Dextrose 50% In Water (D50W)

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Dextrose 50% in water (D50W)

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(25 gm of Dextrose in a 50 ml solution)

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Classification

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Carbohydrate

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Mechanism of action

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Provides immediate source of glucose for cellular metabolism

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Indications

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ALOC due to documented or suspected Hypoglycemia

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Contraindication

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1. There are no ABSOLUTE contraindications to the IV administration of dextrose 50% in the emergency setting
2. relative contraindications: Use with caution in patients with increasing intracranial pressure as the added glucose may worsen the cerebral edema

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Side effects

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1. Patients may complain of warmth pain or burning at the injection site.
2. Dextrose can cause severe neurological symptoms (Wernicke's encephalopathy or Korsakoff's psychosis) if patient is thiamine deficient.

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Precautions

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1. Aspirate prior to administration and after every 10-15 ml to ensure IV potency (MEDICATION WILL CAUSE NECROSIS)
2. Cannulate largest vein possible and run IV wide open prior to and after administration

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Interactions

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None

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Routes of administration

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IV, IO

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Onset and duration of actions

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Onset will be 30-60 seconds but duration depends upon degree and cause of hypoglycemia

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Dosages

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ADULT: 25 gm (50 ml solution preload) IVP/IO
May repeat once in 5 minutes
PEDIATRIC: BIRTH-1 MONTH: 5-10 ml/kg (.0.5-1g/kg) Slow IVP OF A 10% SOLUTION
1 MONTH - 2 YEARS: 2 ml/kg (0.5-1g/kg) Slow IVP/IO OF A 25% SOLUTION May repeat once in 5 minutes
OVER 2 YEARS 1 ml/kg (0.5-1g/kg) Slow IVP/IO OF 50% SOLUTION (same solution as for the adult) May repeat once in 5 minutes

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Notes

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Notes DO not Exceed a 12.5% Concentration in neonates