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
Revised Date: 
February 2020
Indications: 
  • Fluid and calorie replacement
  • Acute symptomatic episodes of hypoglycemia and insulin-induced hypoglycemia
  • Adjunct to insulin for the treatment of hyperkalemia
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- 10% 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- 10% 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 (2.5-5 mL/kg/dose of 10% solution).
  • >6 mths: 0.5 g/kg/dose (5 mL/kg/dose of 10% solution).
  • Maximum: 25 g/dose

- Hyperkalemia:                

  • 0.5-1 g/kg 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:

  • 5 mL/kg/dose of D10W, MAX 250 mL 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 (>12.5%) via a central venous catheter.
  • For solutions > 10% if extravasation occurs, see Treatment of Infiltrated Vesicant or Irritant Drugs Guidelines on CHEOnet.

 

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

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