View source for Intravenous sugar solution

{{Short description|Dextrose solution used to treat low blood sugar}}
{{Use dmy dates|date=March 2024}}
{{Infobox drug
| IUPAC_name        =
| image             = Alpha-D-Glucopyranose.svg
| alt               =
| caption           = Chemical structure of dextrose

<!-- Clinical data -->
| pronounce         =
| tradename         =
| Drugs.com         = {{Drugs.com|monograph|dextrose}}
| MedlinePlus       =
| DailyMedID        = Dextrose_solution
| pregnancy_AU      = <!-- A/B1/B2/B3/C/D/X -->
| pregnancy_AU_comment =
| pregnancy_category=
| routes_of_administration = [[Intravenous]]
| class             =
| ATC_prefix        = B05
| ATC_suffix        = BA03

| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled-->
| legal_AU_comment =
| legal_CA = <!-- OTC, Rx-only, Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_DE = <!-- Anlage I, II, III -->
| legal_NZ = <!-- Class A, B, C -->
| legal_UK = <!-- GSL, P, POM, CD, CD Lic, CD POM, CD No Reg POM, CD (Benz) POM, CD (Anab) POM or CD Inv POM / Class A, B, C -->
| legal_US = <!-- OTC/Rx-only/Schedule I, II, III, IV, V -->
| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV-->
| legal_status      = <!-- Free text -->

<!-- Pharmacokinetic data -->
| bioavailability   =
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| metabolism        =
| metabolites       =
| onset             =
| elimination_half-life =
| duration_of_action =
| excretion         =

<!-- Identifiers -->
| PubChem           =
| DrugBank          =
| ChemSpiderID      = none
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = 5SL0G7R0OK
| synonyms          = dextrose solution, glucose solution

<!-- Chemical and physical data -->
| chemical_formula  =
| molecular_weight  =
}}
<!-- Definition and medical uses -->
'''Intravenous sugar solution''', also known as '''dextrose solution''', is a mixture of [[dextrose]] (glucose) and [[water]].<ref name=AHFS2017>{{cite web|title=Dextrose|url=https://www.drugs.com/monograph/dextrose.html|publisher=The American Society of Health-System Pharmacists|access-date=8 January 2017|url-status=live|archive-url=https://web.archive.org/web/20170118042122/https://www.drugs.com/monograph/dextrose.html|archive-date=18 January 2017}}</ref> It is used to treat [[low blood sugar]] or water loss without [[electrolyte]] loss.<ref name=BNF69/> Water loss without electrolyte loss may occur in [[fever]], [[hyperthyroidism]], [[high blood calcium]], or [[diabetes insipidus]].<ref name=BNF69/> It is also used in the treatment of [[high blood potassium]], [[diabetic ketoacidosis]], and as part of [[parenteral nutrition]].<ref name=BNF69/> It is given by [[intravenous infusion|injection into a vein]].<ref name=BNF69>{{cite book|title=British national formulary : BNF 69|date=2015|publisher=British Medical Association|isbn=9780857111562|pages=683–684|edition=69}}</ref>

<!-- Mechanism and side effects -->
Side effects may include irritation of the [[vein]] in which it is given, [[high blood sugar]], and [[edema|swelling]].<ref name=BNF69/><ref name=WHO2008/> Excess use may result in [[low blood sodium]] and other [[electrolyte problem]]s.<ref name=BNF69/> Intravenous sugar solutions are in the [[volume expander#Crystalloids|crystalloid]] family of medications.<ref name=Dav2016>{{cite book| vauthors = David SS |title=Clinical Pathways in Emergency Medicine|date=2016|publisher=Springer|isbn=9788132227106|page=62|url=https://books.google.com/books?id=JnxBDAAAQBAJ&pg=PA62|language=en|url-status=live|archive-url=https://web.archive.org/web/20170116170118/https://books.google.ca/books?id=JnxBDAAAQBAJ&pg=PA62|archive-date=16 January 2017}}</ref> They come in a number of strengths including 5%, 10%, and 50% dextrose.<ref name=BNF69/> While they may start out [[hypertonic]] they become [[hypotonic solutions]] as the sugar is metabolised.<ref>{{cite book| vauthors = Waldmann C, Soni N, Rhodes A |title=Oxford Desk Reference: Critical Care|date=2008|publisher=OUP Oxford|isbn=9780199229581|page=142|url=https://books.google.com/books?id=eLqMpXfAlEcC&pg=PA142|language=en|url-status=live|archive-url=https://web.archive.org/web/20170116170011/https://books.google.ca/books?id=eLqMpXfAlEcC&pg=PA142|archive-date=16 January 2017}}</ref> Versions are also available mixed with [[saline (medicine)|saline]].<ref name=WHO2008>{{cite book | title = WHO Model Formulary 2008 | year = 2009 | isbn = 9789241547659 | vauthors = ((World Health Organization)) | veditors = Stuart MC, Kouimtzi M, Hill SR | hdl = 10665/44053 | author-link = World Health Organization | publisher = World Health Organization |page=491}}</ref>

<!-- History and culture -->
Dextrose solutions for medical use became available in the 1920s and 1930s.<ref>{{cite book| vauthors = Skipper A |title=Dietitian's Handbook of Enteral and Parenteral Nutrition|date=2012|publisher=Jones & Bartlett Publishers|isbn=9780763742904|page=283|url=https://books.google.com/books?id=f8gjJOPJlowC&pg=PA283|language=en|url-status=live|archive-url=https://web.archive.org/web/20170116170010/https://books.google.ca/books?id=f8gjJOPJlowC&pg=PA283|archive-date=16 January 2017}}</ref><ref>{{cite book| vauthors = Nelms M, Sucher K |title=Nutrition Therapy and Pathophysiology|date=2015|publisher=Cengage Learning|isbn=9781305446007|page=89|url=https://books.google.com/books?id=RGlvCgAAQBAJ&pg=PT121|language=en|url-status=live|archive-url=https://web.archive.org/web/20170116165726/https://books.google.ca/books?id=RGlvCgAAQBAJ&pg=PT121|archive-date=16 January 2017}}</ref> It is on the [[WHO Model List of Essential Medicines|World Health Organization's List of Essential Medicines]].<ref name="WHO21st">{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}</ref>

==Medical uses==
Administering a 5% sugar solution peri- and postoperatively usually achieves a good balance between starvation reactions and [[hyperglycemia]] caused by [[sympathetic nervous system|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 two days, a more complete regimen of [[total parenteral nutrition]] is indicated.

In patients with [[hypernatremia]] and [[euvolemia]], free water can be replaced using either 5% D/W or 0.45% saline.

In patients with [[fatty-acid metabolism disorder]] (FOD), 10% solution may be appropriate upon arrival to the emergency room.

==Side effects==
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 storefront clinics catering to Asian immigrants, despite having no more effect than drinking sugared water. The procedure is commonly called "ringer".<ref name=NYT>{{cite news|author1=Jiha Ham|title=A Life Upended After an IV Glucose Treatment Popular Among Asian Immigrants|url=https://www.nytimes.com/2015/03/21/nyregion/despite-warnings-asian-immigrants-rely-on-glucose-injections-as-a-cure-for-ailments.html|access-date=21 March 2015|work=The New York Times|date=20 March 2015|quote=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.|url-status=live|archive-url=https://web.archive.org/web/20150322034910/http://www.nytimes.com/2015/03/21/nyregion/despite-warnings-asian-immigrants-rely-on-glucose-injections-as-a-cure-for-ailments.html|archive-date=22 March 2015}}</ref>

Concentrated dextrose solutions should not be administered subcutaneously or intramuscularly, as they can cause cell death via dehydration and subsequent [[necrosis]].

==Types==
[[Image:G5% 500ml yellow background.jpg|thumbnail|200px|5% glucose in water]]
Types of glucose/dextrose include:
* '''D5W''' (5% dextrose in water), which consists of 278&nbsp;mmol/L dextrose
* '''D5NS''' (5% dextrose in normal saline), which, in addition, contains [[Saline (medicine)|normal saline]] (0.9% [[Mass concentration (chemistry)|w/v]] of [[sodium chloride|NaCl]]).
** '''D5 1/2NS''' 5% dextrose in half amount of normal saline (0.45% w/v of NaCl).<ref>[http://emedicine.medscape.com/article/241094-treatment eMedicine > Hypernatremia: Treatment & Medication] {{webarchive|url=https://web.archive.org/web/20110302125144/http://emedicine.medscape.com/article/241094-treatment |date=2 March 2011 }} By Ivo Lukitsch and Trung Q Pham. Updated: 19 April 2010</ref>
* '''D5LR''' (5% dextrose in [[lactated Ringer's solution|lactated Ringer solution]])
* '''D50''' – 50% dextrose in water

The percentage is a [[mass concentration (chemistry)|mass concentration]], so a 5% glucose/dextrose solution contains 50&nbsp;[[gram|g]]/[[liter|L]] of glucose/dextrose (<b>5</b>&nbsp;g per <b>100</b>&nbsp;ml). This [[usage]] is imprecise but widely used, as discussed at ''[[Mass concentration (chemistry)#Usage in biology|Mass concentration (chemistry) § Usage in biology]]''.

Glucose provides energy 4 kcal/gram, so a 5% glucose solution provides 0.2 [[kilocalories|kcal]]/ml. If prepared from ''dextrose monohydrate'', which provides 3.4 kcal/gram, a 5% solution provides 0.17 kcal/ml.<ref>[http://health.csusb.edu/dchen/368%20stuff/TPN%20calculation.htm Calculating Parenteral Feedings] {{webarchive|url=https://web.archive.org/web/20101203034443/http://health.csusb.edu/dchen/368%20stuff/tpn%20calculation.htm |date=3 December 2010 }} D. Chen-Maynard at [[California State University, San Bernardino]]. Retrieved September 2010. HSCI 368</ref>
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== References ==
{{reflist}}

{{Intravenous therapy}}
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[[Category:Intravenous fluids]]
[[Category:World Health Organization essential medicines]]
[[Category:Wikipedia medicine articles ready to translate]]