Sodium chloride 0.9% is a plasma replacing medical tool. This pharmacological drug is produced by Solopharm in the form of a clear, colorless liquid, which contains the main active element - sodium chloride and an auxiliary substance in the form of water for injection.
200 ml vials. Sodium chloride 0.9% has a theoretical osmolarity of 308 mOsm / l.
In the process of creating the composition, salts are introduced into distilled water. Each subsequent component is added after the previous one has completely dissolved. To prevent sediment in the liquid, carbon dioxide is passed through sodium bicarbonate. Glucose is introduced into the solution of the latter.
Pharmacological properties
This medication has a rehydrating and detoxifying effect, compensates for the lack of sodium in various pathological conditions and temporarily increases the volume of fluid that circulates in the vessels of the body.
The pharmacodynamic properties of sodium chloride 0.9% are due to the presence of chloride ions and sodium ions. A number of ions, for example, sodium ions, are able to penetrate through cell membranes using various transport mechanisms, among which the sodium-potassium pump is most important. Sodium plays a major role in the transmission of impulses in neurons, metabolic processes in the kidneys and electrophysiological functions of the heart.
Sodium is excreted mainly by the kidneys, but its large volume undergoes renal reabsorption. A small amount of sodium is excreted through the intestines with feces, as well as through sweating.
A 0.9% sodium chloride solution is isotonic to human plasma, therefore, it is rapidly excreted from the vascular bed, only temporarily increasing the volume of fluid. The concentration of sodium ions is 145 mmol / L (interstitial fluid) and 142 mmol / L (plasma), the chloride concentration is 101 mmol / L.
Indications for appointment
The medicine sodium chloride 0.9% is prescribed for the following pathological conditions of a man:
- hyponatremia;
- extracellular isotonic dehydration.
In addition, this medication is used to dissolve and dilute parenteral pharmacological substances (as a basic solution).
Contraindications
0.9% sodium chloride medical solution is not used in the following cases:
- hypernatremia;
- hyperchloremia;
- acidosis;
- hypokalemia;
- circulatory disorders that threaten the development of cerebral and pulmonary edema;
- extracellular hyperhydration;
- swelling of the brain, lungs, left ventricular failure of an acute course, simultaneous administration of high-dose corticosteroids.
When other medications are added to the drug solution, it is necessary to take into account the presence of contraindications to them.
Careful use
With caution, 0.9% sodium chloride solution is used for decompensated heart failure of a chronic type, arterial hypertension, peripheral edema, preeclampsia, chronic renal failure (oligo-, anuria), aldosteronism and other conditions associated with a delay in the body's sodium.
Use during pregnancy and lactation
Reliable information on the use of this drug during pregnancy and lactation is not enough. It can be used exclusively in cases where the benefit to the mother is higher than the probable risk of complications in the fetus or child.
Side effects
When used correctly, the negative effects of 0.9% sodium chloride solution are unlikely. Some adverse events that have been recorded during post-marketing use are grouped by system and organ and are listed below in order to reduce their severity, without indicating frequency of occurrence:
- Circulatory system: hyperhydration, acidosis, hypokalemia.
- Immune system: infusion reactions or hypersensitivity phenomena, including pyrexia, hypotension, tremor, urticaria, chills, rashes, itching.
- General disorders and disorders at the injection site: erythema, hematoma / hemorrhage, urticaria, burning sensation, phlebitis, thrombosis.
- Other adverse reactions: infection of soft tissues at the injection site (for violations of antiseptic rules), fever.
About the preparation of a solution of sodium chloride 0.9% will be discussed below.
When using this medication as a base solvent (solution) for other drugs, the likelihood of side effects is due to the properties of these medicines. In such a case, if adverse reactions occur, it is necessary to suspend the administration of the solution, evaluate the patient's condition, take adequate measures to normalize the condition and save the remaining solution for analysis, if necessary.
Overdose symptoms
In the event of an overdose of sodium chloride 0.9% for inhalation or infusion, the following pathological symptoms may develop:
- nausea, vomiting;
- diarrhea,
- abdominal pain of a spastic nature;
- increased thirst;
- reduced salivation and lacrimation;
- excessive sweating;
- tachycardia;
- fever;
- increase in blood pressure;
- development of renal failure;
- peripheral edema;
- respiratory arrest;
- pulmonary edema;
- headaches;
- dizziness;
- anxiety;
- irritability;
- increased weakness;
- stiffness and muscle cramps;
- generalized convulsions;
- development of coma and death.
Excessive administration of this medical solution can provoke the occurrence of hypernatremia. Excessive intake of chloride can lead to the development of hyperchloremic acidosis. If the solution is used as a basic solution for transport and dilution of other medications, the symptoms and complaints with excessive administration in most cases are associated with the properties of the drugs added to the solution. In case of unintentional excessive administration of this solution, therapeutic measures should be discontinued and the patient's condition monitored. Treatment of overdose is symptomatic.
Dosages and method of administration of the drug
The medicinal solution of sodium chloride 0.9% for infusion is used intravenously (drip). Dosage, speed and duration of use are selected purely individually depending on the clinical indications for use, the patient's age, his body weight, general condition and associated therapeutic methods, as well as the effectiveness of therapy in terms of general symptoms and laboratory values.
How is sodium chloride 0.9% prepared?
Before administration, the medical solution must be heated to 36-38 ° C. The dosage is determined depending on how much fluid is lost by the body, and averages 1000 ml per day as a continuous intravenous drip infusion, while the rate of administration is approximately 180 drops / minute. With significant loss of fluid and severe symptoms of intoxication, a dosage of 3000 ml per day is possible. The rate of infusion at the same time is 540 ml / h, if necessary, increase it.
In childhood
In childhood, with a pronounced decrease in blood pressure against a background of pronounced dehydration (until laboratory parameters are determined, in particular: determination of the concentration of potassium, sodium, chlorine in urine and blood; study of acid-base balance, determination of the concentration of residual nitrogen and plasma creatinine level ) It is recommended to administer the drug in a dosage of 20-30 mg / kg. Subsequently, the dosage regimen should be adjusted depending on the performance of laboratory tests. With prolonged use of large dosages of 0.9% solution, monitoring of blood and urine parameters is necessary.
Use during inhalation
This medical solution is often prescribed for dilution with bronchodilator drugs. Preparations such as Berotek or Lazolvan are diluted with a solution to a total of 3-4 ml. For inhalation, a nebulizer is used. The final dosage when mixing sodium chloride 0.9% and bronchodilators is determined by the doctor. It is not recommended to do this on your own. The substance can be used for inhalation in a pure form of 2-3 ml per application. The frequency of this therapeutic procedure is also determined by a specialist, but usually it is no more than 4 times a day. In the treatment of rhinitis, the use of nasal solution may be prescribed as an adjunctive treatment for rhinitis.
Inhalations with this solution are carried out 2 hours after a meal. In this case, it is recommended to rinse the nose before this, in order to maximally clear the nasal passages from mucus. After the procedure, for 2 hours it is not recommended to smoke, eat and drink, go out.
Inhalations for children are carried out according to similar schemes, the difference will only be in the dosages of medications and in the number of inhalations per day.
Special recommendations for the use of this drug
When carrying out any infusion with physiological sodium chloride solution of 0.9%, it is necessary to carefully monitor the patient's condition, biological biological parameters, it is extremely important to evaluate blood electrolytes.
In the children's body, due to the immaturity of renal functions, the sodium excretion process can be significantly slowed down. Therefore, in this category of patients, repeated infusions should be carried out only after studying the concentration of sodium in the blood. If reactions or hypersensitivity phenomena occur, the administration of the solution must be stopped and the necessary therapeutic measures taken according to clinical indications.
Depending on the speed and volume of infusion against the background of intravenous use of the drug, there may be some likelihood of developing hypervolemia and excessive loading of dissolved components, as well as an imbalance in the electrolytes.
In patients with kidney failure, the solution should be prescribed with extreme caution or not at all, since in such patients this can trigger the development of sodium retention.
It is allowed to use only a clear solution, without visual inclusions, in a holistic package. It should be administered immediately after connecting to the infusion system. The solution should be used with sterile equipment in compliance with the rules of antiseptics and asepsis. In order to avoid the penetration of air into the infusion system, it must be filled with a solution, completely releasing the remaining air from the container.
Drug interaction
As with all parenteral solutions, the compatibility of the substances dissolved in them should be determined before use. At the same time, sodium chloride 0.9% and medications, which are known to be incompatible with it, should not be used. This compatibility is determined by the doctor when checking for possible color changes or the formation of sediment, crystals or insoluble complexes. Before use, it is necessary to determine whether the injected substance is soluble and stable at the same pH level as 0.9% of Solofarm sodium chloride solutions. When dissolving the drug, it is necessary to determine the isotonicity of the final solution until the time of administration. Before adding drugs to the solution, they must be thoroughly mixed according to aseptic rules. The finished solution should be administered immediately, do not store. Each unused dose should be disposed of.