NATIONAL
CALIFORNIA
VENTURA
category
mechanism
- A monosaccharide which is a source of calories for cell metabolism.
indications
- Hypoglycemia
- Dilution solution for medications
contraindications
- Hypersensitivity to dextrose, corn or corn products
- Intracranial or intraspinal hemorrhage
- Delirium tremens (if dehydrated)
- Severe dehydration
- Anuria
dosing
Adult:
IV: 10 to 25 g (40 to 100 mL of 25% solution or 20 to 50 mL of 50% solution)
Pediatric:
IV: 0.5 to 1 g/kg/dose (2 to 4 mL/kg/dose of 25% solution, 1 to 2 mL/kg/dose of 50% solution), maximum dose: 25 g/dose
administration
Concentrated dextrose solutions for venous administration must be diluted (maximum concentration: 12.5%) before administration to avoid vein irritation. In emergency situations only, 25% and 50% dextrose can be used. Infuse at a maximum rate of 200 mg/kg over 1 minute.
onset
immediate
duration
varies
notes
- Hypokalemia: Hyperglycemia from glucose infusions will increase circulating insulin levels which moves potassium from the extracellular space to the intracellular space leading to hypokalemia.
- Hypotonic solution: Dextrose is quickly metabolized leaving behind water. By osmosis, this water will move into the interstitial space. For this reason dextrose should not be used as a fluid replacement for hypovolemia - an isotonic solution should be used.
- Creating solutions: Create Dextrose 25% (D25) by mixing 25mL of Dextrose 50% with 25mL of normal saline.
- Naming: Dextrose is one of the two mirror image forms of glucose (D-glucose), so terms dextrose and glucose are essentially interchangeable.
dosage form
IV solution 5%, 10%, 50%
adverse reactions
- Cardiovascular
- Localized vein irritation
- Central nervous system
- Confusion
- Loss of consciousness
- Endocrine & metabolic
- Dehydration
- Glycosuria
- Hyperglycemia
- Syndrome
- Hypervolemia
- Hypokalemia
- Local
- Local pain at injection site
- Respiratory
- Pulmonary edema
structure
