GlucoBoost - Glucose Gel - Pack of 3

Product Information

Before adding a substance or medication, verify that it is soluble and/or stable in water and that the pH range of the glucose solution is appropriate.

Unless appropriately diluted infusion of hypertonic glucose solutions into a peripheral vein may result in vein irritation, vein damage, and thrombosis. Strongly hypertonic solutions should only be administered through an indwelling intravenous catheter with the tip located in a large vein such as the superior vena cava. water and electrolyte disturbances that could be aggravated by increased glucose and/or free water load (see above). Hypersensitivity/infusion reactions, including anaphylactic/anaphylactoid reactions, have been reported (see section 4.8).Hypoglycaemia in the newborn can cause prolonged seizures, coma and brain damage. Hyperglycaemia has been associated with intraventricular haemorrhage, late onset bacterial and fungal infection, retinopathy of prematurity, necrotizing enterocolitits, bronchopulmonary dysplasia, prolonged length of hospital stay, and death. A gradual increase of flow rate should be considered when starting administration of glucose-containing products. Solutions containing glucose should be used with caution, if at all, in patients with known allergy to corn or corn products. When selecting the type of infusion solution and the volume/rate of infusion for a geriatric patient, consider that geriatric patients are generally more likely to have cardiac, renal, hepatic impairment, and other diseases or concomitant drug therapy. Snap the lid off the tube of gel and squeeze gel into the child’s lower cheek whilst at the same time gently but firmly massaging the outside of the cheek. It is this action that stimulates partial absorption of the Glucogel. DO NOT place gel on your own finger to rub inside your child’s mouth.

Near patient testing devices tend to be less accurate in the lower range, especially < 2.0mmol/l [1] and therefore all low values (≤2.6mmol/L) require confirmation using blood gas analysis as this is considered the gold standard for measuring blood glucose. Refeeding severely undernourished patients may result in the refeeding syndrome that is characterized by the shift of potassium, phosphorus, and magnesium intracellularly as the patient becomes anabolic. Thiamine deficiency and fluid retention may also develop. Careful monitoring and slowly increasing nutrient intakes while avoiding overfeeding can prevent these complications. The infusion must be stopped immediately if any signs or symptoms of a suspected hypersensitivity reaction develop. Appropriate therapeutic countermeasures must be instituted as clinically indicated. If the blood glucose level is still 3.9mmol/l or below when you re-test repeat administration of Glucogel and re-test in another 15 minutes.

Objectives

Pulmonary vascular precipitates have been reported in patients receiving parenteral nutrition. In some cases, fatal outcomes have occurred. Excessive addition of calcium and phosphate increases the risk of the formation of calcium phosphate precipitates. Precipitates have been reported even in the absence of phosphate salt in the solution. Careful symptomatic and laboratory monitoring for fever/chills, leukocytosis, technical complications with the access device, and hyperglycaemia can help recognize early infections. Use of a vented intravenous administration set with the vent in the open position could result in air embolism. Vented intravenous administration sets with the vent in the open position should not be used with flexible plastic containers. If signs of pulmonary distress occur, the infusion should be stopped and medical evaluation initiated. Particular caution is advised in patients at increased risk of water and electrolyte disturbances that could be aggravated by increased free water load, hyperglycaemia or possibly required insulin administration (see below).

Glucose 40% w/v is for administration by intravenous infusion following appropriate dilution or incorporation in to a parenteral nutrition admixture.Identify all late preterm babies at birth and commence a hypoglycaemia/NEWS monitoring chart in labour ward. All babies should be risk assessed for criteria for hypoglycaemia monitoring and/or NEWS monitoring prior to leaving a labour ward environment The resultant admixture should be administered through a central or peripheral venous line depending on its final osmolarity. If the final mixture, to be administered, is hypertonic it may cause irritation of the vein when administered into a peripheral vein. For breast fed babies this will require top-ups. Top ups should be EBM* if sufficient available, otherwise formula should be used. Donor Breast Milk is an option and ensure families are aware this is available and can be used in this scenario. Children (including neonates and older children) are at increased risk of developing hypoosmotic hyponatraemia as well as for developing hyponatraemic encephalopathy. If subsequent prefeed glucose values have improved to lie in the green zone but still remain <2.6 mmol/l, increase top up volumes by one further increment of 5-10 ml/kg/feed