Hypoglycemia. Carbohydrate deficiency and energy shortages. Parenteral nutrition. Hyperosmotic and isoosmotic dehydration. Symptomatic treatment of disease states with increased intracranial pressure.
Composition:
1 ampoule (10 ml) contains 2 g or 4 g of glucose.
Action:
Hypertonic blood Glucose solution for parenteral administration. Glucose is a natural source of energy for the body, used mainly by nerve cells, myocardium, striated muscles and liver. Administered intravenously in the form of drip infusions in low concentrations (5%), it temporarily increases the volume of circulating blood. 100 ml of the 20% preparation provides 80 kcal (334.5 kJ), the osmolarity is 1114 mosmol / l. 100 ml of the 40% preparation provides 160 kcal (669 kJ), the osmolarity is 2228 mosmol / l. 40% solutions, due to their osmotic effects, reduce intracranial pressure and also have alkalizing and diuretic effects. Glucose is rapidly metabolised to pyruvic or lactic acid, and then to carbon dioxide and water, with the release of energy. T0,5 is 41 h. Excess glucose is stored in the liver in the form of glycogen or fat.
Contraindications:
Diabetes. Hyperglycemic coma. Anuria. Bleeding to o.u.n. Glucose and galactose intolerance. Hypotonic dehydration. Conduction state.Delirium tremens in dehydrated patients. Conditions after acute cerebral ischemia. Hypokalemia. Allergic to cereals and cereal products.
Precautions:
Glucose solutions with concentrations above 15% should be administered to the central vessels, except for life-threatening conditions (severe hypoglycaemia). In the case of hypoglycaemia and the need to administer a high concentration solution to the peripheral vein, slow administration is recommended. After a sudden interruption of the hypertonic glucose solution, secondary hypoglycaemia may occur. In addition, caution should also be exercised during infusions of concentrated glucose solutions in patients with sepsis (sepsis), severe injuries, severe malnutrition, and vitamin B deficiency.1, hypophosphatemia and hemodilution (dilution of blood).
Pregnancy and lactation:
In pregnant women, use with caution, due to the possibility of hyperglycaemia, hyperinsulinaemia and metabolic acidosis in the fetus, and hypoglycaemia and jaundice and newborn. Administration of glucose in the infusion (with oxytocin) during labor at 20-25 g / h did not cause metabolic disturbances in the fetus. Concentrated glucose solutions should be given to pregnant women and during breastfeeding only when there is a clear need.
Side effects:
Isolated cases: hot flush sensation (especially when administered too quickly); anaphylactoid reactions (in patients with asthma and diabetes). Frequency unknown: water-electrolyte disturbances (including hypokalemia, hypomagnesaemia, hypophosphatemia, hyponatremia), metabolic disorders (hyperglycemia, hyperglycemic coma, hypermolar, glucosuria and hypoglycaemia - as a result of hyperinsulinemia, following a sudden cessation of glucose solution); site-site pain, vein irritation. Hypertonic glucose solutions can cause osmotic diuresis and dehydration of the body. Glucose solutions above 15% damage the venous endothelium, causing local thrombophlebitis in the peripheral veins. Too fast glucose administration may result in heart failure, pulmonary edema and peripheral edema.
Dosage:
Intravenously, injections or drip infusions. Doses are determined individually, depending on the state of health, age and mc. the patient. Adults. Patients debilitated and malnourished: up to 300 g of glucose in the form of a slow infusion; when administering concentrated glucose solutions, there is a need to administer insulin at a dose of 1 IU. insulin / approx. 4 g glucose. Parenteral nutrition: usually 1.5-3 g glucose / kg / day; the recommended dose is 3 g glucose / kg / day, in a slow infusion into the central vein. Hypoglycaemia: 0.2 g glucose / kg until glucose levels are normal. Children in hypoglycaemia: 0.5 g glucose / kgDuring resuscitation procedures: 0.5-1 g glucose / kg.
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