Dextrose 10%

 

Note: both adult and pediatric patients should receive only dextrose 10%

 

INDICATIONS & DOSAGE: NH

Adult:

• Hypoglycemia (Hypoglycemia 2.10A): Dextrose 10% IV via premixed infusion bag (preferred) or prefilled syringe until mental status returns to baseline and glucose level is greater than70mg/dL.

 

Pediatric:

• Hypoglycemia (Hypoglycemia 2.10P): Administer dextrose 10% IV via premixed infusion bag (preferred) or prefilled syringe until mental status returns to baseline and glucose level is greater than 60mg/dL or per NH Pediatric Color Coded Appendix 3

• Hypoglycemia (Neonatal Resusciation 2.15): Administer dextrose per Pediatric Color Coded Appendix 3.

 

PEARLS

• An IV pump not required for the administration of dextrose 10%.

• Intraosseous (IO) administration of dextrose should be reserved for hypoglycemic patients with severe altered mental status or active seizures and IV access cannot be obtained.

• There are no statistically significant differences in the median recovery time to a GCS score of 15 following administration of D10% versus D50%. D10% may benefit patients by decreasing the likelihood of post-treatment hyperglycemia and reducing the likelihood of extravasation injury. C Moore, C., Woollard, M., Dextrose 10% or 50% in the treatment of hypoglycaemia out of hospital? A randomised controlled trial, Emerg Med J 2005;22:512-515 doi:10.1136/emj.2004.020693

 

ACTIONS

A monosaccharide, which provides calories for metabolic needs, spares body proteins and loss of electrolytes. Readily excreted by kidneys producing diuresis. Hypertonic solution.

 

WARNINGS

Care should be exercised to insure that the needle (or catheter) is well within the lumen of the vein and that extravasation does not occur.

 

CONTRAINDICATIONS

[None in true hypoglycemia.]

 

SIDE EFFECTS

Cardiovascular: Thrombosis, sclerosing if given in peripheral vein.
Local: Tissue irritation if infiltrates. Extravasation may cause tissue necrosis.

Others: Acidosis, alkalosis, hyperglycemia, and hypokalemia.