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Administering D50 safely.

Dextrose 50% (D50) is often given as an intravenous bolus to patients who have hypoglycemia, but many of us have never been taught how to properly administer D50. As the name implies D50 is 50 percent dextrose in water. This makes for a highly concentrated and very thick solution. If D50 infiltrates into the tissue, it can cause tissue sloughing and necrosis and if D50 is given to rapidly it can cause sclerosis of the vein.

Yes, D50 is sugar water--but it's very concentrated sugar water. D50 has a pH of 4. That's like stomach acid! And it is very hyperosmolar with an osmolality of greater than 1,000. These qualities make D50 a caustic drug. Bear these facts in mind the next time that you need to give D50 to your patient; and administer the medication through a central line or through a running IV peripherally.

Lastly, remember that an ampule of D50 will increase the blood glucose by 200. Therefore careful monitoring should be done to assure that the patient doesn't rebound from the D50 and end up with a low blood sugar once again.

References:

Drug label information: http://dailymed.nlm.nih.gov/ dailymed/drugInfo.cfm?id=1600

Moore, C. & Woollard, M. (2005). Dextrose 10% or 50% in the treatment of hypoglycaemia out of hospital? A randomised controlled trial. Emergency Medical Journal, 22: 512-5.

David W. Woodruff, MSN, RN, CNS, CEN www. Ed4Nurses.com, reprinted with permission.
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Title Annotation:News You Can Use; dextrose 50%
Author:Woodruff, David W.
Publication:Nevada RNformation
Article Type:Brief article
Geographic Code:1USA
Date:Aug 1, 2008
Words:240
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