Glucose solution can not be administered quickly and for a long time. If a chill occurs during the administration of the solution, the administration should be stopped immediately.
To prevent thrombophlebitis should be administered slowly through large veins.
With the introduction of dextrose solutions, control of electrolyte balance, glucose in the blood and urine is necessary.
It can be used as a component of various blood substitute and anti-shock liquids and for the preparation of solutions of drugs for intravenous administration.
Since the tolerance of glucose (dextrose) may be impaired in patients with diabetes mellitus, renal insufficiency or in an acute critical condition, their clinical and laboratory parameters, in particular the content of electrolytes in blood plasma, including magnesium or phosphorus, should be closely monitored, concentration of glucose in the blood.In the presence of hyperglycemia, the speed of administration of the drug should be adjusted or short-acting insulin administered. In episodes of intracranial hypertension, a careful control of the concentration of glucose in the blood is necessary.
The use of dextrose solutions can lead to hyperglycemia. Therefore, they are not recommended for administration after acute ischemic stroke, since hyperglycemia is associated with increased ischemic damage to the brain and prevents recovery. Particularly careful clinical monitoring is required at the beginning of intravenous administration of the drug.
Carbohydrate solutions without sufficient electrolyte content can not be used for rehydration therapy, as this can lead to a significant decrease in serum electrolyte concentrations, in particular to severe hyponatremia and hypokalemia, with potentially harmful effects on the patient, such as brain damage or heart disease. In particular, children, elderly and weakened patients are at risk. In the case of deficiency of electrolytes, such as hyponatremia or hypokalemia, the solution should not be used without proper substitution of electrolytes.
It is necessary to monitor the concentration of glucose and the content of electrolytes in the blood, the water balance, as well as the acid-base balance of the body.
The appointment of hyperosmolar glucose solutions may lead to an increase in intracranial / intraspinal pressure in patients with a compromised integrity of the blood-brain barrier.
Various conditions accompanied by metabolic disorders (eg, after surgery or after trauma, with hypoxia or organ failure) can slow the oxidative metabolism of glucose and lead to metabolic acidosis.
Hyperglycemia should be properly monitored and, if necessary, controlled by the introduction of short-acting insulin. The introduction of insulin leads to an additional movement of potassium into the cells and, consequently, can cause hypokalemia or aggravate it.
In newborns, especially preterm or low birth weight, the risk of developing hypoglycemic or hyperglycemia is increased, so careful monitoring of blood glucose levels is necessary during intravenous dextrose solutions to avoid long-term adverse effects.Hypoglycemia in newborns can lead to prolonged seizures, coma and brain damage.
Hyperglycemia is associated with intraventricular hemorrhage, delayed bacterial and fungal infectious diseases, retinopathy of prematurity, necrotic enterocolitis, bronchopulmonary dysplasia, prolonged hospitalization and death.
To avoid potentially fatal overdose of intravenous drugs in newborns, special attention should be paid to the method of administration.
Devices for intravenous infusion and other equipment for the administration of drugs should be monitored regularly.