluids are needed.Hypertonic Dextrose is often used in baking products as a sweetener, and is commonly found in items such as processed foods and corn syrup.

How safe is Hypertonic Dextrose?

Hypertonic Dextrose is usually safe to consume but does have some potential risks and side effects. Hypertonic Dextrose is a simple sugar found in many everyday food items such as bread and honey. But even though it's commonly used and safe, eating too much of it can lead to serious health concerns.

How does Hypertonic Dextrose work?

Hypertonic Dextrose works by quickly increasing the amount of glucose in your blood.

What are the common side effects of Hypertonic Dextrose?

Common side effects of Hypertonic Dextrose are include :

  • Possibility of intracellular lactic acid production in the setting of ischemic brain cells and high blood sugar (hyperglycemia)
  • Low blood potassium (hypokalemia)
  • Fluid retention (edema)
  • High or low blood volume (hyper/hypovolemia)
  • Dehydration
  • Fever
  • Mental confusion
  • Unconsciousness
  • Ketones in urine (ketonuria)
  • Glucose in urine (glycosuria)
  • Excessive urination
  • Phlebitis
  • Venous thrombosis
  • Metabolic acidosis
  • Diarrhea
  • Excessive thirst
  • Vein irritation
  • Pulmonary edema/rapid breathing
  • Extravasation can result in tissue damage

Is Hypertonic Dextrose safe during pregnancy?

Hypertonic Dextrose can cause high blood sugar levels. High blood sugar levels during pregnancy can cause complications and even birth defects.

Is Hypertonic Dextrose safe during breastfeeding?

Hypertonic Dextrose administered into a baby's cheek along with regular feedings can raise hypoglycemic babies' blood sugar, allowing them to stay with their mothers, which promotes breastfeeding. Breastfeeding mothers should avoid or cut back on juice, soda and other sugar-sweetened beverages.

Can I drink alcohol with Hypertonic Dextrose?

Hypertonic Dextrose can be infused at a maximum rate of approximately 0.5 to 0.85 g/kg of body weight/hr without producing significant glycosuria. Thus, the maximum rate that alcohol can be infused without producing sedative effects is well below the maximum rate of utilization of Hypertonic Dextrose.

When should be taken of Hypertonic Dextrose?

If a person's blood sugar is less than 70 milligrams per decilitre (mg/dL) and they are having low blood sugar symptoms, they may need to take the Hypertonic Dextrose tablets.

How should be taken of Hypertonic Dextrose ?

Hypertonic Dextrose is given either by mouth (orally) or by injection.

How long does Hypertonic Dextrose take to work?

Your symptoms should improve within 20 minutes.

How fast does Hypertonic Dextrose raise blood sugar?

Using a mixed-effect regression model, statistically significant increases in serum glucose levels were found at 5 minutes (p < 0.001) and 15 minutes (p < 00001) following administration of D50W.

How long does Hypertonic Dextrose stay in my system?

The Hypertonic Dextrose is taken up rapidly into the cells. Its rate of uptake varies. Usually, plasma half-life of a Hypertonic Dextrose bolus is no greater than 15 minutes, in the absence of diabetes.

Can I take Hypertonic Dextrose for a long time?

It is safe to use long term on an as-needed basis. Hypertonic Dextrose does not come without risks, however, and even those without diabetes should carefully monitor their blood sugar when taking it

Who should not take Hypertonic Dextrose?

If you have an allergy to corn, you could have an allergic reaction to Hypertonic Dextrose. Talk to your doctor before using it. Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What happens if I miss a dose?

Since Hypertonic Dextrose is used when needed, it does not have a daily dosing schedule. Call your doctor promptly if your symptoms do not improve after using dextrose.

What happens if I give too much Hypertonic Dextrose?

Excess consumption of Hypertonic Dextrose can also worsen depression, as well as acne and other skin conditions. It can also cause symptoms such as frequent urination, thirst, nausea and vomiting, shortness of breath, and stomach pain when eaten in excess.

Can Hypertonic Dextrose cause diabetes?

Hypertonic Dextrose should be carefully given to people who have diabetes, because they might not be able to process Hypertonic Dextrose as quickly as would someone without the condition. Hypertonic Dextrose can increase blood sugar too much.

What happens if you stop taking Hypertonic Dextrose ?

Do not stop taking Hypertonic Dextrose without talking to your doctor. If you stop taking Hypertonic Dextrose suddenly, your diabetes may get worse.

Does Hypertonic Dextrose affect heart rate?

Heart rate, but not heart rate variability, was associated with Hypertonic Dextrose status and capillary glucose. After deep breathing, heart rate recovery was altered in patients with known diabetes and was associated with reduced heart rate variability.

Can Hypertonic Dextrose affect my kidneys?

Hypertonic Dextrose can be considered in renal impairment if appropriate attention is paid to the dose.

Can Hypertonic Dextrose affects my liver?

The cause of possible liver injury during Hypertonic Dextrose therapy is not known.

*** Taking medicines without doctor's advice can cause long-term problems.
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