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D50 TO D25 OR D10

Posted · Report post

Hi guys... hitting you with more exciting questions....

My protocols have 3 concentrations of dextrose for adults (d50), ped's(d25) and neonates (d10). My drug sheet states to make d25 just eject half the d50 ampule and refill it with NS (pretty obvious one). I want to be able to do d10 on the fly as well so just to check my math: Eject 80% of the d50 ampule and refill it which makes 50cc of 10% solution correct?

Thanks for your time =)

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Posted · Report post

The simple way I've found is to take the D50 syringe (25 grams), and add it to a 250 mL bag of NS. This gives you a ~7.5% concentration of dextrose without the withdrawing step. Another option is to add the 25 grams to a 250 mL bag of D5. This results in D12.5 and is diluted enough to not cause the phlebitis issue.

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Posted · Report post

First off.. never.. ever.. give 250ml of fluid to a neonate.

Easy med math here..

Start with the doctors order (or protocol) which is asking for d10 (7.5g) divide by how much drug you have (25 g) and multiply by how many mL's it comes in (50mL) and that will give you how many mL you need to infuse 7.5g of dextrose which comes to 15mL.

Want to dilute it? 20mL syringe, draw up 15mL of D50 and 5mL of NS and that's probably the most fluid I'd give a neonate, if that.

This method works for most meds... Demerol (35mg) and is supplied by 50mg/2mL.

35mg / 50mg * 2mL = 1.4mL of demerol you need to push.


This is how I set this up on paper... start with mg (what is ordered/needed to give, can be mg, g, or mcg, depends on the drug) divided by mg (how many mg, g, mcg the drug is supplied in, remember keep your titles the same mg/mg, or g/g, etc) then multiply by mL it's supplied in and it will lead you to x (the answer in mL needed to give). ALWAYS START WITH WHAT IS ORDERED (or what dose is protocol) in the upper left hand corner.

Hope it makes sense... I tried to make an equation but when I post it; it doesn't come out correctly.

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Posted · Report post

You want to make D10.

The drug is for the neonate patient, so we are talking about a very small amount of the drug.

I also am assuming that you protocol wants you to give the neonate 1-2cc's of D10 per Kg. So again, we are talking about a low volume bolus.

AZCEP's methods work fine, but I am just giving you my method in case your company does not buy 250ml bags.

Pull 4cc of D50 into a 20cc syringe. Then pull 16cc's of saline to dilute. This puts 2 grams in 20 cc's, and gives you a 10% solution. This amount should be just slightly more than adequate to administer to a neonate.

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Posted · Report post

Thanks guys. The hypoglycemic protocol calls for 3cc/kg of d10 for the neonate so you're right it won't be very much volume!

The protocol actually has:

1cc/kg d50 for > 2y/o
2cc/kg d25 for < 2 y/o
3cc/kg d10 for neonates

Isn't that basically the same amount of sugar just diluted 2 as 3 times respectively? Could I then just draw up some d50 and then either double or triple the volume with NS and have my correct concentration?

Thanks agin!

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Posted · Report post

Yes jwraider, all you are really changing is the volume that the dextrose is contained in. How to get there depends largely on what you have available to you.

Many ways to accomplish the same end result.

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Posted · Report post

[quote name='jwraider']Thanks guys. The hypoglycemic protocol calls for 3cc/kg of d10 for the neonate so you're right it won't be very much volume!

The protocol actually has:

1cc/kg d50 for > 2y/o
2cc/kg d25 for < 2 y/o
3cc/kg d10 for neonates

Isn't that basically the same amount of sugar just diluted 2 as 3 times respectively?[/quote]

[color="red"] 1cc/kg d50 for > 2y/o[/color] 1cc= 500mg
[color="red"]2cc/kg d25 for < 2 y/o[/color] 2cc= 500mg
[color="red"]3cc/kg d10 for neonates[/color] 3cc= 300mg

[quote name='jwraider']Could I then just draw up some d50 and then either double or triple the volume with NS and have my correct concentration?[/quote]

Three people gave you three different and acceptable ways make D10.



I am not trying to call you out, but I must ask.

Do you know how to do the calculations for drug concentrations?

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Posted · Report post

Feel free to call me on anything I don't want to be out there making stupid mistakes but yes I can sit down and calculate drip rates and concentrations etc. I was worried about running the actual call and being faced with a very sick kid and wanted to make sure my shortcuts weren't changing the dosage.

My previous post was about recognizing that the protocol was calling for more dilution not less dextrose as the PT gets younger.

Thanks again

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Posted · Report post

I was just curious if you knew. It is easy to give you the answer, but better if you know how we got the answer.

Everyone should always want to be prepared for the "sick" patients. Good idea to work out bottle necks you may face when you are caring for a very sick patient!

For neonates, the dosage is slightly lower than for Peds and adults.

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