Glucose-darnitsa

INSTRUCTIONS FOR MEDICAL USE OF THE MEDICINAL PRODUCT GLUCOSE-DARNITSA (GLUCOSE-DARNITSA)

Composition:

Active substance: glucose;

1 ml of solution contains glucose monohydrate 400 mg;

Excipients: sodium chloride, hydrochloric acid diluted, water for injections.

Pharmaceutical form. Solution for injection.

Main physicochemical properties: clear, colorless or slightly yellowish liquid.

Pharmacotherapeutic group. Intravenous solutions. Carbohydrates.

ATC code B05CX01.

Pharmacological Properties.

Pharmacodynamics.

A carbohydrate nutrition agent. Glucose provides substrate replenishment of energy expenditure and activates metabolic processes in the body. A 40% glucose solution, as a hypertonic solution, increases the osmotic pressure of blood, thereby enhancing fluid movement from tissues into the bloodstream; improves hepatic antitoxic function, enhances myocardial contractility, and increases diuresis.

Pharmacokinetics.

After intravenous administration, glucose enters organs and tissues, where it is phosphorylated and converted into glucose-6-phosphate, which actively participates in various pathways of the body's metabolism. Glucose reserves are stored in tissue cells in the form of glycogen.

Clinical characteristics.

Indications.

Hypoglycemia.

Contraindications.

Glucose 40% solution is contraindicated in patients with:

• intracranial and intraspinal hemorrhages, ischemic stroke, except in conditions associated with hypoglycemia;
• severe dehydration, including alcoholic delirium;
• hypersensitivity to glucose and other components of the medicinal product, allergy to corn and corn products;
• diabetes mellitus and other conditions associated with hyperglycemia;
• anuria;
• glucose-galactose malabsorption syndrome.

The medicinal product must not be administered simultaneously with blood products.

Interaction with other medicinal products and other forms of interaction.

Thiazide diuretics and furosemide. These medicinal products reduce glucose tolerance.

Insulin promotes glucose uptake into peripheral tissues, stimulates glycogen formation, and synthesis of proteins and fatty acids.

Pyrazinamide. Glucose solution reduces the hepatotoxic effect of pyrazinamide.

Cardiac glycosides (digitalis preparations). Administration of a large volume of glucose solution may lead to hypokalemia, which increases the toxicity of concurrently administered cardiac glycosides.

Special precautions.

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 as well as serum glucose levels.

Prolonged intravenous administration of the drug requires regular monitoring of blood glucose levels. For better glucose utilization under normoglycemic conditions, administration of the drug should preferably be combined with subcutaneous administration of short-acting insulin at a dose of 1 IU per 4–5 g of glucose (dry substance).

The drug is not recommended during the acute phase of severe traumatic brain injury or acute cerebrovascular events, as it may increase brain tissue damage and worsen disease progression (except in cases of hypoglycemia correction).

When administering the drug to patients with hypokalemia, concomitant potassium supplementation is required due to the risk of worsening hypokalemia. In cases of hypotonic dehydration, administration should be combined with hypertonic saline solutions.

Do not administer the solution subcutaneously or intramuscularly.

The contents of a single ampoule are intended for use in one patient only. After breaking the ampoule seal, any unused portion must be discarded.

This medicinal product contains sodium. Caution is advised when administering this product to patients on a sodium-controlled diet.

Use during pregnancy or breastfeeding.

Administration of this drug to pregnant women with normoglycemia may cause fetal hyperglycemia and lead to metabolic acidosis in the fetus. This should be carefully considered, especially when fetal distress or hypoxia is already caused by other perinatal factors.

Intravenous glucose administration to the mother during labor may affect fetal insulin production, increasing the risk of fetal hyperglycemia and metabolic acidosis, or neonatal hypoglycemia due to the "rebound phenomenon."

Ability to influence reaction speed when driving or operating machinery.

Not studied.

Method of administration and dosage.

Intravenously, very slowly, 20–40–50 mL per administration in adults.

If necessary, administer by drip infusion 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 medicinal product should be used in children only on prescription and under medical supervision.

Overdose.

Symptoms. Overdose of the medicinal product leads to hyperglycemia, glucosuria, increased blood osmotic pressure (up to development of hyperglycemic hyperosmolar coma), hyperhydration, and electrolyte imbalance.

Treatment. Discontinue the medicinal product and administer insulin at a dose of 1 IU for every 0.45–0.9 mmol of blood glucose until blood glucose level reaches 9 mmol/L. Blood glucose should be reduced gradually. Simultaneously with insulin administration, infuse balanced saline solutions. If necessary, symptomatic treatment should be administered.

Adverse reactions.

Gastrointestinal disorders: polydipsia, nausea.

Renal and urinary system disorders: polyuria, glucosuria.

Metabolism and nutritional disorders: hyperglycemia, hypokalemia, hypophosphatemia, hypomagnesemia, acidosis.

Immune system disorders: allergic reactions, including increased body temperature, skin rashes, angioneurotic edema, shock.

General disorders and administration site conditions: hypervolemia, water-electrolyte imbalance.

Glucose administration in the context of thiamine (vitamin B1) deficiency, including in patients with alcoholic delirium, may provoke the development of deficiency states, such as Wernicke's encephalopathy. In patients with severe malnutrition, sodium retention, edema, pulmonary edema, and congestive heart failure may occur.

Local changes at the injection site, including pain at the injection site, venous irritation, phlebitis, venous thrombosis.

If adverse reactions occur, administration of the solution should be discontinued, the patient's condition should be assessed, and appropriate medical assistance provided. The remaining solution should be retained for further analysis.

Shelf life. 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, cyanocobalamin.

It should not be administered in the same syringe with hexamethylenetetramine, as glucose is a strong oxidizing agent. Mixing in the same sy游戏副本