Glucose of 40%

General characteristics. Structure:

Active agent – monohydrate glucose (in recalculation on anhydrous substance) 2.0 g.

Excipients: sodium chloride, acid of chlorohydrogen 0,1 M, water for injections.

Pharmacological properties:

Pharmacokinetics. Easily gets through gistogematichesky barriers into all bodies and fabrics. Transport in a cell is regulated by insulin. In an organism is exposed to biotransformation on a geksozofosfatny way (the main way of energy balance with formation of makroergichesky connections) and to a pentozofosfatny way (the main way of plastic metabolism with formation of nucleotides, amino acids, glycerin). Entering glycolysis process, glucose is metabolized to carbon dioxide and water with formation of energy in the form of ATP. End products of full oxidation of glucose are allocated with lungs (carbon dioxide) and through kidneys (water).

Pharmacodynamics. Glucose provides substrate replenishment of energy costs. At introduction to a vein of hypertonic salt solutions intravascular osmotic pressure increases, intake of liquid from fabrics in blood amplifies, processes of a metabolism accelerate, anti-toxic function of a liver improves, sokratitelny activity of a cardiac muscle amplifies, the diuresis increases. At introduction of hypertonic salt solution of glucose oxidation-reduction processes amplify, adjournment of a glycogen in a liver is activated. At the same time acts as a source of nutrients and the energy necessary for life activity of an organism.

Indications to use:

- a hypoglycemia (decrease in level of sugar in blood)

Route of administration and doses:

The drug is administered intravenously struyno or kapelno.

Glucose enters solution of 40% intravenously very slowly (once), the adult – on 20-40-50 ml on introduction. If necessary enter kapelno, with a speed up to 30 thaws/min. A dose for adults at intravenous drop administration – to 300 ml a day (6,0 g of glucose on 1 kg of body weight).

Features of use:

Drug should be used under control of level of sugar in blood and the level of electrolytes.

It is not recommended to appoint glucose solution during the acute period of a severe craniocereberal injury, at an acute disorder of cerebral circulation as drug can increase damage of structures of a brain and worsen the course of a disease (except a case of correction of a hypoglycemia).

At a hypopotassemia administration of solution of glucose needs to be combined along with correction of deficit of potassium (because of danger of strengthening of a hypopotassemia).

At hypotonic dehydration – use of drug is shown along with introduction of hypertonic saline solutions.

Not to apply solution subcutaneously and intramusculary.

Contents of an ampoule can be used only for one patient, after disturbance of tightness of an ampoule unused solution should be thrown out.

At a renal failure, dekompensirovanny heart failure, a hyponatremia extra care at purpose of glucose is required, control of indicators of the central hemodynamics.

Drug is used to children only to destination and under observation of the doctor. 

Use of glucose according to indications is possible during pregnancy and in the period of a lactation.

Drug does not exert impact on driving and potentially dangerous mechanisms.

Side effects:

- pain in an injection site, irritation of veins, phlebitis, venous thrombosis;

- hyperglycemia, hypopotassemia, hypophosphatemia, hypomagnesiemia, glucosuria, acidosis;

- polyuria;

- polydipsia, nausea;

- hypervolemia;

- allergic reactions (fervescence, skin rashes, Quincke's disease, shock).

Interaction with other medicines:

At combined use with solution of sodium of chloride has the additive effect concerning osmolarity of solution.

Because glucose represents rather strong oxidizer, it should not be entered in one syringe with hexamethylenetetramine, blood preparations in connection with aggregation or hemolysis of erythrocytes.

Solution of glucose is not recommended to be mixed in one syringe with the general anesthetics and hypnotic drugs (their activity decreases), solutions of alkaloids (there is their disintegration).

Glucose weakens action of analgetik, adrenomimetik, inactivates streptomycin, reduces efficiency of nystatin.

For the best digestion of glucose at normoglikemichesky states administration of drug is desirable to combine with appointment 4-8 PIECES of insulin of short action (subcutaneously).

Contraindications:

– hypersensitivity to drug;

– an intracranial and subarachnoidal hematomyelia, except for the states connected with a hypoglycemia;

– heavy dehydration, including a tremens;

– anury;

– the diabetes mellitus and other states which are followed by a hyperglycemia;

– glyukozo-galactose sprue;

– wet brain and fluid lungs;

– acute left ventricular failure;

– hyper lactacidemia;

– giperosmolyarny coma.

Overdose:

Symptoms: a hyperglycemia, a glucosuria, increase in osmotic pressure of blood (up to development of a hyper glycemic coma), an overhydratation and disturbance of electrolytic balance.

Treatment: drug is cancelled and appoint insulin at the rate of 1 PIECE to each 0,45-0,9 mmol of glucose of blood before achievement of level of glucose of blood of 9 mmol/l. Level of glucose of blood should be reduced gradually. Along with purpose of insulin carry out infusion of the balanced saline solutions.

If necessary appoint a symptomatic treatment.

Storage conditions:

In the place protected from light, at a temperature not above 25 °C. To store in the place, unavailable to children!

Issue conditions:

According to the recipe

Packaging:

On 5 ml in ampoules of neutral glass or an ampoule sterile spray filling. On each ampoule paste the label from paper label or apply the text directly on an ampoule with paint of an intaglio printing for glass products.

On 5 ampoules pack into a blister strip packaging from a film of polyvinyl chloride and aluminum foil. Put the scarificator in each packaging ampoule.

When packaging ampoules with notches, rings and points scarificators do not invest.

Planimetric packagings together with the approved instructions on a medical use in the state and Russian languages on number of packagings place in a box from a cardboard for a retail container or from corrugated fibreboard.