D50W*

• D₅₀W

• Dextrose 50%

Classification:

• Carbohydrate

Mechanism of Action:

• Increases blood glucose levels
• Hypertonic solution producing a transient movement of water from interstitial spaces into the venous system
  

Indications:

• Hypoglycemia (< 4.0 mmol/L who are unable to take oral glucose)

Contraindications:

• Hyperglycemia

Precautions:

• Tissue necrosis if infiltration occurs
• May precipitate severe neurological symptoms in alcoholics (thiamine should be consider prior to administration)
• Patients with increased intracranial pressure may worsen cerebral edema

Adverse Effects:

• Phlebitis
• Tissue necrosis
• Rebound hyperglycemia

Dose:

Adult:

• 25 g IVP, may repeat once if symptoms do no resolve and glucometer reading remains less than 4.0 mmol/L

Pediatric:

• 0.5 - 1 g/kg slow IVP; dilute 1:1 with sterile water (NS can be used if no sterile water available) forming D₂₅W
• May repeat once
• Maximum total dose of 25 g

• IV, IO

• To make a D₂₅W solution from D₅₀W:
  • Dispose of 25 mL of the D₅₀W solution from the preloaded syringe and replace with 25 mL of normal saline.

OR

• • Draw 25 mL of the D₅₀W solution from the 50 mL vial using a 50 mL syringe and vial access spike, then add 25 mL of normal saline.

• Compendium of Pharmaceuticals and Specialties (CPS)
• Pharmacology for the Prehospital Professional 2^nd Edition