Name

dextrose 50% (D50)

Class

Carbohydrate, Hypertonic solution

Description/Mechanism

The term "dextrose" is used to describe the six carbon sugar d-glucose, the principal form of carbohydrate utilized by the body for energy production. D50 is used in emergency care to treat hypoglycemia, and in the management of coma of unknown origin.

Onset

<1 min

Duration

Depends on the degree of hypoglycemia

Indications

Hypoglycemia

Refractory cardiac arrest (controversial)

Contraindications

Intracranial hemorrhage

Increased intracranial pressure

Known or suspected CVA in the absence of hypoglycemia

Adverse Reactions

Warmth, pain, burning from medication infusion, thrombophlebitis

Drug Interactions

None significant.

Supplied

25g/50 ml prefilled syring (500 mg/ml)

Dose/Administration

Adult

12.5-25 g slow IV push, may be repeated once

Pediatric

dilute 1:1 with saline for a concentration of 25% dextrose in water; administer 0.5 – 1.0 g/kg/dose (2-4 cc/kg) slow IV, may be repeated once.

Special Consideration

Pregnancy Safety: Not established

Draw blood sample prior to administration if possible

Perform Dextrostix prior to administration if possible.

Extravasation may cause tissue necrosis; use large vein and aspirate occasionally to ensure route patency.

D50 may sometimes precipitate severe neurologic symptoms (Wernicke’s encephalopathy) in thiamine deficient patients, for example, alcoholics. (This can be prevented by administering 100 mg of thiamine IV)