NCTI- Pharmacology- Drug List B- Dextrose 50% in water (D50W)

25 gm of Dextrose in a 50 ml solution

carbohydrate

Provides immediate source of glucose for cellular metabolism

ALOC due to documented or suspected hypoglycemia

• There are no absolute contraindications to the IV administration of dextrose in the emergency setting
• Relative contraindication: Use with caution in patients with increasing Intracranial pressure as the added glucose may worsen the cerebral edema.

• Patients may complain of warmth, pain or burning at the injection site.
• Dextrose can cause severe neurologic symptoms (Wernicke’s encephalopathy or Korsakoff’s psychosis) if patient is thiamine deficient.

• Aspirate prior to administration and after every 10-15 ml to ensure IV patency (medication will cause necrosis)
• Cannulate largest vein possible and run IV wide open prior to and after administration
• Relative contraindication: Use with caution in patients with increasing intracranial pressure as the added glucose may worsen the cerebral edema or potentiate cellular necrosis in hemorrhagic stroke

none

IVP, IO

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

Adult: 25 gm (50 ml solution preload) IVP/IOMay repeat once in 5 minutes

Pediatric: Birth – 1 month: 0.5g-1gm/kg (5-10 ml/kg) slow IVP of a 10% solution. May repeat once in 10 minutes.

1 month+-2 years: 0.5g-1gm/kg (2-4 ml/kg) slow IVP/IO of a 25% solutionMay repeat once in 5 minutes

Over 2 years: 0.5g-1gm/kg (1-2 ml/kg) slow IVP/IO of a 50% solution (same solution as for the adult)May repeat once in 5 minutes

Do not exceed a 12.5% concentration in neonates.