Dextrose in Water (50%)

 


Other Names

D50W


Classification

Caloric Agent


Action

  1. Rapidly increases blood glucose levels

  2. Transient osmotic diuretic


Indications

  1. Documented hypoglycemia (¡Ü 4 mmol)

  2. Seizures of unknown etiology

  3. Cerebral/meningeal edema related to eclampsia


Contraindications

No significant contraindications in the emergency setting


Precautions

  1. Extravasation of the tissue

  2. Suspected intracranial hemorrhage, CVA

  3. Wernicke’s encephalopathy in the alcoholic patient due to probable thiamine deficiency


Adverse Reactions

  1. Pain, phlebitis at injection site

  2. Hyperglycemia and glycosuria

  3. Fluid overload


Interactions/Compatibility/Stability

Dextrose 50% has an acidic pH  (3.5 - 5) and therefore specific compatibility information should be consulted when Dextrose 50% is injected into an IV line containing another drug


Special Considerations

  1. Rapid rates of administration predisposes the patient to pain and may cause phlebitis if a peripheral vein is used; to minimize this effect administer slowly

  2. Excessive IV administration may cause fluid overload, water intoxication, +/or CHF

  3. D50W and Thiamine 100 mg IV (mini bag or IVP) should be given together when alcoholism or malnutrition are suspected


Dosages

Preparation: 25 g/50 ml preload (D50W)

Adult: 12.5 - 25 gm D50W slow IV, repeat PRN x 1

Pediatric:  0.5 gm/kg D25W slow IV to a maximum of 25 gm (dilute D50W 1:1 with NS), repeat PRN x 1


Kinetics

Onset           < 1 minute

Peak             Depends on degree of hypoglycemia

Duration      Depends on degree of hypoglycemia



Want to help out?  Feel free to fill in a template for a medication that you use in your system and send it to me.  These templates are (and always will be) free for anyone to use.  Send it to Marc.