Potassium chloride + Calcium chloride + Magnesium chloride + Sodium acetate + Sodium chloride - instructions for use, dose, side effects, contraindications

Clinical and pharmacological group: & nbsp

Rehydrates

Included in the formulation

Quintasol

solution in / in

BIOSINTEZ, PAO Russia

Ringer's acetate

solution in / in

EAST-PHARM, LLC

Ringer's acetate

solution in / in

MEDPOLIMER, OJSC Russia

АТХ:

B.05.B.B Solutions affecting the water-electrolyte balance

Pharmacodynamics:

The drug eliminates metabolic acidosis, normalizes the acid-base and water-electrolyte composition of the blood. The therapeutic effect is due to a temporary increase in the volume of circulating blood, replenishment of the deficiency of Na ions⁺, K⁺, Ca²⁺, Mg²⁺, as well as by the conversion of the acetate ion to bicarbonate.

Pharmacokinetics:

Calcium and magnesium ions penetrate the placental barrier and into breast milk. Renal excretion is performed (potassium ions - in distal tubules in exchange for sodium ions or hydrogen), a small amount excreted in sweat. 25-30% of magnesium binds to plasma proteins. After infusion solution healthy volunteers kidney provide rapid excretion of water, sodium excretion slower and leads to a small cellular dehydration. The translocation of the liquid is 18% of the infusion volume and is maintained for 2 hours.

Indications:

- shock, thermal injury, acute blood loss;

- hypohydration (isotonic and hypotonic forms);

metabolic acidosis;

- acute diffuse peritonitis, intestinal obstruction (for correction of water balance);

- decompensation of electrolyte disturbances in patients with intestinal fistula;

- therapeutic plasmapheresis (dialysis filtration method).

ICD-10

IV.E70-E90.E86 Reduction of the volume of the liquid

IV.E70-E90.E87 Other violations of water-salt metabolism or acid-base balance

IV.E70-E90.E87.2 Acidosis

XI.K55-K63.K56.6 Other and unspecified intestinal obstruction

XI.K55-K63.K63.2 Intestinal fistula

XI.K65-K67.K65.0 Acute peritonitis

XVIII.R50-R69.R57.9 Shock, unspecified

XVIII.R50-R69.R58 Bleeding, not elsewhere classified

XIX.T20-T32.T30 Thermal and chemical burns, unspecified

Contraindications:

Hypersensitivity, alkalosis, extracellular hyperhydration, hypertonic dehydration, hypernatremia. Conditions in which the introduction of large volumes of fluid is contraindicated: severe chronic heart failure, cerebral edema, pulmonary edema, anuria.

For sodium chloride: with caution in hypertension, heart failure, peripheral edema or pulmonary edema, renal failure, pre-eclampsia, and other conditions associated with sodium ion retention.

For potassium chloride: with caution in heart diseases and conditions predisposing to hyperkalemia (renal or adrenal insufficiency, acute dehydration, massive tissue damage, for example, with severe burns). Regular monitoring of the clinical condition, concentration of electrolytes in the blood plasma, and ECG is necessary. Do not use for hyperchloremia.

For calcium chloride: with caution in renal failure, diseases associated with increased calcium concentrations (sarcoidosis, some malignant tumors). Do not use in patients with calcium kidney stones or stones in the kidneys in the anamnesis. Regular monitoring of calcium in patients with renal insufficiency and simultaneous administration of high doses of vitamin is required.

For magnesium chloride: with caution in cardiac blockade and severe renal failure, myasthenia gravis gravis.

Carefully:

Heart failure, arterial hypertension, renal and / or liver failure, oliguria.

Pregnancy and lactation:

Qualitative and well-controlled studies on humans and animals have not been conducted. There is no information on the penetration into breast milk.Complications are not registered.

The category of FDA recommendations is not defined.

Dosing and Administration:

Assign intravenous drip (60-80 drops per minute) or spray; daily dose - 5-20 ml / kg (up to 30-40 ml / kg). The course of treatment is 3-5 days.

For therapeutic plasmapheresis (dialysis filtration method) - enter in a double volume in comparison with the removed plasma (1,2-2,4 l), with pronounced hypovolemia - together with colloidal solutions.

Side effects:

When large volumes of solution are introduced, hyperhydration, chloride acidosis, hypernatremia, hypokalemia are observed.

Overdose:

Symptoms: edema of the papillae of the optic nerve, cerebral edema, convulsions, hyperthermia. The toxic dose of sodium chloride is 100-150 g.

Interaction:

It is possible to increase sodium retention in the body while taking non-steroidal anti-inflammatory drugs, androgens, estrogens, anabolic hormones, corticotropin, mineralocorticoids, vasodilators or ganglion blockers.

When taking with potassium-sparing diuretics - the development of hyperkalemia.

Calcium in combination with cardiac glycosides increases the likelihood of their toxic effects.

Special instructions:

In the treatment of severe hypovolemia, simultaneous therapy with colloidal solutions, blood and its components (due to the short-term action of the drug) is recommended.

With prolonged administration of large doses of solution, it is desirable to monitor electrolytes in plasma and urine.

Instructions

Potassium chloride + Calcium chloride + Magnesium chloride + Sodium acetate + Sodium chloride (Kalii chloridum + Calcii chloridum + Magnii chloridum + Natrii acetas + Natrii chloridum)