NAME: GIRLIE JANE V.

SEVILLANO DATE: MAY 4, 2012 Generic/Trade Name Date Ordered Classification

Caloric Agent; Nutritive Agent / Carbohydrate

DRUG STUDY
Dosage and Frequency
PREPARATION 25 g/50 ml preload (D50W)

Mechanism of Action
Hyperglycemic; rapidly increases circulating blood glucose levels Transient osmotic diuretic Onset: < 1 minute

Dextrose in Water (50%)

D50W

ROUTE OF ADMINISTRATION
Intravenous (IV) Adult: 12.5 - 25 gm D50W slow IV, repeat PRN x 1 (NOTE: If blood sugar <60mg/dL and the patient have signs and symptoms of hypoglycemia, administer 50% Dextrose in Water (50ml) slow intravenous push) Pediatric: 0.5 gm/kg D25W slow IV to a maximum of 25 gm (dilute D50W 1:1 with NS), repeat PRN x 1 (NOTE: If blood sugar <60mg/dL and the patient have signs and symptoms of hypoglycemia, administer dextrose as follows) Neonates (Birth to 30 days): 2.55ml/kg of 12.5% Dextrose in Water Infants (30 days to 1 year): 12ml/kg of 25% dextrose in Water Children (>1 year): 0.5-1ml/kg of 50% Dextrose in Water

Peak: Depends on degree of hypoglycemia Duration: Depends on degree of hypoglycemia

Indication
Documented, suspected or known hypoglycemia (BS <80mg/dL) Seizures of unknown etiology Cerebral / meningeal edema related to eclampsia Coma of unknown origin

Contraindication
Increased intracranial or intraspinal hemorrhage Delirium tremens in dehydrated patients Glucose-galactose malabsorption syndrome Diabetic coma and hyperglycemia Allergy to corn or corn products Anuria

Adverse reaction SIDE EFFECTS

Cardiovascular: tissue necrosis, thrombophlebitis Endocrine: hyperglycemia, aluminum toxicity, rebound hypoglycemia, hypokalemia, hypomagnesemia, hypophosphatemia Immunologic: anaphylaxis Gastrointestinal: nausea Neurological: cerebral ischemia, intracerebral hemorrhage Renal: glycosuria Respiratory: pulmonary edema

Nursing Responsibility PRECAUTIONS

Extravasation of the tissue; infiltration of dextrose may result in tissue necrosis

Localized venous irritation may occur when smaller veins are used Wernickes encephalopathy in the alcoholic patient due to probable thiamine deficiency Should not be used as a diagnostic agent in the patient with altered LOC unless the BS is known to be <80mg/dL or, if BS cannot be determined, patient is known to be diabetic.

ADVERSE EFFECTS
Pain, phlebitis or tissue necrosis at injection site if infiltration occurs Hyperglycemia and glycosuria Fluid overload; may aggravate HTN and CHF

If CVA or head trauma is suspected as the cause of altered mental status, contact medical control physician prior to administration. Patients with diabetes mellitus or carbohydrate intolerance. Suspected hemorrhage. intracranial

IV COMPATABILITY
NS (Normal Saline Sodium Chloride 0.9 %)

INTERACTIONS / STABILITY
Dextrose 50% has an acidic pH (3.5

5) and therefore specific compatibility information should be consulted when Dextrose 50% is injected into an IV line containing another drug

SPECIAL CONSIDERATIONS
Rapid rates of administration predisposes the patient to pain and may cause phlebitis if a peripheral vein is used; to minimize this effect administer slowly Excessive IV administration may cause fluid overload, water intoxication, +/or CHF D50W and Thiamine 100 mg IV (mini bag or IVP) should be given together when alcoholism or malnutrition are suspected