Instructions Glucose-Darnitsa solution for injection 40% ampoule 20 ml No. 10
Composition
active ingredient: glucose;
1 ml of solution contains 400 mg of glucose monohydrate;
Excipients: sodium chloride, diluted hydrochloric acid, water for injections.
Dosage form
Solution for injection.
Main physicochemical properties: clear colorless or slightly yellowish liquid.
Pharmacotherapeutic group
Intravenous solutions. Carbohydrates.
ATX code B05C X01.
Pharmacological properties
Pharmacodynamics
Carbohydrate nutrition. Glucose provides substrate replenishment of energy expenditure, activates metabolic processes in the body. 40% glucose solution as a hypertonic solution increases the osmotic pressure of the blood, resulting in increased movement of fluid from tissues into the blood; improves the antitoxic function of the liver, increases myocardial contractility, and increases diuresis.
Pharmacokinetics
After intravenous administration, glucose enters organs and tissues, where it is phosphorylated, turning into glucose-6-phosphate, which is actively involved in various metabolic processes in the body. Glucose reserves are deposited in tissue cells in the form of glycogen.
Indication
Hypoglycemia.
Contraindication
Glucose solution 40% is contraindicated for use in patients with:
intracranial and intraspinal hemorrhages, ischemic stroke, except for conditions associated with hypoglycemia;
severe dehydration, including alcoholic delirium;
hypersensitivity to glucose and other components of the drug, allergy to corn and its products;
diabetes mellitus and other conditions accompanied by hyperglycemia;
anuria;
glucose-galactose malabsorption syndrome.
The drug should not be administered simultaneously with blood products.
Interaction with other medicinal products and other types of interactions
Thiazide diuretics and furosemide. Under the influence of these drugs, glucose tolerance is reduced.
Insulin promotes the entry of glucose into peripheral tissues, stimulates the formation of glycogen, and the synthesis of proteins and fatty acids.
Pyrazinamide. Glucose solution reduces the toxic effects of pyrazinamide on the liver.
Digitalis preparations. The introduction of a large volume of glucose solution contributes to the development of hypokalemia, which increases the toxicity of simultaneously used digitalis preparations.
Application features
Glucose solutions should be used with caution in patients with impaired carbohydrate tolerance of any origin, severe malnutrition, thiamine deficiency, hypophosphatemia, hemodilution, sepsis, trauma, shock, metabolic acidosis, or severe dehydration.
Monitor fluid and electrolyte balance and serum glucose levels.
With prolonged intravenous use of the drug, blood sugar levels should be monitored. For better glucose absorption in normoglycemic states, it is advisable to combine the administration of the drug with the administration of short-acting insulin (subcutaneously) at the rate of 1 U per 4–5 g of glucose (dry matter).
It is not recommended to prescribe the drug during the acute period of severe traumatic brain injury, with acute cerebral circulation disorders, since the drug may increase damage to brain structures and worsen the course of the disease (except in cases of correction of hypoglycemia).
In case of hypokalemia, the administration of the drug must be combined with simultaneous correction of potassium deficiency due to the risk of worsening hypokalemia; in case of hypotonic dehydration, with simultaneous administration of hypertonic saline solutions.
Do not administer the solution subcutaneously or intramuscularly.
The contents of the ampoule can only be used for one patient; after breaking the ampoule seal, the unused portion of the ampoule contents should be discarded.
This medicinal product contains sodium. If the patient is on a controlled sodium diet, caution should be exercised when using this medicinal product.
Use during pregnancy or breastfeeding
The use of the drug in normoglycemic pregnant women may cause fetal hyperglycemia and metabolic acidosis. The latter is important to consider, especially when fetal distress or hypoxia is already caused by other perinatal factors.
Intravenous glucose administration to the mother during labor may affect intrauterine insulin production, causing the risk of fetal hyperglycemia and metabolic acidosis or hypoglycemia in the newborn due to the “rebound phenomenon.”
Ability to influence reaction speed when driving vehicles or other mechanisms
Not studied.
Method of administration and doses
Intravenously, very slowly for adults, 20–40–50 ml per injection.
If necessary, administer by drip at a rate of up to 30 drops per minute (1.5 ml/kg/h), up to 300 ml per day.
The maximum daily dose for adults is 15 ml/kg and should not exceed 1000 ml.
Children
The medicine should be used in children only as prescribed and under the supervision of a doctor.
Overdose
Symptoms: In case of an overdose of the drug, hyperglycemia, glycosuria, increased blood osmotic pressure (up to the development of hyperglycemic hyperosmolar coma), hyperhydration, and electrolyte imbalance develop.
Treatment. The drug should be discontinued and insulin should be administered at the rate of 1 unit for every 0.45–0.9 mmol of blood glucose until the blood glucose level reaches 9 mmol/l. The glucose level should be reduced gradually. Infusion of balanced salt solutions should be performed simultaneously with insulin administration. If necessary, symptomatic treatment should be administered.
Side effects
Gastrointestinal: polydipsia, nausea.
From the kidneys and urinary system: polyuria, glycosuria.
From the side of metabolism: hyperglycemia, hypokalemia, hypophosphatemia, hypomagnesemia, acidosis.
On the part of the immune system: allergic reactions, including fever, skin rashes, angioedema, shock.
General disorders and administration site conditions: hypervolemia, electrolyte disturbances.
Administration of glucose in the setting of thiamine (vitamin B1) deficiency, including in patients with alcoholic delirium, may precipitate deficiency states such as Wernicke's encephalopathy. In severely malnourished patients, sodium retention, edema, pulmonary edema, and congestive heart failure may occur.
Injection site changes, including injection site pain, vein irritation, phlebitis, venous thrombosis.
If adverse reactions occur, the solution should be discontinued, the patient assessed, and appropriate treatment provided. The remaining solution should be stored for future analysis.
Expiration date
3 years.
Storage conditions
Store in the original packaging at a temperature not exceeding 25 ° C. Do not freeze.
Keep out of reach of children.
Incompatibility
Glucose is incompatible in solutions with aminophylline, soluble barbiturates, erythromycin, hydrocortisone, warfarin, kanamycin, soluble sulfonamides, and cyanocobalamin.
It should not be administered in the same syringe with hexamethylenetetramine, because glucose is a strong oxidizer. It is not recommended to mix in the same syringe with alkaline solutions: with general anesthetics and hypnotics, because their activity is reduced, with solutions of alkaloids; inactivates streptomycin, reduces the effectiveness of nystatin.
Packaging
10 ml or 20 ml in an ampoule; 5 or 10 ampoules in a pack.
Vacation category
According to the recipe.
Producer
PrJSC "Pharmaceutical Company "Darnitsa".
Address
Ukraine, 02093, Kyiv, Boryspilska St., 13.
