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.