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dextrose (Rx)Brand and Other Names:D50W, DGlucose, more...glucose

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

intravenous solution

  • 2.5%
  • 5%
  • 10%
  • 20%
  • 30%
  • 50%
  • 70%

oral liquid

  • 55%
more...

Hypoglycemia

IV: 10-25 g (ie, 20-50 mL 50% solution or 40-100 mL of 25%)

PO: 4-20 g as a single dose; may repeat after 15 min if self-montoring of blood glucose shows continued hypoglycemia

Dosage Forms & Strengths

intravenous solution

  • 2.5%
  • 5%
  • 10%
  • 20%
  • 30%
  • 50%
  • 70%

oral liquid

  • 55%
more...

Hypoglycemia

Dilute before IV administration, may give more concentrated solution peripherally in emergency (ie, 12.5-25%)

< 6 months

  • 0.25-0.5 g/kg/dose (1-2 mL/kg/dose of 25% solution) IV; not to exceed 25 g/dose 

Infants > 6 months and Children

  • 0.5-1 g/kg up to 25 g (2-4 mL/kg/dose of 25% solution) IV; not to exceed 25 g/dose 

Adolescents

  • IV: 10-25 g (ie, 20-50 mL 50% solution or 40-100 mL of 25%) 
  • PO: 4-20 g as a single dose; may repeat after 15 min if self-montoring of blood glucose shows continued hypoglycemia
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Interactions

Interaction Checker

dextrose and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Hyperosmolarity

            Edema

            Venous thrombosis

            Tachypnea

            Fever

            Hypermolar syndrome

            Hypervolemia

            Phlebitis

            Diarrhea

            Polydipsia

            Pulmonary edema

            Cerebral hemorrhage

            Mental confusion, unconsciousness

            Cerebral ischemia

            Hypophosphatemia

            Hypomagnesemia

            Hyperglycemia

            Injection site extravasation

            Tissue necrosis

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            Warnings

            Contraindications

            Documented hypersensitivity; severe dehydration

            Cautions

            Use caution in DM or carbohydrate intolerance

            Give 5% or 10% dextrose to avoid reactive hypoglycemia when highly concentrated dextrose infusion is abruptly withdrawn

            An unexpected rise in blood glucose level in a stable patient may be an early symptom of infection; monitor for signs and symptoms of infection and laboratory parameters

            Significant hypokalemia may occur from administration of potassium free IV dextrose solutions

            Significant hyponatermia or water intoxication may occur from low sodium or sodium-free IV dextrose solution

            Use caution in patients with diabetes mellitus; reduce the rate of infusion to reduce the possibilities of causing hyperglycemia and glycosuria

            Increased serum osmolality and possible intracerebral hemorrhage may occur from rapid or excessive dextrose administration

            Rebound hypoglycemia may occur following abrupt withdrawal

            Hypertonic solutions (>10%) may cause thrombosis when infused through peripheral veins; best to infuse through a central venous catherer

            Monitor changes in fluid balance, electrolyte concentrations, and acid-base balance during prolonged use

            Caution advised, to avoid air embolism, when infusing medication

            Monitor glucose levels and for possible hyperglycemia when treating pediatric patients

            Dextrose injection contains aluminum that may be toxic; patients with impaired renal function, and preterm infants, at higher risk;. limit aluminum to <4 mcg/kg/day

            Parenteral nutrition associated with liver disease; increased risk in patients who receive parenteral nutrition for extended periods of time, especially preterm infants; monitor liver function tests, if abnormalities occur consider discontinuation or dosage reduction

            Monitor blood glucose and administer insulin as needed

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            Pregnancy & Lactation

            Pregnancy Category: C/A (oral)

            Maternal and fetal hyperglycemia may occur during labor and delivery; monitor

            Lactation: Excretion in milk unknown; use with caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Parenteral dextrose is oxidized to carbon dioxide and water, and provides 3.4 cal/g of d-glucose

            Pharmacokinetics

            Bioavailability: Rapidly absorbed

            Metabolism: dextrose (the monosaccharide glucose) is used, distributed and stored by body tissues and is metabolized to carbon dioxide and water with the release of energy

            Metabolites: Carbon dioxide and water

            Onset of action: 10 min (hypglycemia)

            Peak plasma time: 40 min (PO)

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            Administration

            IV Administration

            Hypertonic dextrose solutions are preferably administered via an IV catheter placed into a large central vein

            If hypertonic (10%) dextrose solutions are administered peripherally, use a large arm vein, if possible, alternate injection site daily

            Except in the emergency treatment of severe hypoglycemia, higher concentrations of dextrose injections (e.g., 20% and higher) should be administered via central veins and only after appropriate dilution

            When used for the emergency treatment of hypoglycemia, hypertonic dextrose injections may be administered slowly via a peripheral vein

            Include final filter to administration protocol and visually inspect container

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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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