DEXTROSE 50% SOLUTION (D50)

CLASS:

• antihypoglycemic

• carbohydrate

ACTION:

• rapidly increases blood sugar level

INDICATIONS:

• hypoglycemia

• altered mental status, etiology unknown

• seizures in diabetics

CONTRAINDICATIONS:

• Use with caution in pt’s with increasing intracranial pressure as the added glucose may worsen the cerebral edema

STANDARD PREP:

• 25 gm (50% Dextrose) in 50 cc preloaded syringe

DOSAGE/ROUTE:

• See Hawaii S.O. – 25 grams 50% Dextrose IV

PEDS DOSE:

• See Hawaii S.O. – 0.5 mg/kg

• {After you dilute the dextrose to 25% dextrose [1cc 50% dextrose to 1cc NS], then you can calculate the amount to be given at 2cc/kg of this diluted mixture} {10% Dextrose solution = 1 part to 4 part NS – 0.2g/kg (2 ml/kg)}

SIDE EFFECTS:

• venous irritation

• localized tissue necrosis

• intracerebral hemorrhages in neonates

PRECAUTIONS:

• use large bore catheter

• Undiluted D50 in neonates causes intracerebral bleeds

• Dextrose can cause severe neurologic symptoms (Wernikie’s encephalopathy, Korsakoff’s psychosis) if patient is thiamine deficient. Use with 100 mg thiamine in pt’s suspected of having thiamine deficiency