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Introduction

Glucose 10% Infusion is a solution of sugar (glucose/dextrose) in water. Glucose is one of the body’s sources of energy. This solution for infusion provides 400 kilocalories per liter.

Uses within SJA

Glucose 10% infusion is used to prevent or treat a low level of sugar in the blood (hypoglycemia)

Pharmacokinetics

Onset

Virtually immediate (<=1 minute) raise in blood glucose levels. IV Glucose delivers usable energy directly to the blood. In the case of a hypoglycaemic episode, we should expect to see an effect within 10 minutes.

Absorption

Absorption is extremely rapid

Distribution

Glucose is very rapidly taken up by cells, the net effect is of administering pure water, so it is distributed throughout the total body water.

Metabolism

Dextrose (the monosaccharide glucose) is used, distributed and stored by body tissues and is metabolized to carbon dioxide and water with the release of energy

Excretion

The metabolites of glucose/dextrose are carbon dioxide and water.

Excretion of water occurs via the kidneys; carbon dioxide is transported back to the lungs and excreted via exhalation

Pharmacodynamics

Desired Effects

  • Raise in GCS
  • Increase Blood sugar levels

Side Effects

The main side effect would occur only as a result of accidental extravasation (administer IV Glucose to an area outside the vein/tissued IV cannulation) which can cause tissue necrosis. Extravasation is the inadvertent leakage of a vesicant or non-vesicant solution (blistering or non-blistering solution) from its intended vascular pathway (vein) into the surrounding tissue. Due to the osmolality of IV Glucose 10%, a degree of tissue damage can occur. Most extravasations have relatively minor sequelae, but once an extravasation has occurred, damage can continue for months and involve nerves, tendons, and joints. If treatment is delayed, surgical debridement, skin grafting, and even amputation have been reported in literature. Thus it is imperative to ensure the patency of an IV line before administration of any medication. Also, it is recommended to use a large vein where possible.

Some other potential side effects include:

  • Hyperglycemia
  • Hyper-osmolality Venous thrombosis Tachypnea
  • Fever
  • Hyper molar syndrome Phlebitis
  • Polydipsia
  • Cerebral hemorrhage
  • Cerebral ischemia
  • Hypophosphatemia
  • Hypomagnesemia

Other Drug Interactions

Very minor interaction with magnesium based medication. Dextrose can reduce levels of magnesium in the body by increasing renal clearance


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