Glugicir

Glugicir is a combination drug containing two active components: dextrose and sodium citrate.

1. Dextrose is a form of glucose, the main source of energy for the body's cells. Dextrose is used to quickly raise blood glucose levels and compensate for energy loss in cases of hypoglycemia (low blood glucose) or during exercise.
2. Sodium citrate is a salt of citrate acid, which has alkaline properties. It is used as an alkaline supplement to increase the alkalinity of urine and prevent the formation of kidney stones. Sodium citrate can also be used to correct the acid-base balance in cases of metabolic acidosis.

Glugicir is usually used in medical settings as a solution for intravenous administration or as tablets for oral administration. It can be used in various situations, such as treating hypoglycemia, restoring electrolyte balance, and during exercise or to prevent kidney stones.

Indications Glugicira

1. Hypoglycemia: Used to quickly raise blood glucose levels in cases of hypoglycemia (low glucose), especially in patients with diabetes or during vigorous exercise.
2. Correction of electrolyte balance: Sodium citrate contained in the drug can be used to correct electrolyte balance and increase the alkalinity of urine.
3. Kidney Stone Prevention: Sodium citrate may help prevent kidney stones by regulating urine pH and reducing the likelihood of crystal formation.
4. Treatment of metabolic acidosis: Sodium citrate may be used to correct metabolic acidosis, especially in patients with renal impairment or other metabolic disorders.
5. Increased energy: Dextrose can be used to increase energy in patients who are exhausted or who have been exercising for a long time.

Release form

Glugicir is available as a hemopreservative solution, which is used to maintain the stability of blood or its components, such as red blood cells or plasma.

Pharmacodynamics

1. Dextrose:

   • Dextrose, or glucose, is a simple sugar that is the body's main source of energy.
   • When dextrose enters the body, it is quickly absorbed and released into the bloodstream. This increases blood glucose levels (glycemia), which stimulates the pancreas to secrete insulin.
   • Dextrose can be used by cells to synthesize energy through the process of glycolysis.

2. Sodium citrate:

   • Sodium citrate is a salt of citric acid.
   • It can be used to regulate the acid-base balance in the body. For example, it can help neutralize excess acid in the stomach, which can be helpful for excess acidity or reactive distress syndrome.
   • Sodium citrate can also increase the alkalinity of the blood, which may be useful in treating some forms of metabolic acidosis.

3. Combined effect:

   • The combination of dextrose and sodium citrate in Glugicir can help normalize blood glucose levels and regulate acid-base balance.
   • This drug can be used in a variety of medical conditions that require maintaining optimal glucose levels and acid-base balance in the body.

Pharmacokinetics

1. Dextrose:

   • Absorption: Dextrose is rapidly absorbed from the gastrointestinal tract into the bloodstream after oral administration.
   • Metabolism: Dextrose is a simple sugar and the main source of energy for cells. It is metabolized in tissues through the processes of glycolysis and oxidation.
   • Excretion: Any dextrose that is not used in metabolic processes is usually excreted via the kidneys as urea or uric acid.

2. Sodium Citrate:

   • Absorption: Sodium citrate can be absorbed from the gastrointestinal tract, although its absorption may be less efficient than that of dextrose.
   • Metabolism: Sodium citrate is normally broken down in the body to citrate ions, which can participate in various metabolic processes.
   • Excretion: Sodium citrate is excreted from the body through the kidneys in the form of urine.
3. Peak Concentration and Duration of Action: Since glucose is a quick source of energy, its peak concentration in the blood is usually reached within a short time after ingestion. Sodium citrate may have a slower absorption rate and therefore may have a slower action.

Dosing and administration

1. Directions for use:

   • Before use, dilute the Glugicira powder with solvents according to the instructions on the package or the doctor's recommendations.
   • Typically the resulting solution is used for intranasal administration.
   • For intranasal use, the solution can be administered using special nasal applicators or a dropper.

2. Dosage:

   • The dosage of Glugicir may vary depending on the patient's age, severity of symptoms and the doctor's recommendations.
   • Generally, for adults and children, it is recommended to administer 1-2 drops of solution intranasally into each nostril, depending on the need and response to treatment.
   • The frequency of use may also vary depending on your doctor's recommendations and the severity of your symptoms.

Use Glugicira during pregnancy

The use of Glugicir (dextrose, sodium citrate) during pregnancy in clinical settings is associated with a risk of citrate intoxication, although serious effects are rare and are usually related to technical errors in dosing. Glugicir is used to stabilize blood in extracorporeal procedures, and based on studies, its use can be considered relatively safe when the correct dosage is observed and the patient's condition is monitored. No significant changes in blood coagulation or other basic health parameters in patients, including pregnant women, have been recorded with this method (Egorov et al., 1991).

If Glugicira is to be used during pregnancy, it is important to closely monitor the patient's condition and adjust the dosage according to clinical indications in order to minimize risks. It is always necessary to consult with the attending physician to assess all possible risks and benefits of such treatment.

Contraindications

1. Hypersensitivity: People with known hypersensitivity to dextrose, sodium citrate or any of the ingredients of the drug should not use Glugicir.
2. Hyperglycemia: Glugicir may be contraindicated in patients with hyperglycemia (high blood sugar) as it contains dextrose, which may increase blood glucose levels.
3. Hypernatremia: Patients with hypernatremia (high levels of sodium in the blood) should avoid using Glugicir due to its sodium citrate content.
4. Heart failure: In patients with severe heart failure, the use of Glugicira may be contraindicated due to the possible risk of worsening the condition.
5. Hepatic impairment: Patients with severe hepatic impairment should use Glugicir with caution and under medical supervision, as changes in drug metabolism may require dosage adjustment.
6. Renal impairment: In the presence of severe renal impairment, dosage adjustment of Glugicir or its discontinuation under medical supervision may be required.
7. Pregnancy and breastfeeding: There is limited information on the safety of Glugicira during pregnancy and breastfeeding, so its use during this period should only be carried out on the advice of a doctor.
8. Paediatric population: The efficacy and safety of Glugicir in children may not be fully studied, so its use in children may require consultation with a doctor.

Side effects Glugicira

1. Hyperglycemia: Excessive dextrose intake may lead to elevated blood glucose levels, especially in patients with diabetes.
2. Hypernatremia: Elevated sodium citrate levels may cause fluid and electrolyte imbalances and cause hypernatremia (increased sodium levels in the blood).
3. Metabolic Alkalosis: Excessive sodium citrate intake can cause metabolic alkalosis (increased blood pH), which can lead to various symptoms such as dizziness, drowsiness, muscle cramps, and abnormal heart rhythms.
4. Gastrointestinal Disorders: Digestive disturbances including nausea, vomiting, diarrhea, or abdominal pain may occur.
5. Hyperkalemia: Some patients may develop hyperkalemia (high levels of potassium in the blood) as a result of using sodium citrate.
6. Allergic reactions: Rarely, allergic reactions to the components of the drug may occur, manifested in the form of skin rash, itching, swelling or hives.
7. Hypertension: Blood pressure may increase when using dextrose.
8. Changes in urine pH: Sodium citrate may change the pH of urine, which may affect the composition of urinary stones and the risk of their formation.

Overdose

1. Hyperglycemia: Excessive dextrose consumption can lead to elevated blood glucose levels (hyperglycemia). This can cause symptoms such as polydipsia (excessive thirst), polyuria (frequent urination), fatigue and drowsiness.
2. Hypernatremia: Excessive sodium citrate intake can cause high sodium levels in the blood (hypernatremia), which can lead to a variety of symptoms including headache, drowsiness, muscle cramps, vomiting, and seizures.
3. Acid-Base Disorders: Since sodium citrate affects acid-base balance, its excess consumption can cause various disorders including alkali insufficiency and metabolic alkalosis.
4. Digestive disorders: Excessive consumption may lead to various digestive disorders such as nausea, vomiting, diarrhea and abdominal pain.
5. Other possible complications: Depending on the individual characteristics of the body and the amount of the drug used, other complications may arise, such as hypertension, the risk of pulmonary edema, and possible allergic reactions.

Interactions with other drugs

1. Medicines that affect blood glucose levels:

   • Medicines such as insulin or antidiabetic drugs used to treat diabetes may affect blood glucose levels. When used concomitantly with Glugicir, they may lead to hypoglycemia or hyperglycemia. Patients receiving insulin or antidiabetic drugs may require regular monitoring of blood glucose levels and dose adjustments.

2. Medicines that affect electrolyte balance:

   • Since sodium citrate is a source of sodium, drugs that affect electrolyte balance, such as diuretics or potassium supplements, may interact with Glugicir, changing the sodium level in the body and increasing the risk of hypernatremia or hyponatremia.

3. Drugs that affect urine acidity:

   • Sodium citrate may increase urine pH. Therefore, its use with drugs that change urine acidity, such as drugs containing aminoglycosides or acyclovir, may affect their effectiveness or adverse effects.

4. Drugs that affect kidney function:

   • Because sodium citrate is eliminated from the body via the kidneys, medications that affect kidney function may affect its metabolism and elimination. For example, some nonsteroidal anti-inflammatory drugs (NSAIDs) may decrease the elimination of sodium citrate.

5. Medicines that affect the gastrointestinal tract:

   • Because dextrose and sodium citrate are administered orally, medications that affect the gastrointestinal tract, such as antacids or medications containing aluminum or magnesium, may interact with Glugicir, changing its absorption or effectiveness.