Glucose / Dextrose
Glucose (also known as dextrose) is a simple sugar used primarily in veterinary medicine for **fluid replacement** and as a **parenteral energy source**. Dilute glucose solutions (often combined with electrolytes like sodium chloride) are used to replace intracellular and interstitial fluid losses. Concentrated solutions are utilized to treat **hypoglycaemia** or as part of parenteral nutritional support (in combination with amino acids and lipids). > **Clinical Warning:** Solutions containing >5% glucose are hypertonic and can be highly irritant if administered outside of a central vein. The 50% solutions are extremely hypertonic (2525 mOsm/l) and must be handled with extreme care.
Mecanismo: Glucose acts as a direct **source of energy** for cellular metabolism. It enters cells via specific glucose transporters (GLUT) and undergoes glycolysis → ATP production. In fluid therapy, it also acts as an **osmotic agent**, drawing water into the intravascular space or providing free water once the glucose is rapidly metabolized.
Vías de administración
Contraindicaciones
- Use with caution in patients with insulin resistance
- Use with caution in patients with diabetes mellitus
Efectos adversos
- Phlebitis and tissue irritation (with hyperosmolar solutions >5%)
- Severe hypophosphataemia (refeeding syndrome in starved patients)
- Hyperglycaemia
Monitoreo
- Blood glucose concentrations
- Serum phosphorus (especially in starved patients)
- Catheter site for signs of phlebitis or extravasation
- Hydration status and electrolyte balance
Sobredosis
If glucose loading produces signs of **hyperglycaemia**, insulin may be added to correct it. Overdosage can also lead to osmotic diuresis, resulting in dehydration and electrolyte imbalances.
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