Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
АТХ:B.05.B.B.01 Electrolytes
Pharmacodynamics:Provides rehydration. Compensates Na salts+, K+, Ca2+, is involved in the formation of a carbonate ion. Normalizes acid-base state (eliminates metabolic acidosis) and water-electrolyte composition of blood. Replenishes the deficiency of the volume of circulating blood. Has a detoxification effect.
Pharmacokinetics:Calcium ions penetrate the placental barrier and into breast milk. Excretion is performed by the kidneys (potassium ions in the distal tubules in exchange for sodium or hydrogen ions), a small amount is excreted with sweat.
Indications:Replenishment of deficiency of water and electrolytes at saved acid-base state or mild acidosis (vomiting, diarrhea, burns, peritonitis, severe infections); maintaining the volume of extracellular fluid during and after operations; initial therapy of blood deficit, shock, trauma.
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
XI.K55-K63.K59.1 Functional diarrhea
XI.K65-K67.K65 Peritonitis
XVIII.R10-R19.R11 Nausea and vomiting
XVIII.R50-R69.R57 Shock, not elsewhere classified
XIX.T08-T14 Injuries to the unspecified part of the trunk, limb or body region
XIX.T20-T32.T30 Thermal and chemical burns, unspecified
XIX.T79.T79.4 Traumatic shock
XIX.T80-T88.T81.1 Shock during or after the procedure, not elsewhere classified
Contraindications:- hypervolemia;
- hypertonic dehydration;
- hyperkalemia;
- hypernatremia;
- arterial hypertension;
- cardiac and / or renal insufficiency;
- hyperchloremia;
- alkalosis;
- hepatic insufficiency (decrease in the formation of bicarbonate from lactate);
- hyperlactacidemia;
- individual intolerance.
Carefully:- respiratory insufficiency;
- acute dehydration;
- simultaneous treatment glucocorticosteroids.
Pregnancy and lactation: The category of FDA recommendations is not defined. Qualitative and well-controlled studies on humans and animals have not been conducted. Complications are not registered. There is no information on the penetration into breast milk. Complications are not registered.
Dosing and Administration:Intravenous drip introduction, the average daily dose of 1 liter, the maximum daily dose of 2.5 liters.
Side effects:- thrombophlebitis;
- gandpervolemia, hyperhydration, hyperchloremia;
- anxiety;
- allergic reactions.
Overdose:In case of an overdose may develop edema of the optic nerve papilla, brain edema, seizures, hyperthermia. The toxic dose of sodium chloride is 100-150 g.
Treatment of sodium chloride overdose: gastric lavage, symptomatic maintenance therapy, hemodialysis.
Treatment of hyperkalemia (potassium concentration above 6-7 mmol / l, changes in ECG). The appointment of calcium preparations to stop the effects on cardiac conduction (10-20 ml of 10% calcium gluconate solution intravenously, the dose titrated under the control of ECG changes). Short-acting insulin (5-10 units with 50 ml of 50% dextrose intravenously slowly for 5-10 minutes, repeat if necessary), or sodium hydrogen carbonate (with severe acidosis and pH less than 7.2), or salbutamol intravenously or through a nebulizer (enhances intracellular potassium capture, but can also cause cardiac arrhythmias, possibly more effective when used with insulin). Increased potassium excretion using cation-exchange resins (calcium or sodium polystyrene sulfonate or rectally), hemo- or peritoneal dialysis.
Interaction:Dextrose reduces the concentration of potassium in the blood plasma.
For potassium preparations: use with caution with drugs that increase the concentration of potassium (potassium-sparing diuretics, angiotensin-converting enzyme inhibitors; ciclosporin; flavoring agents containing potassium salts; drugs that are potassium salts).
For calcium preparations: thiazide diuretics, vitamin D cause a decrease in renal calcium excretion, an increased risk of hypercalcemia.
Potassium-sparing diuretics can cause the development of hyperkalemia.
Non-steroidal anti-inflammatory drugs, androgens, estrogens, anabolic hormones, corticotropin, mineralocorticoids, vasodilators or ganglion blockers increase Na retention+.
Cardiac glycosides increase the risk of developing their toxic effects (in combination with Ca2+) and glycosidic intoxication; avoid simultaneous appointment.
Special instructions:The concentration and dosage of sodium chloride solution for intravenous use is determined by factors such as age, body weight, clinical condition of the patient and the state of hydration. A careful monitoring of the electrolyte content in the blood plasma is necessary. In case of severe loss of sodium, administer 2-3 l of 0.9% sodium chloride solution for 2-3 hours, then at a slower rate. With the combined loss of water and sodium, it is possible to administer a 0.9% solution of sodium chloride and 5% dextrose in a ratio of 1: 1. With severe hyponatremia, it is possible to prescribe a hypertonic solution of sodium chloride, but too rapid correction can cause serious neurologic disorders.