Slide 1: Dextrose, USP vs Glucose: Part 2
DEXTROSE, USP VS GLUCOSE: PART 2 Baxter: Hurricane Helene Recovery Resource Baxter Medical Affairs November 2024 US_Nutrition_2024-0082_ME_v1.0 Non-promotional education , not intended to be reproduced without the prior written permission of Baxter Healthcare Corporation 1
Slide 2: Temporary Importation: Glucose
TEMPORARY IMPORTATION: GLUCOSE Glucose injection products have been authorized for temporary importation into the US due to supply challenges stemming from Hurricane Helene. Glucose and Dextrose are both manufactured with glucose as the source ingredient. Note: As glucose is approved for temporary i
Slide 3: Why? Dextrose, USP vs Glucose, PhEUR
Why? DEXTROSE, USP GLUCOSE, PhEUR DEXTROSE = D-GLUCOSE MONOHYDRATE GLUCOSE = D-GLUCOSE In the US and Canada, labeling is expressed In Europe, labeling is expressed in percent of in percent Dextrose, USP. glucose. It is measured as a hydrous form of It is measured as the anhydrous form of glucose. de
Slide 4: Comparative Concentrations
COMPARATIVE CONCENTRATIONS • Glucose injection products have been authorized for temporary import into the US due to supply challenges stemming from Hurricane Helene. • Key Point: Glucose 50% and Dextrose 50% are both manufactured with glucose as source ingredient. Therefore, active component is che
Slide 5: How Does This Impact Compounding?
HOW DOES THIS IMPACT COMPOUNDING? Glucose and Dextrose are chemically identical therefore compatibility and stability are expected to be the same. Per the ASHP Applying Stability Data in Compounding Parenteral Nutrition in: Extended Stability for Parenteral Drugs • Drugs that are generically and che
Slide 6: Stability and Compatibility
STABILITY AND COMPATIBILITY • In the US, compatibility and stability, including calcium-phosphate, are expressed in the dextrose form of measurement (final admixture concentration) • Remember that Glucose 50% is equivalent to Dextrose 55% • Remember that Glucose 70% is equivalent to Dextrose 77% • T
Slide 7: Background on Energy Content
BACKGROUND ON ENERGY CONTENT FACTS AND HOW TO DERIVE THE VALUES • Glucose provides 3.75 kcal/gram (Ref: Merrill AL, Watt BK. Energy value of foods- basis and derivation. Human Nutrition Research Branch Agricultural Research Service US Department of Agriculture. Agriculture Handbook No 74. 1973) • Gl
Slide 8: Example 1 (Neonatal Patient)
EXAMPLE 1 (NEONATAL PATIENT) 8
Slide 9: Vignette #1
VIGNETTE #1 Neonatal patient (3 kg) with a DIR of 12 mg/kg/min If using Dextrose 70% for compounding (or any concentration of dextrose): Step 1: Determine how many grams of dextrose needed 12 mg/kg/min = 51.84 grams (52 g) of dextrose/day Step 2: Calculate the amount of calories provided by dextrose
Slide 10: Vignette #1 (Continued)
VIGNETTE #1 (CONTINUED) Neonatal patient (3 kg) with a DIR of 12 mg/kg/min What does this mean for PN compounding? • Can not do a 1:1 conversion of grams of dextrose to grams of glucose • However, remember glucose 50% is equivalent to dextrose 55% • To do a 1:1 conversion, think of glucose 50% as de
Slide 11: Dextrose compounding example
D-glucose monohydrate (Dextrose) D-glucose (Glucose) Dextrose Note: slight differences reflect rounding 11
Slide 12: Glucose compounding example
Glucose Note: slight differences reflect rounding 12
Slide 13: Assessing Compatibility: Calcium Phos Curves
ASSESSING COMPATIBILITY: CALCIUM PHOS CURVES D-glucose (Glucose) D-glucose monohydrate (Dextrose) Assess using compatibility curves for dextrose Dextrose How? Step 1: calculate dextrose % • 52 g/200 mL = 26% Step 2: calculate AA % • 3.2 g/200 mL = 1.6% Step 3: • Assess compatibility using Ca-Phos cu
Slide 14: Example 2 (Adult Patient)
EXAMPLE 2 (ADULT PATIENT) 14
Slide 15: Vignette #2
VIGNETTE #2 Adult patient (70 kg); Desired Dextrose: 500 g If using Dextrose 70% for compounding (or any concentration of dextrose): Step 1: Determine how many grams of dextrose needed 500 g Step 2: Calculate the amount of calories provided by dextrose 500 g/dextrose/day x 3.4 kcal/g = 1700 kcal/day
Slide 16: Vignette #2 (Continued)
VIGNETTE #2 (CONTINUED) Adult patient (70 kg); Desired Dextrose: 500 g What does this mean for compounding PN? • Can not do a 1:1 conversion of grams of dextrose to grams of glucose • However, remember glucose 50% is equivalent to dextrose 55% • To do a 1:1 conversion, think of glucose 50% as dextro
Slide 17: Dextrose compounding example
D-glucose monohydrate (Dextrose) D-glucose (Glucose) Dextrose Note: slight differences reflect rounding 17
Slide 18: Glucose compounding example
Glucose Note: slight differences reflect rounding 18
Slide 19: Assessing Compatibility: Calcium Phos Curves
ASSESSING COMPATIBILITY: CALCIUM PHOS CURVES D-glucose (Glucose) D-glucose monohydrate (Dextrose) Assess using compatibility curves for dextrose Dextrose How? Step 1: calculate dextrose % • 500 g/2000 mL = 25% Step 2: calculate AA % • 100 g/2000 mL = 5% Step 3: • Assess compatibility using Ca-Phos c
Slide 20: Summary of Key Points
SUMMARY OF KEY POINTS Glucose injection products have been authorized for temporary import into the US due to supply challenges stemming from Hurricane Helene. Glucose 50% is equivalent to Dextrose 55% Glucose 70% is equivalent to Dextrose 77% The active component is chemically identical, however, i
Slide 21: Dextrose, USP vs Glucose: Part 2
DEXTROSE, USP VS GLUCOSE: PART 2 Baxter: Hurricane Helene Recovery Resource Baxter Medical Affairs November 2024 21