D5W (Dextrose 5%)

Class
Water solution and carbohydrate source


Pharmacological Effects
1. Provides calories for some metabolic needs. Each 100 mL provides 5 gm of Dextrose. Depending on the presence of insulin, glucose enters cells and is broken down to pyruvate. With adequate oxygen, it enters the Kreb's cycle in the mitochondria and is converted into energy (A.T.P.), CO2 and H2O. The brain and gonads do not require insulin for glucose metabolism.
2. Supplies body water for hydration.
3. Spares body protein by providing carbohydrate for metabolism.
4. Osmolarity of D5W is 252 mOsm/L. The fluid is isotonic when in the container. After administration, the dextrose is quickly metabolized in the body, leaving only water - a hypotonic fluid.
5. The pH range is 3.5 - 6.5.
6. Capable of producing diuresis depending on clinical state of the patient.


Uses
1. Adult I.V. solution to keep vein open.
2. Vehicle for mixing medications for I.V. delivery for all age groups.
3. It may be the primary adult I.V. fluid for medical emergencies, though many services use only L.R. or N.S.


Duration of Action
1. Glucose use depends on metabolic rate. It is stored in the liver and muscle as glycogen.
2. Water use depends on clinical state of patient, body temperature and renal function. Excreted through the skin, lungs, and kidney.


Side Effects
1. Hyperglycemia.
2. Fluid overload.


Contraindications
1. Patients at risk for increased I.C.P.
2. Patients who have an acute neurological dysfunction.
3. Hypovolemic states.
4. Patients at risk for third-space fluid shifts.
5. Elevated blood glucose concentrations.


Precautions/Information
1. Since the tonicity is low, avoid using in head injury patients.
2. Use sterile technique in venipuncture and equipment assembly, with all venipunctures
3. Do not administer quantity in excess of that required to keep vein open or administer appropriate dose of medication.
4. Do not use solution if outdated, cloudy or the seal is not intact, as with all IV solutions.
5. Monitor E.C.G. continuously.
6. Monitor blood pressure, pulse rate and respiratory rate frequently.