Intravenous dextrose (glucose water) available conc., doses, side effects, precautions & direction for adm.
presented at Al-Mahmoudiya General Hospital on 20/12/2022
Iv fluid therapy (types, indications, doses calculation)kholeif
All what you need to know intravenous fluids, types, indications, contraindications, how to calculate fluid rate and drug dosages.
Embed code (http://www.slideshare.net/slideshow/embed_code/16138690)
Iv fluid therapy (types, indications, doses calculation)kholeif
All what you need to know intravenous fluids, types, indications, contraindications, how to calculate fluid rate and drug dosages.
Embed code (http://www.slideshare.net/slideshow/embed_code/16138690)
Emeset (Generic Ondansetron Hydrochloride Tablets) is used for the management of nausea and vomiting induced by cytotoxic chemotherapy and radiotherapy, and for the prevention and treatment of post-operative nausea and vomiting (PONV).
This PPT gives an idea to MBBS students about the Type of fluids, Calculating the daily requirements as well as the drop rate to be used in day today clinical practice.
INTRODUCTION OF FUROSEMIDE
CLINICAL DATA
CHEMISTRY OF DRUG (INCLUDING DRUG PROPERTIES)
DRUG DATABASES (AVAILABILITY,STORAGE,DOSAGE,ROUTE PREFERENCE)
PHARMACOKINETICS (SITE OF ACTION,TIME/ACTION PROFILE)
MECHANISM OF ACTION
ACTIONS
DESIRED EFFECT
INDICATIONS
THERAPEUTIC USES
CONTRAINDICATIONS
PRECAUTIONS
ADVERSE EFFECTS/SIDE EFFECTS
WARNINGS INCLUDING DOSE ADJUSTMENT IN SPECIAL POPULATION
DRUG INTERACTIONS
TOXICOLOGY & IT’S MANAGEMENT
NURSING CONSIDERATIONS
;RESPONSIBILITIES;ASSESSMENT;POTENTIAL DIAGNOSIS; IMPLEMENTATIONS;EVALUATIONS DURING FUROSIDE ADMINISTRATION
PATIENT/FAMILY TEACHING
SPECIAL CALCULATIONS
CONCLUSION OF FUROSEMIDE
REFERENCES OF FUROSEMIDE
Emeset (Generic Ondansetron Hydrochloride Tablets) is used for the management of nausea and vomiting induced by cytotoxic chemotherapy and radiotherapy, and for the prevention and treatment of post-operative nausea and vomiting (PONV).
This PPT gives an idea to MBBS students about the Type of fluids, Calculating the daily requirements as well as the drop rate to be used in day today clinical practice.
INTRODUCTION OF FUROSEMIDE
CLINICAL DATA
CHEMISTRY OF DRUG (INCLUDING DRUG PROPERTIES)
DRUG DATABASES (AVAILABILITY,STORAGE,DOSAGE,ROUTE PREFERENCE)
PHARMACOKINETICS (SITE OF ACTION,TIME/ACTION PROFILE)
MECHANISM OF ACTION
ACTIONS
DESIRED EFFECT
INDICATIONS
THERAPEUTIC USES
CONTRAINDICATIONS
PRECAUTIONS
ADVERSE EFFECTS/SIDE EFFECTS
WARNINGS INCLUDING DOSE ADJUSTMENT IN SPECIAL POPULATION
DRUG INTERACTIONS
TOXICOLOGY & IT’S MANAGEMENT
NURSING CONSIDERATIONS
;RESPONSIBILITIES;ASSESSMENT;POTENTIAL DIAGNOSIS; IMPLEMENTATIONS;EVALUATIONS DURING FUROSIDE ADMINISTRATION
PATIENT/FAMILY TEACHING
SPECIAL CALCULATIONS
CONCLUSION OF FUROSEMIDE
REFERENCES OF FUROSEMIDE
B. Pharm. (Honours) Part-III Practical, Pharmacology II,MANIKImran Nur Manik
a) Estimation of blood glucose by enzymatic method.
b) Estimation of blood glucose by chemical method.
c) Estimation of aspirin after oral administration by UV spectrophotometric method.
d) Estimation of aspirin after oral administration by calorimetric method.
e) Estimation of plasma protein by enzymatic method.
f) Estimation of plasma protein by burette method.
g) Estimation of blood uric acid level by enzymatic method.
h) Estimation of Paracetamol after oral administration by UV/Visible spectrophotometric method.
i) Handling of experimental animals: mice and rat.
j) Different routes of administration of drugs in experimental animals.
k) Assay of serum SGOT and SGPT activities in mice.
l) Assay of serum alkaline phosphatase activity
m) Isolation and determination of cholesterol content of biological samples.
EFFECT OF DIFFERENT CHROMATOGRAPHIC FRACTION AQUEOUS AND ALCOHOLIC EXTRACTS O...Jing Zang
In recent studies Teucrium polium(T. polium ) was known as a hypoglycemic plants. But further research is needed to better understand the effect of Teucrium polium and biological active part of it. The purpose of this investigation is to examine the effect of different chromatographic fractions of aqueous and alcoholic extract of this plant on the level of insulin secretion and glucose content in hyperglycemic rat model. Also, our aim is determination of biological active fraction of aqueous and alcoholic extract of this plant. This study was carried out on the 36 rats. Hyperglycemia induced by administrating of 50 mg/kg alloxan intraperitoneally and glucose level was monitored for hyperglycemic status. Hyperglycemic was confirmed by blood glucose measurement. In each experiment 100 grams of Teucrium polium aerial parts powder were boiled with 2 Litter of distilled water for 36 h. The decoction preparation was then filtered through a gauz cloth followed by filtration through filter paper. The extract was evaporated to one-fifth of its original volume and kept at 4oC until its use. Determination of different fraction aqueous extract effect of Teucrium polium on glucose level and insulin secretion was carried out. Blood was collected from the tail of the rats. Then glucose and insulin level was evaluated. The hyperglycemic animals showed significant decrease in the blood glucose level in rats administered with fourth fraction compared with other factions. Administration of fourth fraction Teucrium polium aerial parts extract cause increase in insulin levels in alloxan-treated rats. Results suggest that treatment of fourth fraction Teucrium polium aerial parts extract may be useful in preventing the increase of glucose level in hyperglycemic rats. The interesting phenomenon of our results has shown that fourth fraction given parenterally possesses a hypoglycemic effect in alloxan hyperglycemic rats. Fourth fraction was found biological active and to be responsive to glucose challenge as evidenced by increase in insulin secretion.
a) Estimation of blood glucose by enzymatic method.
b) Estimation of blood glucose by chemical method.
c) Estimation of aspirin after oral administration by UV spectrophotometric method.
d) Estimation of aspirin after oral administration by calorimetric method.
e) Estimation of plasma protein by enzymatic method.
f) Estimation of plasma protein by burette method.
g) Estimation of blood uric acid level by enzymatic method.
h) Estimation of Paracetamol after oral administration by UV/Visible spectrophotometric method.
i) Handling of experimental animals: mice and rat.
j) Different routes of administration of drugs in experimental animals.
k) Assay of serum SGOT and SGPT activities in mice.
l) Assay of serum alkaline phosphatase activity
m) Isolation and determination of cholesterol content of biological samples.
Normal fluid and electrolytes physiology, its abnormalities and corrective modalities in adults and paediatrics alike. Also included acid base balance, types of intravenous fluids, categories of intravenous cannula sizes
lecture presented at 5th. March 2024 as part of the newly pharmacist training course about patient safety program
high alert medications
look alike sound alike medication
lecture presented at 3rd. March 2024 about the Iraqi pharmacovigilance system as part of the newly appointed pharmacist training course (2024),
Update was performed depending on the latest version of the (Iraqi Pharmacovigilance Guidelines for Healthcare Professionals) 2024
IPhVC recommendations & monitoring requirement of biosimilars, Worldwide & Iraq control of Bioproducts & biosimiliars, as well as references enlisted adverse reactions to common products used in our hospital
Lecture presented at the 31st Jan 2024 in our hospital
Systemic & inhaled Quinolone antibiotic EMA/MAHRA update considering when not to administr this groups of antibiotics
According to the Iraqi Pharmacovigilance Centre instructions
Benzyl alcohol as parenteral drugs additives
Their effects on specialist populations like pediatrics, pregnant and lactating females
With possible prepartaions were they are added
According to the Iraqi Pharmacovigilance Centre instructions
Antibiotic stewardship, Clinical pharmacyDrug information Centre, Medication...Alaa Fadhel Hassan Alwazni
Training workshop held at Al-Mahmoudiya General Hospital in 18/10/2023
about work & duties of different comittes & units realted to the clinical pharmacy & pharmacovigilance
lecture presented at Al-Mahmoudiya General hospital in the 30th Aug 2023
based upon recent governmental protocols of antibiotic selection, dosage forms conversion by MOH 2023
IV drug additives
Updated on 1st Aug 2023
Refrences:
British National Formulary, (Sep. 2022) v3.1.6 android application
* Medscape, (July, 2023) v1131.0 & v181.0 android application
**Others: Elsevier’s Intravenous Medications: A Handbook for Nurses and Health Professionals,
Mosby’s Drug Reference for Health Professions,
Drugs.com website, Professionals, AFHS Monographs,
Electronic Medicines Compendium (emc) website,
& MMS home website, Drugs, Info.
The medical ethics lecture was presented online as part of the newly - employed pharmacists training course on 23/5/2023
Al-Mahmoudiya General Hospital
High alert medications (HAM)
Lecture presented in the unit of clinical pharmacy, Al-Mahmoudiya General Hospital
As part of the training course for clinical pharmacy 22/5/2023
brief review on clinical pharmacy, drug information centre & patient safety program
The lecture was presented at Al-Mahmoudiya General Hospital as part of the training course for fresh appointed pharmacist at 16/5/2023 at 11 & 15/5/2023
Resistant culture for the bacterial isolate of Al-Mahmoudiya G.Hospital as part of antibiotic stewardship mission
presented on 23/11/2022 at our hospital
differences & indications of ringers (solution/buffered with lactate & acetate) Vs Normal saline in different medical conditions
Presented as lecture at 25th.July 2022
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Dextrose solution (GW).pdf
1. Dextrose solution (GW)
Alaa F. Hassan (MSc. Pharmacology)
Drug Information Centre/ Al-Mahmoudiya G. Hospital
Doses equivalence & conversion
75 g anhydrous glucose eq. to glucose BP 82.5g (1)
Oral liquid containing 250mg/ml & tablet containing glucose 4g/tab. (1)
Buccal gel tube of 40% oral gel containing 10g/tube (1)
IV solution available as (GW) 2.5%, 5% & 10%, (HT) 15%, 20%, 30 %, 40% 50% & 70%
(2, 4); note thatref. 4 classify sol.>5% as HT.
Available in our Hosp. Anhydrous glucose conc.
5% 500ml 50mg/ml
10% 500ml 100mg/ml
20% 50ml 200mg/ml
50% 20ml 500mg/ml
pH value 3.5-6.5, stored at 20-25°C (3)
Indication & doses-only parenteral
Indication (3) Concentrations
Energy source & fluid replacement (peripheral inf.) 2.5%, 5%, 10% (3, 4)
Energy source (CV inf. As TPN) 10%-70% (3, 4)
Insulin induced hypoglycaemia 25%, 50%
Neonates & infant acute symptomatic episodes of
hypoglycaemia
25%
Adj. management of hyperkalaemia 25% or 50%
As IV diluent for drugs adm. 2.5%-10%
Hypoglycaemia
Preterm & term neonates’ 200mg/kg slow IV inj. Followed by 3-6mg/kg/min inf.
(2ml/kg GW 10%) (2)
Infant ≤6month 250-500mg/kg/dose (1-2ml HT 25%) (3-4)
Neonates 500mg/kg/hr as GW 10% IV inf., initial dose 250mg/kg/5min may be required
for severe hypoglycaemia (associated with loss of consciousness&/seizures) (1)
Children>1month (6months) 500mg-1g/kg IV inj./inf. (5-10ml/kg GW 10% or 2-4ml
HT 25%) into large vein through large gauge needle (1-3)
Adult 10000-25000mg (40-100ml HT 25% or 20-50ml HT 50%) repeated as needed (3)
children & adult 20-50ml HT 50% at rate of 3ml/min , maintenance dose of GW 10% (4)
2. Hyperkalaemia
500mg/kg (2ml HT 25%) with soluble insulin 0.1U/kg repeated as needed (unlabelled)
(3)
Neonates 500mg-1g/kg (2.5-5ml/kg HT 20%) with soluble insulin 0.3-0.6U/kg/hr (2)
Children >1month 500mg-1g/kg (2.5-5ml/kg HT 20%) with soluble insulin 0.05-
0.2U/kg/hr (2)
Adult 25000mg (50ml HT 50%) with soluble insulin 10U/5min repeated as needed
(unlabelled) (3)
Persistent cyanosis combined with propranolol & followed by morphine
If (blood glucose < 3mmol/l) Children 200mg/kg as GW 10% IV inf. /10 min (1)
Energy source (nutritional support), carbohydrate/calorie &/fluid replacement
Mixed with amino acid &/ sterile water for inj. (SWFI) with dose adjustment for individual pt.
requirement (1, 3)
Children & Adult 2.5%, 5% & 10% sol. via peripheral line or 10%-70% sol. Through large CV
line (typically mixed with TPN) (4)
Diabetic ketoacidosis (1)
Insulin secreting islet cell adenoma & varicose veins (off-label) (4)
Common Side effects, contraindications, precautions
Febrile reaction (3, 4), fever&/chills (1, 4)
Electrolyte & fluid imbalances-dilution of serum electrolyte conc.,
overhydration/congested state, polyuria & pulmonary oedema (1, 3, 4)
Acidosis & alkalosis (3)
Rash & hypersensitivity (anaphylaxis, difficult breathing, periorbital/facial &/ laryngeal
oedema, pruritus, sneezing & urticaria)(3, 4) , local reaction & pain (1, 4)
Hypertension, heart failure (4), venous thrombosis & phlebitis (1-4)
Delirium tremens with dehydration, anuria(3, 4)
Diabetic coma with excessive blood sugar while used in caution with pt. have
subclinical/overt diabetes or receiving corticosteroids, hepatic coma (3, 4)
Heart failure (4), intracranial/intraspinal haemorrhage (3, 4)
Corn&/corns’ product allergy, drug hypersensitivity (3, 4)
Glycosuria is associated with rate of adm., while 0.5g/kg/hr not causes glycosuria; an inf.
at rate of 0.8g/kg/hr when 95% of the solution is retained will cause glycosuria (3)
Excessive&/rapid adm. Will result in hyperosmolar syndrome, (generally used with
extreme caution in new born/very low birth weight infant= hypo-/hyperglycaemia),
characterized with ↑ serum Osmolarity, mental confusion, loss of consciousness &
possible intracerebral haemorrhage (3, 4)
3. Also fatty liver infiltration, acute respiratory failure & hypermetabolic pt. difficult
weaning from respirator (3), besides resulting in sig. hypokalaemia & hypophosphatemia
(3).While prolong administration of glucose without electrolyte is associated with
hyponatraemia & electrolyte imbalance (1)
Slow iv inf. /5min suggested for conc. not >25% (2), When higher conc. >5% to be given
via peripheral vein, adm. Slowly preferably through small bore needle into large vein to
minimize irritation (3, 4), use umbilical/central venous catheter for sol. Conc.>10% after
appropriate dilution (1, 2) , > 12.5% (5), or an inf. via CV line for conc. not >25% or 30%
(considered irritant to central vein) (2)
HT 50% sol. should be only administered in emergency; avoid sudden withdrawal, adm.
GW 5% or 10% infusion after the HT inj. To avoid rebound hypoglycaemia (2-4)
1 manufacturer state the use final filter during adm. Of all parenteral sol. When possible
(3)
Causes pseudoagglutination of RBCs when adm. simultaneously with whole blood (3, 4)
Do not use plastic bags in series connection, pressurize bag to increase flow rate nor use
vented IV adm. Set (results in air embolism) (3,4)
Some sol. Contains Aluminium, in pt. with impaired renal fx. , toxicity is expected
(Premature neonates are at particular risk-their immature kidneys & requirement of
calcium + phosphate) (pt. with impaired renal fx. Receiving parenteral Al >4-5mcg/day
are at risk for CNS or bone toxicity) (3)
Preparation of other conc. From GW 10% 500ml +HT 50% (2)
Volume removed
from GW 10% (ml)
Volume of HT 50% to
be added (ml)
Final conc. Final vol. (ml)
31.25 31.25 12.5% 500
62.5 62.5 15% 500
93.75 93.75 17.5% 500
187.5 187.5 25% 500
Volume req. HT 50%= (% change [higher conc. – lower conc.] * final volume) /40 (5)
If you need to add NaCl 0.9% to the made 500ml bottle, remove 15ml prepared solution & add
15ml NaCl 30% (2)
References
1. British National Formulary for Children. V3.1.6 updated 28th Sep. 2022 [Android apk]
2. Guy’s & St Thomas’ NHS Foundation Trust - Paediatric Formulary. First Ed. Updated 27th
April 2020 [Android apk]
3. Elsevier’s 2032 Intravenous Medications, A handbook for nurses and health professionals.
Thirty-nine Ed. V3.6.14 [Android apk]
4. McGraw-Hill - I.V Drug Handbook. V3.0.82 2009-2010 [Android apk]
5. Neonatal Guidelines And Drug Doses 2015 [Android apk]