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Poisoning Information for the Public & Health Care Professionals
Last updated: 09/2020
Antidote
Adult

Dextrose

Glucose, d-glucose

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Antidote
Adult

Dextrose

Glucose, d-glucose

Indications

  • Treatment of hypoglycemia
  • Concurrent treatment with high dose insulin for beta blocker or calcium channel blocker toxicity 

Dosage

For Hypoglycemia:

  • IV Direct: 20-50 mL (10-25 g) dextrose 50%. Repeat as needed.

For Beta Blocker and/or Calcium Channel Blocker Toxicity:

  • IV Direct:  50 mL of dextrose 50%

Infusion:

  • 0.25-0.5 g/kg/hour . Titrate to maintain serum glucose 6-14 mmol/L
    • Peripheral IV:  2.5 – 5 mL/kg/hour of dextrose 10%
    • Central Line:  0.5-1 mL/kg/hour of dextrose 50%
  • In the context of high dose insulin treatment for beta blocker or calcium channel blocker toxicity: dextrose infusion may need to continue for approximately 24 hours after insulin is discontinued, as rebound hypoglycaemia may occur

Administration

IV Direct: Use pre-filled syringes of dextrose 50% or withdraw from 50 mL vial

Infusion 

For a central line, place 50% dextrose in an empty IV bag. 

For a peripheral line, use dextrose 10%. 

If dextrose 10% is not available, dextrose 9.5% can be prepared and used in place of dextrose 10% according to the following instructions:

  • Remove 50 mL dextrose 5% from a 500 mL bag.  Add 50 mL dextrose 50%. Label bag appropriately.

       OR

  • Remove 100 mL dextrose 5% from a 1000 mL bag.  Add 100 mL dextrose 50%. Label bag appropriately.

Compatibility, Stability

  • Dextrose 50% has an acidic pH (3.5-5) and therefore specific compatibility information should be consulted when dextrose 50% is injected into an IV line containing another drug.
  •  Store at room temperature. Do not use cloudy solutions.

Potential Hazards of Administration

  • Pain, phlebitis and/or thrombosis at injection site.
  • Tissue necrosis may result if extravasation occurs.
  • Hyperglycemia and glycosuria.
  • Hyperosmolar syndrome. Signs include mental confusion and loss of consciousness especially in patients with chronic uremia or carbohydrate intolerance.
  • May cause fluid or solute overload leading to fluid and electrolyte disturbances (especially phosphate and potassium), overhydration or fluid congestion.
  • May cause vitamin B complex deficiency.

Miscellaneous

  • Consider the administration of thiamine in potential thiamine-deficient patients (e.g., alcoholic malnourished) 
  • Draw blood glucose or check Chemstrip® before administering. In emergency situations administer without waiting for lab results.
  • Dextrose 50% has an osmolarity of 2526 mOsm/L. 

 


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