DEXTROSE 7.7% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for DEXTROSE 7.7% IN PLASTIC CONTAINER (DEXTROSE 7.7% IN PLASTIC CONTAINER).
Dextrose is a simple sugar that provides a source of calories and fluid for intravenous administration. It increases blood glucose levels, enhancing cellular metabolism and energy production via the glycolytic pathway and subsequent oxidative phosphorylation.
| Metabolism | Dextrose undergoes glycolysis and enters the Krebs cycle to produce ATP. It is metabolized via the Embden-Meyerhof pathway and the pentose phosphate pathway. Insulin facilitates cellular uptake. |
| Excretion | Renal: 100% as CO2 and water; no unchanged dextrose excreted in urine under normal conditions. |
| Half-life | 30-60 minutes for blood glucose to return to baseline after infusion cessation; clinical context: rapid metabolism via glycolysis. |
| Protein binding | None (0%); dextrose does not bind to plasma proteins. |
| Volume of Distribution | 0.15-0.25 L/kg; approximates extracellular fluid volume. |
| Bioavailability | Oral: 100% (dextrose is completely absorbed). |
| Onset of Action | Intravenous: immediate; oral: 5-10 minutes. |
| Duration of Action | Intravenous: 30-60 minutes after infusion stops; oral: 1-2 hours. Clinical notes: duration depends on infusion rate and patient's metabolic state. |
| Molecular Weight | 180.16 |
Intravenous infusion. Typical adult dose is 500-1000 mL of 7.7% dextrose solution infused at a rate of 100-200 mL/hour, titrated to clinical response and serum glucose levels.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment for GFR; however, monitor fluid balance and serum glucose in patients with renal impairment due to risk of fluid overload and hyperglycemia. |
| Liver impairment | No specific dose adjustment for Child-Pugh class; monitor serum glucose closely in patients with hepatic impairment due to altered glucose metabolism. |
| Pediatric use | Intravenous infusion at a dose of 5-10 mL/kg of 7.7% dextrose solution, infused at a rate not to exceed 0.5-1 g/kg/hour of dextrose, with careful monitoring of serum glucose. |
| Geriatric use | Use with caution; consider lower infusion rates and volumes due to decreased renal function and increased risk of fluid overload and hyperglycemia. Monitor serum glucose and electrolytes frequently. |
| 1st trimester | Dextrose 7.7% is considered safe for use during the first trimester when administered intravenously for appropriate indications. It is a source of calories and water for hydration. No teratogenic effects have been reported at therapeutic doses. |
| 2nd trimester | Safe for use during the second trimester. Dextrose is a physiologic monosaccharide used for energy and does not pose a risk to the fetus. It is often used in maternal hydration and nutrition. |
| 3rd trimester | Safe for use during the third trimester. However, caution is advised in cases of gestational diabetes or hyperglycemia, as dextrose may elevate maternal blood glucose levels, potentially affecting the fetus. Monitoring of blood glucose is recommended. |
Clinical note
Comprehensive clinical and safety monograph for DEXTROSE 7.7% IN PLASTIC CONTAINER (DEXTROSE 7.7% IN PLASTIC CONTAINER).
| Placental transfer | Dextrose freely crosses the placenta via facilitated diffusion. The degree of transfer depends on maternal blood glucose levels; higher maternal levels result in increased fetal exposure. Fetal blood glucose levels are maintained at approximately 70-80% of maternal levels. |
| Breastfeeding | Dextrose is a normal constituent of human milk and is safely used intravenously during breastfeeding. It does not accumulate in milk, and no adverse effects on the nursing infant are expected. It is considered compatible with breastfeeding. |
| Lactation Rating | L1: Safe |
| Teratogenic Risk | Dextrose is a physiological nutrient; at standard infusion rates, no teratogenic effects are expected. However, hyperglycemia from excessive infusion may increase the risk of fetal macrosomia, neonatal hypoglycemia, and congenital anomalies (first trimester). Avoid maternal hyperglycemia. |
| Fetal Monitoring | Monitor maternal blood glucose levels, serum electrolytes, fluid balance, and urine output. Fetal monitoring is standard for pregnant patients; assess for signs of macrosomia or polyhydramnios with prolonged use. |
| Fertility Effects | No direct effects on fertility reported. Dextrose is a standard component of parenteral nutrition; no adverse reproductive outcomes are expected. |
■ FDA Black Box Warning
No black box warning.
| Serious Effects |
Diabetic ketoacidosis with hyperglycemia (unless used with insulin)Hyperglycemia (blood glucose > 200 mg/dL) unless insulin is concurrently administeredIntracranial or intraspinal hemorrhage (if administered via same line as blood products)Known allergy to corn or corn products (dextrose is derived from corn)Severe electrolyte disturbances such as hypernatremia (if dextrose is in a hypotonic solution)
| Precautions | Use with caution in patients with diabetes mellitus or glucose intolerance; may cause hyperglycemia, Monitor serum glucose levels during administration, Risk of fluid overload in patients with renal or cardiac impairment, Avoid extravasation; can cause tissue necrosis, High concentrations may cause hyperosmolality and osmotic diuresis |
| Food/Dietary | No specific food interactions. However, because this is a parenteral solution, oral intake may be restricted per clinical condition. Monitor blood glucose levels closely if oral intake is resumed. |
| Clinical Pearls | Dextrose 7.7% is a hypertonic solution (approx. 770 mOsm/L) that must be administered via a central venous line to avoid phlebitis. It is commonly used as a component of parenteral nutrition or for treatment of hypoglycemia. Monitor serum glucose closely; rapid infusion can cause hyperglycemia and osmotic diuresis. Do not administer if solution is cloudy or contains precipitate. |
| Patient Advice | This solution contains sugar (dextrose) and will be given through a central intravenous line. · Report any signs of infection at the catheter site, such as redness, swelling, or pain. · Notify your healthcare provider if you experience headaches, confusion, or frequent urination, which could indicate high blood sugar. · Do not adjust the infusion rate; it is precisely controlled to avoid complications. |
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