Dextrose 50% in Water

Question 1

D50W Class

Answer 1

Monosaccharide, principal form of carbohydrate used in the body

Question 2

D50W Action

Answer 2

Increases serum blood glucose levels

Question 3

D50W Indication

Answer 3

• Hypoglycemia confirmed by glucometer
• Coma or seizure of unknown etiology
• Refractory cardiac arrest (controversial)

Question 4

D50W Contraindication

Answer 4

• Intracranial hemorrhage

* Closed head injury

Question 5

D50W Precaution

Answer 5

• Can precipitate severe neurologic impairment in alcoholic patients(Wernicke-Korsakoff’s syndrome)
This is related to thiamine deficiency and thiamine should be given before D50 in these cases
• In smaller veins irritation may occur
• Infiltration may cause necrosis

Question 6

D50W Dosage

Answer 6

Adults:
• IV/IO: 12.5-25 g slow IV push or infusion
Pediatrics:
• Birth - 3 months: (D10) 10ml/kg SIVP IV/IO
• > 3 months: (D10) 10 ml/kg or (D25) 4 ml/kg SIVP IV/IO

Question 7

D50W Onset/ Duration

Answer 7

Onset:
• ~ 1 min for immediate improvement
•5-20 min for complete resolution s/s
Duration:
• usually not long duration. requires meal

Question 8

D50W Side Effects

Answer 8

• Pain, warmth, burning upon administration
• Phlebitis, sclerosis, and thrombosis of vein can occur
• Rhabdomyolitis
• Infiltration can cause necrosis and extravasation

Question 9

D50W Interactions

Answer 9

• No significant interactions