Drug Guide

Generic Name

Dextrose

Brand Names Dextrose 5% in Plastic Container, Dextrose 10% in Plastic Container, Dextrose 50% in Plastic Container, Dextrose 40% in Plastic Container, Dextrose 30% in Plastic Container, Dextrose 20% in Plastic Container, Dextrose 60% in Plastic Container, Dextrose 70% in Plastic Container, Dextrose 60%, Dextrose 2.5% in Plastic Container, Dextrose 38.5% in Plastic Container, Dextrose 50%, Dextrose 25%, Dextrose 7.7% in Plastic Container, Dextrose 5

Classification

Therapeutic: Nutritional supplement

Pharmacological: Carbohydrate (monosaccharide)

FDA Approved Indications

Hypoglycemia
Parenteral nutrition support
Fluid replacement

Mechanism of Action

Dextrose provides glucose, which is utilized by cells for energy production via glycolysis and the citric acid cycle, supporting cellular function and energy metabolism.

Dosage and Administration

Adult: Administer as per medical order based on patient needs and glucose levels; typically 5-25 grams of dextrose with IV infusion, titrated to patient response.

Pediatric: Dosing based on weight and clinical condition; common initial doses are 0.5-1 g/kg of dextrose 5% or 10%.

Geriatric: Adjust dose and infusion rate carefully considering comorbidities and fluid status.

Renal Impairment: Use cautiously; adjust by monitoring blood glucose and osmolarity.

Hepatic Impairment: Use cautiously; monitor for hypoglycemia or hyperglycemia.

Pharmacokinetics

Absorption: Rapidly when administered IV, directly into bloodstream.

Distribution: Distributed quickly throughout body water compartments.

Metabolism: Metabolized primarily in the liver via glycolysis and stored as glycogen.

Excretion: Excreted mainly in urine.

Half Life: Approximately 20-30 minutes, varying with infusion rate and metabolic rate.

Contraindications

Hyperglycemia
Diabetic ketoacidosis
Known hypersensitivity to dextrose

Precautions

Monitor blood glucose levels during infusion, especially in diabetics.
Use with caution in patients with heart failure or renal impairment.

Adverse Reactions - Common

Hyperglycemia (Rare with appropriate monitoring)
Fluid overload (e.g., pulmonary edema) (Rare, with rapid infusion)

Adverse Reactions - Serious

Hyperglycemic hyperosmolar state (Very rare)
Serious allergic reactions (Rare)

Drug-Drug Interactions

Insulin and other hypoglycemic agents (dextrose may alter their requirements)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose, serum electrolytes, fluid status, and signs of hyperglycemia or hypoglycemia.

Diagnoses:

Risk for unstable blood glucose levels
Fluid volume imbalance

Implementation: Infuse via appropriate IV line, monitor infusion rate and site, and check blood glucose regularly.

Evaluation: Maintain blood glucose within target range, monitor for signs of fluid overload or dehydration.

Patient/Family Teaching

Report symptoms of hyperglycemia (excessive thirst, frequent urination) or hypoglycemia (shaking, sweating).
Maintain hydration and inform healthcare provider of any adverse effects.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: None specific to dextrose.

Lab Test Interference: May affect blood glucose measurements.

Overdose Management

Signs/Symptoms: Hyperglycemia, fluid overload, pulmonary edema.

Treatment: Discontinue infusion, provide supportive care, administer insulin if needed, and manage fluid status.

Storage and Handling

Storage: Store at room temperature, protect from light.

Stability: Stable until expiration date on container.