Dextrose (5gm) is a sterile, hypertonic solution of dextrose monohydrate, equivalent to 5 grams of anhydrous dextrose. It is a rapidly absorbable carbohydrate source used primarily for intravenous administration to correct hypoglycemia and provide calories in patients unable to maintain adequate oral intake. In the Indian context, it is a critical, low-cost emergency medication widely available across all levels of healthcare, from primary health centers to tertiary care hospitals.
Adult: Hypoglycemia: 10-25 gm (20-50 ml of 50% solution or 40-100 ml of 25% solution) IV push over 1-3 minutes. Follow with continuous IV infusion of D5% or D10% if needed. Caloric support: As part of total parenteral nutrition (TPN) or IV fluids, dosage is individualized based on caloric needs.
Note: For IV push: Use 25% or 50% solution. Administer into a large vein or through a running IV line to minimize venous irritation and thrombophlebitis. Check blood glucose before and after administration. For infusion: Use appropriate concentration (D5%, D10%, D25%, D50%). Must be administered using sterile, pyrogen-free equipment. Do not mix with blood in the same infusion set (can cause hemolysis).
Dextrose provides a direct source of glucose, the primary metabolic substrate for cellular energy production (ATP generation via glycolysis and oxidative phosphorylation). It increases blood glucose concentration, correcting hypoglycemia. When administered intravenously in hypertonic concentrations (>5%), it creates an osmotic gradient, drawing fluid from the intracellular and interstitial compartments into the intravascular space, providing transient volume expansion and an osmotic diuretic effect.
Pregnancy: Category C (US FDA). Dextrose crosses the placenta. Use is considered safe when clinically indicated, such as for treating maternal hypoglycemia. Fetal hyperinsulinemia and macrosomia are risks with sustained maternal hyperglycemia. Monitor blood glucose.
Driving: Hypoglycemia impairs cognitive and motor functions. Patients treated for hypoglycemia should be advised not to drive until their blood glucose is stable and they feel fully alert.
| Insulin | Synergistic effect on lowering potassium; dextrose may be needed to prevent hypoglycemia when giving insulin for hyperkalemia. | Major |
| Corticosteroids (e.g., Dexamethasone, Prednisolone) | May antagonize the hyperglycemic effect of dextrose or cause significant hyperglycemia. | Moderate |
| Diuretics (e.g., Furosemide, Thiazides) | Increased risk of hyperglycemia. Concurrent use with dextrose infusion requires close monitoring. | Moderate |
| Beta-blockers (e.g., Propranolol) | May mask tachycardia, a sign of hypoglycemia, and impair glycogenolysis. | Moderate |
| Phenytoin | Dextrose-containing IV fluids can cause precipitation of phenytoin. Use NS for phenytoin infusion. | Major |
Same composition (Dextrose (5gm)), different brands: