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Wednesday, October 21, 2009

Why is 5% Dextrose dangerous to a patient?


Answer:
Contraindications:Hyperglycemia,
Overhydration,
Hypotonic dehydration,
Acidosis,
Hypokalemia,
Diabetic coma while blood sugar is excessively high,
Glucose intolerance.WarningsDextrose injections should not be administered through the same infusion equipment, simultaneously, before or after an administration of blood, because of the possibility of pseudo-agglutination.
This fluid should only be administered with great care to patients with renal insufficiency.Fluid/solute overloadDextrose solutions I.V can cause fluid or solute overload resulting in dilution of serum electrolyte concentrations, overhydration, congested states of pulmonary edema.
Hypertonic dextrose solutions may cause thrombosis if infused via peripheral veins, therefore, administer via a central venous catheter.
Diabetes mellitus: Use dextrose-containing solutions with caution in patients with sub-clinical or overt diabetes mellitus or carbohydrate intolerance.
Rapid administration of hypertonic solutions may produce significant hyperglycemia or hyperosmolar syndrome, especially in patients with chronic uremia or carbohydrate
intolerance.Pregnancy
Safety for use during pregnancy has not been established. Use only when clearly needed and when the potential benefits outweigh the potential hazards to the fetus.ChildrenUse with caution in infants of diabetic mothers, except as may be indicated in hypoglycemic neonates.PrecautionsHyperglycemia and glycosuria may be functions of rate of administration or metabolic insufficiency. To minimize these conditions, slow the infusion rate, monitor blood and urine glucose; if necessary, administer insulin. When concentrated dextrose infusion is abruptly withdrawn, administer 5% dextrose to avoid hypoglycemic reactions. Administer so that extravasation does not occur. If thrombosis occurs during administration, stop infusion and correct.
Clinical supervision should include regular checks of blood glucose level, serum electrolytes and water balance. Electrolytes are to be supplemented as required.
Hypokalemia: Excessive administration of potassium free solutions may result in significant hypokalemia. Add potassium to dextrose solutions and administer to fasting patients with good renal function, especially those on digitalis therapy.
Vitamin B complex deficiency may occur with dextrose administration.
Caution is to be exercised in patients with hyponatremia.
No other medication or substance should be added to this fluid, unless it is known to be compatible.Drug interactionsCorticosteroids:Cautiously administer parenteral fluids to patients receiving corticosteroids or corticotrophin.Side effectsFebrile response; infection at the injection site; tissue necrosis; venous thrombosis or phlebitis extending from the site of the injection; extravasation; hypovolemia, hypervolemia; dehydration; mental confusion or unconsciousness. These may occur because of the solution of administration technique. Use the largest available peripheral vein and a well placed small bore needle.Hypertonic solution are more likely to cause irritation; administer into larger central veins. Significant hyperglycemia, hyperosmolar syndrome and glycosuria may occur with too rapid administration of hypertonic solutions.
It can cause fliud overload and congestive heart failure.
who said so?
5% dextrose may be dangerous in some patients with pre existing conditions such as diabetes mellitus or head injury.It may augument the sugar levels in the former,and may cause brain swelling in the latter

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