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carbohydrates

B05BA03

Forms & Strengths

Intravenous infusion: 5%, 10%, 20%, 50% Dextrose in Water (D5W, D10W, D20W, D50W)
Oral solution/gel: Various concentrations for hypoglycemia

Adult Dosing

Hypoglycemia: 10-25 g IV of D50W, repeat as needed
Parenteral nutrition: 2.5 to 5 mg/kg/min IV, titrated based on metabolic response and glycemic control (max generally 5-7 mg/kg/min)

Pediatric Dosing

Neonates/Infants (Hypoglycemia): 200-500 mg/kg IV (2-5 mL/kg of D10W) slowly
Children (Hypoglycemia): 0.5-1 g/kg IV of D25W or D50W diluted
Parenteral nutrition: Initial 4-8 mg/kg/min IV, adjusted to maintain normoglycemia

Indications

Treatment of severe hypoglycemia
Caloric source in parenteral nutrition
Management of insulin-induced hypoglycemia

Mechanism of Action

Metabolized to carbon dioxide and water, providing a source of dietary calories
Rapidly elevates blood glucose concentrations, halting catabolism and reversing hypoglycemia

Contraindications

Anuria or severe renal failure where fluid administration cannot be tolerated
Intracranial or intraspinal hemorrhage
Severe dehydration
Delirium tremens with dehydration

Adverse Reactions

Hyperglycemia and glycosuria
Fluid overload, pulmonary edema, and peripheral edema
Electrolyte disturbances (hypokalemia, hypomagnesemia, hypophosphatemia)
Venous irritation, thrombosis, and extravasation necrosis (with hypertonic solutions)

Drug Interactions

Insulin and oral antidiabetic agents antagonize the hyperglycemic effect
Corticosteroids may increase blood glucose, requiring careful monitoring
Incompatible with certain drugs in IV admixture (e.g., blood products due to pseudoagglutination)

Curated Content: Needs Vetting Before Put to Clinical Use