Thursday, October 26, 2006

Dextrose in IV and Injection Fluid

I found a copy of the package insert for the 5% dextrose lactated ringer solution used in IVs. It's on the FDA website--incidentally, a great resource for finding things like that.

It reads:

Baxter Lactated Ringer’s and 5% Dextrose Injection, USP
in VIAFLEX Plastic Container

Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn product.

Allergic reactions or anaphylactoid symptoms such as localized or generalized urticaria and pruritus; periorbital, facial, and/or laryngeal edema, coughing, sneezing, and/or difficulty with breathing have been reported during administration of Lactated Ringer’s and 5% Dextrose Injection, USP. The reporting frequency of these signs and symptoms is higher in women during pregnancy.

Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypervolemia.

If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures, and save the remainder of the fluid for examination if deemed necessary.

I also found out that there is an alternative readily available. Plain saline solution without the dextrose can be substituted, and should be available anywhere.

I'm starting a binder right now with a copy of the package insert, relevant parts circled in red. I'll add other relevant information and a statement from Baby E's doctor. I think he'll be happy to give us something saying that she has severe allergies, including corn and soy, and needs to completely avoid anything containing these ingredients.

That way I can keep that binder with me or in a readily accessible place, available at all times. I don't want to end up in the emergency room some day arguing with some lunkhead about why Baby E can't have an IV with dextrose in it.

I'm thinking I should probably get some kind of medical alert bracelet or something for Baby E to wear, too, since an IV would be one of the first things placed in a real emergency.

There's no way I'm going to let a doctor mainline corn into my highly allergic baby's system. Not this mama.


Anonymous said...

"The reporting frequency of these signs and symptoms is higher in women during pregnancy."

Ah, this does explain a lot. I seemed to have been much more sensitive to corn when I was pregnant with the second, so much so that I have wondered if the pregnancy triggered the allergy. I also reacted in the hospital, itching like mad, but we assumed it was a drug reaction at the time because I didn't know about the corn.

It does seem that an overwhelming majority of us are women, doesn't it?


Anonymous said...

Very useful information on the IV solution with dextrose.

I am one of those highly allergic and anaphylaxis with IV's with dextrose in them.

Yes, its a great idea you have for keeping information about this allergy for your daughter. I for one have had many many times argued with a bobblehead hospital pharmasist that thought since they had the degree..they knew more. Ahh not so.

When I had my hysterectomy years ago. I seriously explained I could not have any IV solution that contained Dextrose that I would get sick and chock. Anaphylaxis I wasn't for sure at the time is how I should have called it, but anyone telling anyone that a sympton is chocking as a reaction should have put two and two together. So back and forth between myself getting ready for surgery with the hospital pharmasist of insisting that the dextrose was not anything to be allergic to in the IV they wanted to inject me with. After my surgery being somewhat delayed in this controversy I stupidly said ok.

Later after waking from surgery, being wheeled to my room, I tried and tried to tell the nurse's that I couldn't get any air from the mask. They insisted it was working and to just breath. With all of the effort trying to breath, my bad back of which I had prior surgery to stressed so much, on top of not breathing I spasmed so hard which made breathing even harder. By this time my mom was in my hospital room for which I tried telling her I couldn't breather and back was spasming. Finally the nurse got intouch with DR who did surgery and they IV'd valum. That ended up working because I went to sleep and since breathing wasn't a big issue I couldn't fight with needing air...LOL go figure.

The next morning when I was more allert. I explained to my mom that I was choking and couldn't get air and such. I then explained that I allowed them after arguing with the pharmasist to have the dextrose. It was then I was able to diagnose my corn allergy to dextrose in the IV as one of the same and that I will ANAPHYLAXIS to this IV solution with DEXTROSE.

My advise to anyone. Please please, dont let even a medical degree so called wanna be expert talk you into somthing you maynot have a degree in but you are highly more educated in making that decision.... AND STICK WITH IT.

I now keep this information in my cell phone, with my drivers license, on my wrist, close people have a card with information on it.

Hope this helps others.


aip100 said...

I have a genetic condition, porphyria, and corn is an allergen, and yet each week i get a 10% dextrose iv in a ten whatever bag and i seem to be okay with it. i tried to find someone who mfged cane sugar in the u.s. for infusions and came up with a zero. How can I get back to this site?

aip100 said...

why is corn syrup so plentiful and cane sugar not plentiful?

constancecv said...

Corn syrup is cheaper than cane sugar and there are huge farm subsidies supporting corn production. I'm facing open heart surgery after a heart catheterization last week. On the 2nd day after the procedure I was shaking, very weak and extremely dizzy whenever I stood up. I had the same rection years ago after a glucose tolerance test. Any advice? --Constance

constancecv said...

I called the National Jewish Health hot line and got an answer we all should know: D5W solution is another or a different name for saline solution that contains 5% dextrose derived from corn. It's also used to dilute meds for intravenous use and some meds come pre-mixed with the stuff. I ordered a Medic Alert bracelet yesterday.

I've been so dizzy and weak for 8 days that I haven't been able to walk any distance or safely drive.
It also made my seasonal alllergy symptoms a lot worse.

jngo said...

What did you put on your medic-alert bracelet? I'm thinking of getting one too, but I'm not sure it will be helpful. I'm thinking of putting dextrose, but I'm allergic to all corn products and most doctors/paramedics don't know that that I can react to corn starch and corn syrup in medication.