Phocytan

Indications

Glucose (also called dextrose) is a simple sugar that is the body's main source of energy. Taken by mouth as a powder or drink, it is used to provide quick energy, for example during tiredness, heat exhaustion, after illness, and to treat low blood sugar (hypoglycaemia) in people who are awake and can swallow. In hospitals, glucose solutions are given into a vein to treat severe low blood sugar, to provide fluid and calories, to prevent ketosis, together with Insulin to lower high potassium, and as part of intravenous (parenteral) nutrition mixtures that also contain amino acids and fats.

How It Works

Glucose is absorbed quickly from the gut or goes straight into the blood when given by drip. Cells take it up with the help of Insulin and burn it to make energy. It raises blood sugar levels within minutes, and when given with water it also helps restore body fluids.

Dosage and Administration

By mouth: use as directed on the label, usually dissolved in water. For a low blood sugar episode in an adult who is awake, about 15 to 20 g of fast-acting glucose is usually taken, then blood sugar is rechecked after 15 minutes and followed by a snack or meal. Intravenous glucose and nutrition mixtures are given only by doctors and nurses in hospital; the strength, volume and rate are given as prescribed according to blood sugar, fluid needs and body weight.

Interactions

• Insulin and diabetes medicines (such as Sulfonylureas) lower blood sugar; glucose is used to correct low sugar caused by them.
• Corticosteroids, thiazide diuretics and some antipsychotics can raise blood sugar further.
• In hospital, glucose infusions must not be given through the same line as blood transfusions.

Contraindications

• High blood sugar that is not controlled (uncontrolled diabetes, diabetic ketoacidosis), unless used with Insulin by a doctor.
• Glucose-galactose malabsorption (oral use).
• For intravenous use: severe dehydration with high sodium, fluid overload, head injury within 24 hours, and some brain bleeds, as decided by the doctor.
• For nutrition mixtures: allergy to any component and conditions where the doctor judges them unsafe.

Side Effects

By mouth: usually none at normal amounts; large amounts can cause nausea, bloating or diarrhoea and raise blood sugar. Intravenous use can cause high blood sugar, fluid overload, low potassium or sodium, and pain or vein irritation (phlebitis) at the drip site, especially with strong solutions.

Get urgent medical help for low blood sugar with confusion, fits or unconsciousness (do not give anything by mouth to an unconscious person), very high blood sugar with extreme thirst, frequent urination and drowsiness, breathlessness or swelling during a drip, or pain and redness at the drip site.

Pregnancy and Lactation

Glucose is a normal food substance and can be used during pregnancy and breastfeeding. People with diabetes or gestational diabetes should follow their doctor's advice on sugar intake. Intravenous solutions in pregnancy are given only as prescribed, with blood sugar monitoring.

Precautions and Warnings

• People with diabetes should use glucose only to treat low blood sugar or as advised by their doctor.
• Glucose drinks are not a replacement for oral rehydration salts in diarrhoea.
• Intravenous solutions require monitoring of blood sugar, salts and fluid balance; strong solutions are given into a large vein.
• Frequent sugary drinks can harm the teeth.

Overdose

Too much can cause high blood sugar, sugar in the urine, dehydration and, with intravenous use, fluid overload and salt imbalance. Seek medical advice; in hospital the infusion is slowed or stopped and Insulin may be given.

Therapeutic Class

Carbohydrate, caloric agent and fluid replenisher (dextrose); component of parenteral nutrition.

Storage

Powder: store below 30°C in a dry place, tightly closed, out of the reach of children. Intravenous solutions and nutrition bags: store as directed on the pack, usually below 25°C, do not freeze.