d-glucose

glucose, d-glucose

a simple sugar, a monosaccharide in certain foodstuffs, especially fruit, and in normal blood; the major source of energy for many living organisms. See also dextrose.

Glucose, whose molecular formula is C₆H₁₂O₆, is the end product of carbohydrate digestion; other monosaccharides (fructose and galactose) are largely converted into glucose. Glucose is the only monosaccharide present in significant amounts in the body fluids. The oxidation of glucose produces energy for the body cells; the rate of metabolism is controlled by a number of hormones the most important of which are insulin and glucagon. Glucose that is not needed for energy is stored in the form of glycogen as a source of potential energy, readily available when needed. Most of the glycogen is stored in the liver and muscle cells. When these and other body cells are saturated with glycogen, the excess glucose is converted into fat and stored as adipose tissue. See also hypoglycemia, hyperglycemia.

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[1-¹⁴C]-glucose

radioactive glucose used experimentally.

liquid glucose

a thick syrupy, sweet liquid, consisting chiefly of dextrose, with dextrins, maltose and water, obtained by incomplete hydrolysis of starch; used as a flavoring agent, as a food, and in the treatment of dehydration.

glucose-1-phosphate

an intermediate in carbohydrate metabolism.

glucose-6-phosphatase

a liver (and kidney) enzyme that irreversibly cleaves glucose-6-phosphate to free glucose and phosphate; important in glucose homeostasis.

glucose-6-phosphate

an intermediate in carbohydrate metabolism.

glucose-6-phosphate dehydrogenase (G6PD)

a regulatory enzyme in the metabolism of glucose-6-phosphate. A deficiency of the enzyme in the erythrocyte results in a hemolytic anemia; an inherited abnormality in humans, rats and mice and acquired in animals in phenothiazine toxicity and ingestion of kale.

glucose phosphate isomerase

converts glucose-6-phosphate to fructose-6-phosphate and the reverse reaction.

glucose suppression test

suppression of blood levels of growth hormone by the intravenous administration of glucose is used to diagnose acromegaly.

glucose tolerance factor (GTF)

a naturally occurring substance containing chromium which potentiates the effects of insulin.

glucose tolerance test

a test of the body's ability to utilize carbohydrates. It is often used to detect abnormalities of carbohydrate metabolism such as occur in diabetes mellitus, hypoglycemia, and liver and adrenocortical dysfunction. If administered orally, it may also be used to assess the absorptive capacity of the small intestine.

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dextrose (d-glucose) Warning - High-alert drug!

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.
☞ Infuse concentrations above 10% through central vein.
• Don't infuse concentrated solution rapidly, because doing so may cause hyperglycemia and fluid shifts.
☞ Never stop infusion abruptly.

Route	Onset	Peak	Duration
P.O.	10-20 min	40 min	Unknown
I.V.	2-3 min	Unknown	Unknown

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

☞ 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.