Dextrose Flashcards
Drug classification for dextrose
carbohydrate
How is dextrose supplied?
Preload 25g/50 mL (D50W)
Actions (Pharmacodynamics) of dextrose
A rapidly metabolized source of calories and fluids in patients with inadequate oral intake. While increasing glucose levels, dextrose may decrease body protein and nitrogen losses, promote glycogen deposition and decrease or prevent ketosis; may also induce diuresis.
Indications for dextrose
Hypoglycemia
Adult dosage for dextrose
12.5 - 25g of D50W SIVP; Second dose may be given if first dose ineffective q 5 minutes
Pediatric dose for dextrose
0.5 – 1 g/kg of D25W slow IVP in kids, max single dose 25 g. Repeat q 5 minutes prn.
How do you create D25W?
Take a preload of D50W (which is 25 g of solution in 50mL), expel 25mL and use saline to fill the preload back up to 50 ml. You will now have 12.5 g of dextrose in 50mL, resulting in D25W.
Neonate dose for dextrose?
0.2 grams/kg SIVP repeat q 5 min. prn.
To create D10W, remove 40ml from the D50W preload and replace it with 40ml of normal saline. The concentration will now be 5g/50ml.
In which limb should you recheck blood glucose level after administration of dextrose?
Re-check blood glucose in opposite limb
Do we withhold dextrose in patients with increase ICP or suspected head injury?
No, we give a half dose (12.5g D50W SIVP). Never withhold if the patient’s metabolic needs are deficient.
Complications with dextrose administration
❑ None in the emergency setting with patients in diabetic coma from hypoglycemia.
❑ Hyperglycemia may worsen neurologic outcome of cardiopulmonary arrest or trauma.
Precautions with dextrose administration
❑ Dextrose greater that 5% is considered a hypertonic solution. It can be very irritating to the vein (give with a very slow IV push through large bore IV and vein). Ensure patency of IV – can cause tissue sloughing if interstitial
❑ Give thiamine before or immediately after administration of dextrose to all patients who are malnourished (this will decrease the possibility of the patient developing Wrenekie’s encephalopathy).
Can dextrose exacerbate hypovolemia and shock?
Yes. Using large volumes of fluids containing dextrose can cause an increase in serum osmolality producing an osmotic dieresis that will exacerbate hypovolemia and shock.
