Parenteral Manual

Dextrose (STORES PRODUCT)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Glucose
Classification: 
Carbohydrate caloric agent
Original Date: 
August 2005
Indications: 
  • Fluid and calorie replacement- 5% and 10% dextrose solutions
  • Acute symptomatic episodes of hypoglycemia and insulin-induced hypoglycemia- 25% and 50% dextrose solutions
  • Adjunct to insulin for the treatment of hyperkalemia- 25% and 50% dextrose solutions
Reconstitution and Stability: 
  • Store at room temperature not more than 25 °C, protect from freezing and extreme heat
  • Do not use cloudy solutions
  • Discard any unused portions
  • Except for emergency situations, dilute concentrated dextrose solution for peripheral venous administration to a MAXIMUM concentration of 12.5%, solutions with a concentration greater than 12.5% should be administered via a central line.
Compatibility: 

- Please check the specific drug for interactions

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct

YES
Usual dilution: peripheral line- 12.5% dextrose.  In emergency situations, 25% dextrose has been used peripherally

Infusion rate: do not exceed 200 mg/kg/minute

IV Intermittent Infusion NO
IV Continuous Infusion YES
Usual dilution: peripheral line- 12.5% dextrose.  In emergency situations, 25% dextrose has been used peripherally

Infusion rate: 4.5-15 mg/kg/minute

Click here to access SDC Drug Infusion Sheet

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatrics:
- Hypoglycemia:

  • <6 mths: 0.25-0.5 g/kg/dose (1-2 mL/kg/dose of 25% solution).
    Maximum: 25 g/dose
  • >6 mths: 0.5-1 g/kg/dose (2-4 mL/kg/dose of 25% solution).
    Maximum: 25 g/dose

- Hyperkalemia:                

  • 0.5-1 g/kg (using 25% or 50% solution) combined with regular insulin 1 unit for every 4-5g of dextrose given; infuse over 2 hours (infusions as short as 30 minutes have been recommended).

Adolescent/Adults:  
- Hyperkalemia:   

  • 25-50 g dextrose (250-500 mL D10W) with 10 units of regular insulin administered over 30-60 minutes, or alternatively, if urgent, 25 g dextrose (50 mL D50W) combined with 5-10 units of regular insulin infused over 5 minutes.

- Hypoglycemia:

  • 10-25 g dextrose solution (40-100 mL of 25% solution or 20-50 mL of 50% solution) I.V. slowly

                                                   

Potential hazards of parenteral administration: 
  • Pain, phlebitis at injection site due to rapid administration if a peripheral vein is used.
  • Fluid and electrolyte disturbances: hyperglycemia, hypokalemia, hypophosphatemia, reactive hypoglycemia after infusion, glycosuria; side effects can be decreased by decreasing the rate of infusion.
  • Mental confusion, unconsciousness, hyperosmolar syndrome
  • Administer hypertonic solutions (>10%) via a central venous catheter.
  • If extravasation occurs, click HERE for treatment guidelines. 

 

Notes: 
  • Contraindications:  anuria; hypertonic solutions in patients with intercranial or intraspinal hemorrhage; hepatic coma; diabetic coma with hyperglycemia, or patients with delirium tremens and dehydration.
  • Use with caution in premature infants and in patients with diabetes mellitus
  • D5W is 50 mg of dextrose/mL
  • D10W is 100 mg of dextrose/mL
  • D25W is 250 mg of dextrose/mL
  • D50W is 500 mg of dextrose/mL

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.