Dextrose

Question 1

Trade name

Answer 1

Dextrose 50%, D50, D10 in 250 NS

Question 2

Class

Answer 2

Carbohydrate, Hypertonic solution

Question 3

Mechanism of action

Answer 3

Reverse CNS effects of hypoglycemia by rapidly increasing serum glucose levels

Question 4

Indications

Answer 4

Hypoglycemia, Hyperkalemia

Question 5

Contraindications

Answer 5

Known thiamine deficiency; intracranial hemorrhage or stroke. incompatible with Sodium Bicarbonate

Question 6

Adverse Effects

Answer 6

Cerebral edema in children when given IV undiluted; worsening elevated ICP or cerebral edema from trauma or CVA; extravasation leads to severe tissue necrosis; sclerosing effect on peripheral veins secondary to IV infiltration

Question 7

Adult dose

Answer 7

Dextrose 10% in 250cc NS 12.5 gms IV bolus 125cc and re-check glucose (target >60) and improved mental status. May repeat x 1

Question 8

Pediatrics

Answer 8

Neonates: D10% - 1-2cc/kg IVP
Peds: Dextrose 10% in 250 NS 20cc/kg (max 125cc) bolus. May repeat x1

Question 9

Special considerations

Answer 9

Determine a blood glucose level before initiating administration of Dextrose
Give Thiamine if alcoholism or malnutrition is present/ suspected prior to administration

Question 10

Protocols used

Answer 10

A-8 Asystole/PEA
A-13 Diabetic emergencies
B-6 Pediatric Asystole/PEA
B-15 Pediatric diabetic emergencies
B-17 neonatal resuscitation