Intravenous sugar solution
Chemical structure of dextrose
|Other names||Dextrose solution, glucose solution|
|Main uses||Low blood sugar|
|Side effects||Vein irritation, tissue damage|
|Defined daily dose||not established|
Intravenous sugar solution, also known as dextrose solution, is a mixture of dextrose (glucose) and water. It is used to treat low blood sugar or water loss without electrolyte loss. Water loss without electrolyte loss may occur in fever, hyperthyroidism, high blood calcium, or diabetes insipidus. It is also used in the treatment of high blood potassium, diabetic ketoacidosis, and as part of parenteral nutrition. It is given by injection into a vein.
Side effects may include irritation of the vein in which it is given, high blood sugar, and swelling. Excess use may result in low blood sodium and other electrolyte problems. Intravenous sugar solutions are in the crystalloid family of medications. They come in a number of strengths including 5%, 10%, and 50% dextrose. While they may start out hypertonic they become hypotonic solutions as the sugar is metabolised. Versions are also available mixed with saline.
Dextrose solutions for medical use became available in the 1920s and 1930s. It is on the World Health Organization's List of Essential Medicines. The wholesale cost in the developing world is about US$1.00–1.80 per liter of 10% dextrose in water, and it is about US$0.60–2.40 per liter of 5% dextrose in normal saline. In the United Kingdom a 50 ml vial of 50% solution costs the NHS 2.01 pounds.
Administering a 5% sugar solution peri- and postoperatively usually achieves a good balance between starvation reactions and hyperglycemia caused by sympathetic activation. A 10% solution may be more appropriate when the stress response from the reaction has decreased, after approximately one day after surgery. After more than approximately 2 days, a more complete regimen of total parenteral nutrition is indicated.
In people with fatty-acid metabolism disorder (FOD), 10% solution may be appropriate upon arrival to the emergency room.
The defined daily dose is not established. In adults the typical dose is 1 ml/kg by intravenous of a 50% glucose solution (also known as a 50% dextrose solution). A second dose may be given in those whose blood sugar is still low after 15 minutes. In children a 10% glucose solution should be used at a dose of 2 ml/kg by injection. Children who are awake may be given a dose of 10 ml/kg of a 10% glucose solution by mouth.
Intravenous glucose is used in some Asian countries as a pick-me-up, for "energy", but is not part of routine medical care in the United States where glucose solution is a prescription drug. Asian immigrants to the United States are at risk of infection if they seek intravenous glucose treatment. It may be had at store-front clinics catering to Asian immigrants, despite having no more effect than drinking sugared water. The procedure is commonly called "ringer".
Concentrated dextrose solutions should not be administered subcutaneously or intramuscularly as they can cause cell death via dehydration and subsequent necrosis.
Types of glucose/dextrose include:
- D5W (5% dextrose in water), which consists of 278 mmol/L dextrose
- D5NS (5% dextrose in normal saline), which, in addition, contains normal saline (0.9% w/v of NaCl).
- D5 1/2NS 5% dextrose in half amount of normal saline (0.45% w/v of NaCl).
- D5LR (5% dextrose in lactated Ringer solution)
- D50 – 50% dextrose in water
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Although many doctors warn Asian immigrants in New York that the effects of injecting glucose differ little from drinking sugary water, many Asians, especially of older generations, still use the intravenous solution. In their homelands, it is commonly prescribed by doctors as a method to cure colds, fevers and sometimes an upset stomach.CS1 maint: discouraged parameter (link)
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