Supplementation of lost extracellular fluid in the case of isotonic dehydration, with the occurrence of acidosis or in the case of imminent danger of acidosis.
Composition:
1000 ml of solution for infusion contains 6.8 g of sodium chloride, 0.3 g of potassium chloride, 0.2 g of Magnesium chloride hexahydrate, 0.37 g of Calcium chloride dihydrate, 3.27 g of sodium acetate, 0.67 g of L acid -jabłkowego; electrolyte concentration - 145 mmol / l sodium, 4 mmol / l potassium, 1 mmol / l Magnesium, 2.5 mmol / l Calcium, 127 mmol / l chlorine, 24 mmol / l acetate, 5 mmol / l malate. Theoretical osmolarity: 309 mOsmol / l. pH 5.1-9.9
Action:
Isotonic solution of electrolytes with electrolyte concentrations adjusted to the concentrations of these substances in the plasma. The purpose of administering the solution is to restore and maintain normal osmotic conditions in the extracellular and intracellular space. The anionic standard reflects the balanced content of chlorides, acetate and malate that counteract metabolic acidosis. The bioavailability of ingredients is 100%.
Contraindications:
Hypervolemia. Severe congestive heart failure. Renal failure with oliguria or anuria. Severe generalized edema. Hyperkalemia. Hypercalcemia. Metabolic alkalosis.
Precautions:
High volume infusions can be used under specific monitoring conditions in patients with mild to moderate heart or lung failure. Solutions containing sodium chloride should be administered with caution in patients with mild to moderate heart failure, peripheral or pulmonary edema or excess extracellular fluid, with hypernatremia, hyperchlororrhea, hypertonic dehydration, hypertension, renal impairment, eclampsia or in the event of imminent danger of its occurrence. , aldosteronism or other conditions or patients undergoing treatment (e.g., corticoids / steroids) associated with sodium retention. Solutions containing potassium salts should be administered with caution to patients with heart disease or conditions predisposing to hyperkalemia, such as renal or adrenal insufficiency, acute dehydration or extensive tissue damage that occurs in severe burns. Due to the presence of calcium, caution should be exercised to prevent extravasation during intravenous infusion and the solution should be administered with caution to patients with impaired renal function or diseases associated with the presence of elevated levels of vitamin D, such as sarcoidosis. In the case of the accompanying blood transfusion, the solution must not be administered using the same infusion set. Solutions containing metabolite anions should be administered cautiously to patients with respiratory failure. It is necessary to monitor electrolytes in serum, fluid balance and pH. During long-term parenteral therapy, the patient should be provided with nutrients in a suitable form.
Pregnancy and lactation:
There are no data on the use of the drug in women during pregnancy and lactation. In cases specified in the indications, when volume, electrolytes and acid / base concentrations are closely monitored, no hazards are anticipated. The drug should be used with caution in the case of gestational toxemia.
Side effects:
Following intravenous administration of magnesium salt, isolated cases of hypersensitivity reactions characterized by urticaria have been reported. After infusion of intravenous magnesium sulphate, paralytic intestinal obstruction has rarely been reported. Adverse reactions, including fever, infection at the injection site, local pain or reaction, vein irritation, venous thrombosis or phlebitis spreading from the injection site and extravasation, may be associated with the administration technique. Adverse reactions may be associated with drugs added to the solution.
Dosage:
Intravenously. Adults, including the elderly, adolescents: 500 ml to 3 l / day, which corresponds to 1-6 mmol sodium / kg / day and 0.03-0.17 mmol / kg / day. Infants, children: 20 to 100 ml / kg / day, corresponding to 3-14 mmol sodium / kg / day and 0.08-0.4 mmol potassium / kg / day.The maximum infusion rate depends on the patient's need to replenish fluids and electrolytes, body weight, clinical and biological status. In infants, the infusion rate is on average 5 ml / kg / h, but the value depends on the age: 6-8 ml / kg / infant, 4-6 ml / kg / kg of small children and 2-4 ml / kg mc./hu school-age children. The medicine can be given as long as there are indications for topping up fluids. The drug can be infused into peripheral veins.
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