Dextrose 50%

How supplied

500mg/ml

Dosage and administration

Adults: Hypoglycemia, ALOC, or seizures of unknown etiology: 25-100 ml of D50 (12.5-50 Gm, 1/2 to 2 amps) IV. Hyperkalemia: 50Gm of detrose IV administered in conjunction with calcium chloride and sodium bicarbonate. Insulin may be given on arrival at ED. PEDS: (14 yrs and below including infant) 0.5-1 Gm/kg of dextrose 10% solution; recommended to give slowly over 20 minute period. To make D10%, draw and waste 50 ml from a 250ml bag of NS. Add 50 ml of D50% to the 250 ml bag to get D10%.

Mechanism of action

Aerobic metabolic substrate (ATP production). Reverses CNS effects of hypoglycemia by rapidly increasing serum glucose levels. Provides short term osmotic diuresis.

Class

Carbohydrate, hyperglycemic

Adverse reactions/side effects

Cerebral edema in children when given IV undiluted. Worsening elevated ICP or cerebral edema from trauma or cerebral vascular accident. Extravasation leads to severe tissue necrosis. Sclerosing effect on peripheral veins.

Names

Dextrose 50%

Indications

Hypoglycemia, ALOC with unknown reason, seizures with unknown reason, hyperkalemia.

Duration of action

Onset: Seconds Peak effects: Variable Duration of action: Variable

Special considerations

Pregnancy safety category C. Determine a blood glucose level before initiating administration of dextrose. Unnecessary hyperosmolar state during certain illnesses (head injuries, cerebral edema, intracranial bleeds, etc) may worsen neurological outcome. Dextrose is also very necrosing to the vascular system, will cause necrosis if infiltrated and should not be administered through small veins.

Drug interactions

Sodium bicarbonate. Diazepam will precipitate if given concurrently without flushing.

Contraindications

Thiamine deficiency, delerium tremens; use caution in patients with acute alcoholism-administer with thiamine. Head injury (unless documented hypoglygemia), intra cranial hemorrhage (relative), severe pain (paradoxical excitement may occur)