Dextrose prevention

HES is produced from 93—96% dextrose hydrolyzate that has been clarified, carbon-treated, ion-exchanged, and evaporated to 40—50% dry basis. Magnesium is added at a level of 0.5—5 mAf as a cofactor to maintain isomerase stabiUty and to prevent enzyme inhibition by trace amounts of residual calcium. The feed may also be deaerated or treated with sodium bisulfite at a level of 1—2-mAf SO2 to prevent oxidation of the enzyme and a resulting loss in activity. 

Sweetness is primarily a function of the levels of dextrose and maltose present and therefore is related to DE. Other properties that increase with increasing DE value are flavor enhancement, flavor transfer, freezing-point depression, and osmotic pressure. Properties that increase with decreasing DE value are bodying contribution, cohesiveness, foam stabilization, and prevention of sugar crystallization. Com symp functional properties have been described in detail (52). 

In the canning and preserving industries, com symps are used to prevent crystallization of sucrose, provide body, accentuate tme fmit flavors, and improve color and texture. In the beverage industry, the predominant use is in the beer and malt-Hquor areas. High conversion symps are used to replace dry cereal adjuncts, provide fermentable sugars, enhance flavor, and provide body. These symps contain controlled amounts of dextrose and maltose for proper fermentation. 

To prevent a rebound hypoglycemic reaction from the sudden withdrawal of TPN containing a concentrated dose of dextrose, the rate of administration is slowly reduced or the concentration of dextrose gradually decreased. If TPN must be abruptly withdrawn, a solution of 5% or 10% dextrose is begun to gradually reduce the amount of dextrose administered. 

Dextrose used in PN compounding typically is provided as a 70% stock solution (70 g/100 mL), although some institutions use a 50% stock solution. The final dextrose concentration in the PN solution typically should not exceed 35%. Hydrous dextrose provides 3.4 kcal/g (14.2 kj/g). A dextrose infusion rate of 2 mg/kg per minute should be sufficient to suppress gluconeogenesis and prevent protein breakdown in adults.5 Continuous dextrose infusion rate in adult patients generally should not exceed 4 to 5 mg/kg per minute in most hospitalized patients.6,7... 

Factors that can predispose patients to developing metabolic bone disease include deficiencies of phosphorus, calcium, and vitamin D vitamin D and/or aluminum toxicity amino acids and hypertonic dextrose infusions chronic metabolic acidosis corticosteroid therapy and lack of mobility.35,39 Calcium deficiency (due to decreased intake or increased urinary excretion) is one of the major causes of metabolic bone disease in patients receiving PN. Provide adequate calcium and phosphate with PN to improve bone mineralization and help to prevent metabolic bone disease. Administration of amino acids and chronic metabolic acidosis also appear to play an important role. Provide adequate amounts of acetate in PN admixtures to maintain acid-base balance. 

Various additive mixtures have been proposed for inclusion in blood collection tubes to prevent in vitro platelet activation. One formulation involves the use of a mixture of acid-citrate-dextrose (ACD, 1 5 dilution), 30 p-M acetylsalicylic acid... 

Staphylococcus aureus > Salmonella spp. and Clostridium botullnum (22) In the case of the latter, the combination of lactic starter with either sucrose or dextrose has proven effective in preventing toxin production even without nitrite (23, 24). Table IV illustrates the Inhibitory effect of lactic cultures on the growth and production of enterotoxin by staphylococci in dry sausage (25) ... 

Prevention of chemotherapy-induced emesis - For doses in excess of 10 mg, dilute injection in 50 ml of a parenteral solution (Dextrose 5% in Water,... 

At this point, every patient with altered mental status should receive a challenge with concentrated dextrose, unless a rapid bedside blood glucose test demonstrates that the patient is not hypoglycemic. Adults are given 25 g (50 mL of 50% dextrose solution) intravenously, children 0.5 g/kg (2 mL/kg of 25% dextrose). Hypoglycemic patients may appear to be intoxicated, and there is no rapid and reliable way to distinguish them from poisoned patients. Alcoholic or malnourished patients should also receive 100 mg of thiamine intramuscularly or in the intravenous infusion solution at this time to prevent Wernicke s syndrome. 

Tonicity agents are added to injectable preparations to prevent osmotic shock at the site of injection upon administration, and thereby reduce local irritation. Typical excipients used for tonicity adjustment include saline, glycerin, mannitol, dextrose, and trehalose. Tonicity is a colligative property that depends primarily on the number of dissolved particles in solution. Hence, the amount of tonicity agent to be added depends on the specific formulation. Typically, osmolality of 280 to 320mOsm is considered iso-osmotic. 

A 25-year-old woman and a 52-year-old woman injected lispro instead of insulin glargine (29). The first realized her mistake and managed to prevent severe hypoglycemia by eating continuously, despite a fall in blood glucose to 3.7 mmol/1. The other had a blood glucose of 3.1 mmol/1 and recovered after intravenous dextrose. 

Acid Citrate Dextrose (ACD) Dissolve 2.1 g di-sodium hydrogen citrate and 2.5 g D-glucose in 50 mL of sterile distilled water, fdter (0.2 microns) and autoclave (at the relatively low temperature of 90°C, to prevent degradation of the glucose). Store at 4°C. 

Effervescents comprise a soluble organic acid and an alkali metal carbonate salt. Citric acid is most commonly used for its flavor-enhancing properties. Malic acid imparts a smoother after taste and fumaric, ascorbic, adipic, and tartaric acids are less commonly used [14], Sodium bicarbonate is the most common alkali, but potassium bicarbonate can be used if sodium levels are a potential issue with the formulation. Both sodium and potassium carbonate can also be employed. Other excipients include water-soluble binders such as dextrose or lactose, and binder levels are kept to a minimum to avoid retardation of disintegration. All ingredients must be anhydrous to prevent the components within the formulation reacting with each other during storage. 

Tacrolimus, an immunosuppressant used to prevent rejection of liver and kidney transplants, is insoluble in water and is solubilized in Prograf to 5mg/ml with 20% Cremophor RH 60 and 80% ethanol and is administered by IV infusion after a 250-fold or a 1,000-fold dilution with saline or dextrose 5%. The dose of tacrolimus is up to 35 mg, which is 7 ml of Prograf, of which 1.4 ml is Cremophor RH60 per dose, representing the estimated maximum amount administered intravenously. 

Convulsions were more common in hypoglycemic children. This commonly unrecognized comphcation contributes to morbidity and mortality in cerebral Plasmodium falciparum malaria. Hypoglycemia is amenable to treatment with intravenous dextrose or glucose, which may help to prevent brain damage (SEDA-13, 804). 

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