Dextrose 50%

Indications

Dextrose 50% is used for: Parenteral Nutrition and Hydration, Hypoglycemia, Hyperkalaemia

Adult Dose

Intravenous Hypoglycaemia Adult: 10-25 g (20-50 ml of 50% solution). Doses may be repeated in severe cases. Hyperkalaemia Adult: 25-50 g combined with 10 units of regular insulin, administered over 30-60 minutes; may repeat if necessary. Alternatively, 25 g combined with 5-10 units of regular insulin infused over 5 minutes; may repeat if necessary.

Child Dose

Intravenous Hypoglycaemia Child: <6 mth: 0.25-0.5 g/kg/dose; >6 mth: 0.5-1 g/kg/dose. Doses may be repeated in severe cases. Max: 25 g/dose. Hyperkalaemia Child: and infants: 0.5-1 g/kg (using 50% solution) combined with regular insulin (1 unit for every 4-5 g dextrose given); infuse over 2 hr, may repeat if necessary.

Renal Dose

Administration

Contra Indications

The infusion of hypertonic dextrose injections is contraindicated in patients having intracranial or intraspinal hemorrhage, in patients who are severely dehydrated, in patients who are anuric, and in patients in hepatic coma. Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products.

Precautions

Care should be taken to avoid circulatory overload, particularly in patients with cardiac insufficiency. Caution must be exercised in the administration of these injections to patients receiving corticosteroids or corticotropin. These injections should be used with caution in patients with overt or subclinical diabetes mellitus. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Do not administer unless solution is clear and seal is intact. Lactation: Excretion in milk unknown; use with caution

Pregnancy-Lactation

Pregnancy Category: C Maternal and fetal hyperglycemia may occur during labor and delivery; monitor Lactation: Excretion in milk unknown; use with caution

Interactions

Adverse Effects

Side effects of Dextrose 50% : Venous thrombosis, phlebitis, hypovolemia, hypervolemia, dehydration, oedema, fever, mental confusion, unconsciousness, hyperosmolar syndrome, hyperglycaemia, hypokalaemia, acidosis, hypophosphataemia, hypomagnesemia, polyuria, glycosuria, ketonuria, nausea, diarrhoea, polydipsia, vein irritation, tissue necrosis, pulmonary oedema, tachypnoea.

Mechanism of Action

Dextrose is a monosaccharide that is used as a source of calories and water for hydration. It helps to reduce loss of body protein and nitrogen. It also promotes glycogen deposition in the liver. When used with insulin, it stimulates the uptake of potassium by cells, especially in muscle tissue, thus lowering serum potassium levels.