dextrose

dextrose /dex·trose/ (dek´stros) a monosaccharide, d-glucose monohydrate; used chiefly as a fluid and nutrient replenisher, and also as a diuretic and for various other clinical purposes. Known as d-glucose in biochemistry and physiology.

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dex·trose (dkstrs)

n.

The dextrorotatory form of glucose found naturally in animal and plant tissue and derived synthetically from starch.

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dextrose (dek´strōs),

n dextrorotatory glucose, a monosaccharide occurring as a white, crystalline powder; colorless and sweet.

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dextrose

an old chemical name for d-glucose, an important energy source for all tissues and the sole energy source for the brain in some species such as the sheep. The term dextrose continues to be used to refer to glucose solutions administered intravenously for fluid or nutrient replacement. See also glucose.

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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.