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Poisoning Information for the Public & Health Care Professionals
Last updated: 03/2023
Antidote
Pediatric

Dextrose

Glucose, d-glucose

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Antidote
Pediatric

Dextrose

Glucose, d-glucose

Indications

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

Dosage

For Hypoglycemia:

IV Direct:

     0.25 g/kg  (1 mL/kg of dextrose 25%).  Repeat as needed

For Beta Blocker and/or Calcium Channel Blocker Toxicity:

IV Direct:

      0.25 g/kg  (1 mL/kg of dextrose 25%).

Infusion: Titrate to maintain serum glucose 6-14 mmol/L

          Peripheral IV: 0.25 to 0.5 g/kg/hour (2.5 to 5 ml/kg/hour of dextrose 10%)  

          Central line: 0.25 to 0.5 g/kg/hour (1 to 2 ml/kg/hour of dextrose 25%) 

  • 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

NOTE:

  • Dextrose 10% = dextrose 0.1 g/mL
  • Dextrose 25% = dextrose 0.25 g/mL

Administration

IV Direct:  To prepare dextrose 25% - use a 1:1 dilution of dextrose 50% and sterile water for injection (equal volumes of each)

Example: For a final volume of 50 mL, dilute 25 mL of dextrose 50% with 25 mL of sterile water for injection

Infusion

For a central line, prepare dextrose 25% as above.

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

  • Dextrose 25% has an osmolarity of 1263m/L. 

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