Dextrose

The dextrose solution 5% during pregnancy is usually used as a hydrating and vehicle when using other drugs (in particular oxytocin).

Since patients with diabetes mellitus, renal failure or in an acute critical condition, glucose tolerance (dextrose) can be impaired, their clinical and biological parameters, in particular, electrolyte concentration in plasma, including magnesium or phosphorus, should be carefully monitored. blood glucose. In the presence of hyperglycemia, you should adjust the rate of administration of the drug or appoint short-acting insulin. Usually, glucose is completely absorbed by the body (normally not excreted by the kidneys), therefore the appearance of glucose in the urine may be a pathological sign.

In the case of prolonged administration or use of dextrose in high doses, it is necessary to control the concentration of potassium in the blood plasma and, if necessary, to introduce potassium in addition to avoid hypokalemia.

For episodes of intracranial hypertension, careful monitoring of the glucose concentration in the blood is necessary.

The use of dextrose solutions can lead to hyperglycemia. Therefore, they are not recommended to be administered after acute ischemic stroke, since hyperglycemia is associated with increased ischemic brain damage and interferes with recovery.

Particularly careful clinical monitoring is required at the start of intravenous administration of the drug.

For rehydration therapy, carbohydrate solutions should be used in combination with electrolyte solutions in order to avoid electrolyte imbalance (hyponatremia, hypokalemia).

It is necessary to control the concentration of glucose and the content of electrolytes in the blood, the water balance, as well as the acid-base state of the body.

Before use, the solution should be inspected. Use only a clear solution without visible inclusions and in the absence of damage to the package. Enter directly after connecting to the infusion system.

The solution should be injected with the use of sterile equipment in compliance with the rules of asepsis and antisepsis.

To avoid air embolism, remove air from the infusion system with a solution.

Do not connect containers one by one in order to avoid air embolism, which may occur due to the air being drawn from the first container until the solution from the second container is completed.

Supplying intravenous solutions contained in soft plastic containers under increased pressure to increase the flow rate may result in an air embolism, if before introduction the residual air in the container is not completely removed.

Using a system for intravenous administration with a gas outlet can lead to an air embolus with an open gas outlet. Soft plastic containers with such systems should not be used.

Additives can be administered before the infusion or during the infusion through the injection site (if there is a special port for drug administration).

Adding other drugs to the solution or impaired administration may cause fever due to possible pyrogens.

With the development of unwanted reactions, infusion should be stopped immediately.

When adding other drugs before parenteral administration, it is necessary to check the isotonicity of the resulting solution.

Thorough and thorough mixing under aseptic conditions is mandatory.

Solutions containing additional substances should be applied immediately, their storage is prohibited.

With the introduction of additional nutrients should be determined by the osmolarity of the mixture prior to the start of infusion.

The resulting mixture must be administered through a central or peripheral venous catheter, depending on the final osmolarity.

Compatibility of additionally administered drugs must be cordoned off before they are added to the solution (similar to the use of other parenteral solutions). The assessment of the compatibility of additionally administered drugs with the drug is within the competence of the physician. It is necessary to check the resulting solution for discoloration and / or sediment, insoluble complexes or crystals. You should study the instructions for use of added drugs.

From a microbiological point of view, the diluted drug should be used immediately. Exceptions are dilutions prepared under controlled and aseptic conditions. Otherwise, after the preparation of the solution, the terms and conditions of its storage prior to the introduction are the responsibility of the user.

Children

In newborns, especially in premature or low birth weight babies, there is an increased risk of hypo or hyperglycemia, therefore, in the period of intravenous administration of dextrose solutions, careful monitoring of the glucose concentration in the blood is necessary to avoid long-term undesirable effects. Hypoglycemia in newborns can lead to prolonged seizures, coma and brain damage. Hyperglycemia is associated with intraventricular hemorrhage, delayed bacterial and fungal infectious diseases, retinopathy of prematurity, necrotizing enterocolitis, bronchopulmonary dysplasia, prolonged hospitalization and mortality.

In order to avoid a potentially fatal overdose of intravenous drugs in newborns, special attention must be paid to the method of use. For the treatment of "symptomatic" hypoglycemia, it is preferable to use a 10% glucose solution. At the same time, it is necessary to constantly monitor the level of glucose and blood and, if necessary, correct it. It should be borne in mind that newborns with different pathologies have different needs for exogenous glucose. Abrupt cessation of the infusion can cause hypoglycemia, therefore, the dose of glucose is gradually reduced, titration of the glucose solution is stopped in the case when the child maintains normal glucosemia with the introduction of glucose at a rate of 4 mg / kg / min.

When using a syringe pump for intravenous administration of drugs to newborns, the container with the solution should not be left attached to the syringe.

When using an infusion pump, before removing the system from the pump or disconnecting it, it is necessary to close all system clamps, regardless of whether there is a device in the system that prevents the free flow of fluid.

Intravenous infusions and other equipment for administering drugs should be regularly monitored.

If the drug contains dextrose derived from corn, the use of the drug is contraindicated in patients with known intolerance to corn or corn products, because The following manifestations of hypersensitivity are possible: anaphylactic reactions, chills and fever.

For preparations in containers:

Dispose of containers after a single use.

Dispose of each unused dose.

Do not put together reused partially used containers.

Impact on the ability to drive trans. Wed and fur .:

Not applicable (due to the use of the drug exclusively in the hospital).

Symptoms: long-term infusion of the drug can lead to hyperglycemia, glycosuria, hyperosmolarity, osmotic diuresis and dehydration. Rapid infusion can create an accumulation of fluid in the body with hemodilution and hypervolemia, and with an increase in the body's ability to oxidize glucose, rapid administration can cause hyperglycemia. There may also be a decrease in the content of potassium and inorganic phosphate in the blood plasma.

When using dextrose solution for infusion to dilute and dissolve other drugs for intravenous administration, the clinical signs and symptoms of overdose may be related to the properties of the drugs used.

Treatment: upon the onset of symptoms of overdose, it is necessary to suspend the administration of the solution, evaluate the patient's condition, inject short-acting insulin, and if necessary, carry out supportive symptomatic therapy.