Dextrose 50% In Water (D50W)

Question 0

Actions

Answer 0

Provides an immediate source of glucose, which is rapidly utilized for cellular metabolism

Question 1

Drug classification

Answer 1

Hyperglycemic agent (Crystalloid)

Question 2

Indications (3)

Answer 2

1. Altered level of consciousness due to suspected hypoglycemia
2. Cardiac arrest due to hypoglycemia
3. Seizures due to hypoglycemia

Question 3

Contraindication

Answer 3

Patient without documented hypoglycemia

Question 4

Adverse effects

Answer 4

Nausea/vomiting

Question 5

Administration

Answer 5

50ml (=25gm) IVP

Question 6

Pediatrics

Answer 6

0-2 years - dilute to a 25% solution - then give: 2ml/kg slowly (10ml/min) IVP

> 2 years - 1ml/kg slowly (10ml/min) IVP

Question 7

Onset

Answer 7

30-60 sec

Question 8

Duration

Answer 8

Depends on the degree and cause of hypoglycemia

Question 9

Precaution

Aspirate prior to administration and after every 10-15 ml to ensure IV patency

Answer 9

Rationale

Causes tissue necrosis if infected into interstitial space

Question 10

Precaution

Perform glucose test

Answer 10

Rationale

May increase cerebral ischemia or infarction caused by a CVA or increased cerebral edema in patients with normal or elevated blood glucose levels.

Question 11

Precaution

Establish largest bore cannula possible in large vein and run IV wide open while administering D50W

Answer 11

Rationale

Drug may cause pain, warmth or burning at IV site. Patient may develop phlebitis, sclerosis or thrombosis of vein

Question 12

Precaution

Place patient in recovery position

Answer 12

Rationale

Protect airway

Question 13

Dilution to D50W to D25W

Answer 13

1. Discard 25 ml of D50W from pre-filled syringe
2. Withdraw 25ml of normal saline from IV bag or vial into pre-filled syringe
3. Gently shake syringe to mix solution

Question 14

How supplied

Answer 14

50%=25 gm in 50ml pre-filled syringe

25%=2.5 gm in 10ml pre-filled syringe