D50

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GENERIC NAME

Dextrose 50%, D50

BRAND NAME

Dextrose 50%, D50

CLASS

Carbohydrate, hyperglycemic

MECHANISM OF ACTION

Aerobic metabolic substrate (ATP production). Reverses CNS effects of hypoglycemia by rapidly increasing serum glucose levels. Provides short-term osmotic diuresis.

INDICATIONS

Known hypoglycemia, Altered level of consciousness of unknown etiology, Seizures of unknown etiology. Hyperkalemia

CONTRAINDICATIONS

Known thiamine deficiency (relative). Delirium tremens; use with caution in patients with acute alcoholism, may be ineffective without thiamine. Head injury. Intra cranial hemorrhage (relative).Severe pain (paradoxical excitement may occur).

ADVERSE REACTIONS

Cerebral edema in children when given IV undiluted, Worsening elevated ICP or cerebral edema from trauma or cerebral vascular accident. Extravasation leads to severe tissue necrosis. Sclerosing effect on peripheral veins.

NOTES ON ADMINISTRATION

Inducing an unnecessary hyperosmolar state during certain illness/injury states(head injuries,cerebral edema,Intra cranial bleeds,etc.)May worsen neurological outcome.Dextrose is very necrosing to the vascular system,shouldn't be given through small veins

INCOMPATABILITIES/DRUG INTERACTIONS

Sodium bicarbonate, Diazepam will precipitate if given concurrently without flushing

DOSE/ROUTE, AULT

Hypoglycemia, altered level of consciousness or seizures of unknown etiology; 25-100 ml of D50 (12.5-50 Gm, 2 to 2 amps) IV Hyperkalemia; 50 Gm of Dextrose IV total may be given over 1 hour. Pediatric Dosage

ONSET OF ACTION

Seconds

PEAK EFFECTS

Variable

DURATION OF ACTION

Variable

AZ DRUG BOX SUPPLY RANGE

2 - 4 prefilled syringe