D-50

Question 1

Pharm and Actions

Answer 1

Glucose is used by the body as quick energy; It is regulated by insulin, which stimulates storage of glucose from the blood stream lowering blood glucose levels; Glucagon, which mobilizes stored glucose into the bloodstream, raises glucose levels.

Question 2

Indications

Answer 2

Hypoglycemic states usually associated with insulin shock in diabetes; the unconscious patient, when history is unobtainable but after a blood glucose test; CPR patients when the cause of arrest is not known; In patients with any focal or partial neurologic defecit or altered mental status; Hypothermia, generalized.

Question 3

Contraindications

Answer 3

None noted

Question 4

Administration

Answer 4

Perform a blood glucose level to determine level= normal range 80-120 mg/dL; If blood glucose meter is unavailable, draw blood for a red top tube (5ml); Adult dose 25g of D50 IV into a large secure vein, if patient is not able to tolerate oral glucose;Pediatric dose 0.5 g/kg IV or IO for 3 and older, 0.5g/kg of D25 for 3 and younger; recheck BG 5 minutes after administering.

Question 5

Side Effects and Special Notes

Answer 5

Extravasation of dextrose will cause necrosis in the tissue; IV should be secured in a large vein and free return of blood into the syringe or tubing should be checked 2-3 times prior to and during administration; If extravasation does occur immediately dilute with up to 10ml lidocaine 1% or normal saline injected SQ into extravasated area; Dextrose may precipitate Wernicke’s encephalopothy in alcoholics. If suspected, give thiamine 50-100 mg IV prior to administration of dextrose; Do not draw blood for glucose determination from site proximal to an IV containing glucose or dextrose; Effect is delayed in elderly patients with poor circulation.

Question 6

Class

Answer 6

A