Dextrose 50% & 25%
Class
Carbohydrate, hypertonic solution
Description
The term dextrose is used to describe the six-carbon sugar d-glucose, the
principal form of carbohydrate used by the body. D50 is used in emergency care
to treat hypoglycemia and to manage coma of unknown origin.
Onset & Duration
Onset: #1 min.
Duration: Depends on the degree of hypoglycemia.
Indications
1. Hypoglycemia
2. Altered level of consciousness
3. Coma of unknown etiology
4. Seizure of unknown etiology
5. Refractory cardiac arrest (controversial)
Contraindications
There are no significant contraindications for IV administration of dextrose in
emergency care, except in the setting of intracerebral bleeding or hemorrhagic
CVA.
Adverse Reactions
1. Warmth, pain, burning from medication infusion
2. Thrombophlebitis
3. Rhabdomyolysis
Drug Interactions
There are no significant drug interactions with other emergency medications.
Special Considerations
1. Pregnancy safety: NA
2. Draw blood sample before administration if possible.
3. Extravasation may cause tissue necrosis; use a large vein and aspirate
occasionally to ensure route patency.
4. D50 sometimes precipitates severe neurological symptoms (Wernicke's
encephalopathy) in thiamine-deficient patients such as alcoholics. This can be
prevented by administering 100 mg. IV of thiamine.
5. Use D25% with pediatric or D50% and dilute 1:1 with NS.
Note: Feel free to discuss this medication and your experiences in administering it in an emergency or hospital based setting on our message board