COLLEGE OF NURSING Student: _________________________ Block:___________

PHARMACOLOGICAL MANAGEMENT

DRUG STUDY

Brand Name: Injectafer Generic Name: dextrose 50% Drug Classification: ________Hypoglycemia Antidotes________

Dosage, Route & Frequency Drug-Drug & Drug- Side Effects Adverse Reactions
Drug Action Indications Contraindications
Recommended Prescribed Food Interactions (By System) (By System)
Acute Alcohol When administered Drug-drug: Indicated in the A concentrated Integumentary:
Intoxication intravenously this treatment of insulin dextrose solution Signs of an allergic
solution restores The risk of toxicity hypoglycemia to should not be used Integumentary:
reaction, like rash;
25-50 g (50- blood glucose levels can be increased restore blood glucose when intracranial or Warmth, pain,
100 mL of D50W hives; itching; red,
in hypoglycemia and by diazoxide with levels. The solution is intraspinal burning from
solution); administer swollen, blistered,
provides a source of thiazide diuretics also indicated, after hemorrhage is medication infusion,
with thiamine (50-100  or peeling skin with
mg IV) to prevent carbohydrate since these the two dilution, for present, nor in the thrombophlebitis,
calories. intravenous infusion presence of delirium or without fever.
Wernicke's encephaliti of them are rhabdomyolysis,
s Carbohydrate in the as a source of tremens if the patient
structurally similar. severe tissue Respiratory:
form of dextrose may carbohydrate calories is already dehydrated.
damage (necrosis) wheezing; tightness
Sulfonylurea Overdose aid in minimizing liver Anticoagulation in patients whose oral
glycogen depletion intake is restricted or
in the event of in the chest or
effects will be extravasation. throat; trouble
10-25 g (40- and exerts a protein- inadequate to
100 mL of D25W improved by breathing,
sparing action.  maintain nutritional
solution or 20-50 mL of Glucagon with oral requirements. swallowing, or
D50W solution) IV; anticoagulants.
may require repeated
talking; unusual
boluses hoarseness.

Insulin Overdose Head, Mouth, ENT:

Very bad dizziness
400-600 mg or passing out,
of glucose/kg/hour Swelling of the
needed for most insulin
mouth, face, lips,
overdoses
Alternatively, tongue, or throat.
administer 25-50 g Endocrine: Blood
(D50W) IV; sugar stays low
may repeat doses in
after stopping the
severe cases;
determine glucose
levels before injecting drug.
dose; in emergencies,
may administer
promptly before
obtaining glucose
results

Hyperkalemia

25-50 g (250-
500 mL D10W) plus 10
units regular insulin IV
over 30-60 min

Insulin Induced
Hypoglycemia

Children under
6 months: 250-500
mg/kg/dose (1-2
mL/kg/dose D25W)  
Children over 6
months: 0.5-
1g/kg/dose (2-4
mL/kg/dose D25W)

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
ASSESSMENT: INTERVENTION:

 Assess for contraindications and cautions: history of allergies, renal and hepatic  Monitor and observe the patient during administration.
dysfunction, pregnant women to prevent adverse reactions.  Document baseline data. Before infusion, assess the patient’s vital signs,
 Perform a complete physical assessment to establish a baseline before edema status, lung sounds, and heart sounds. Continue monitoring during and
beginning therapy, monitor effectiveness of therapy, and evaluate for any after the infusion.
potential adverse effects during therapy.  Monitor and observe the patient during administration. Hypertonic solutions
 Track laboratory test results, including urinalysis, to assess for glucosuria, serum should be administered only in high acuity areas with constant nursing
glucose to evaluate therapy reaction, and tests of renal and liver function to surveillance for potential complications
evaluate the need for possible dosage modification or to detect potential toxic  Prevent fluid overload. Ensure that administration of hypertonic fluids does not
effects. precipitate fluid volume excess or overload. 

DIAGNOSIS:  Do not administer peripherally. Hypertonic solutions can cause irritation and

damage to the blood vessel and should be administered through a central
  Imbalanced nutrition: more than body requirements related to metabolic effects. vascular access device inserted into a central vein. 

PLANNING:  Monitor blood glucose closely. Rapid infusion of hypertonic dextrose solutions

can cause hyperglycemia. Use with caution for patients with diabetes mellitus. 
 Review any patient data that may be a contraindication to the medication. 
 Review patient’s other medication to prevent potential drug interaction
EVALUATION:
 Develop a patient teaching about the patient as well as SO, esp. about some
important specifics concerning the administration of the drug.  Restores blood glucose levels in patients with hypoglycemia.
 During emergency have insulin on hand to treat serious hyperglycemia if it
happens due to overdose.
 Monitor nutritional status to provide nutritional consultation as needed.
 Provide comfort measures to help patient cope with drug effects
