Calcium Chloride + Potassium Chloride + Sodium Chloride + Sodium Lactate (Lactated Ringers solution)
Indications
Calcium Chloride + Potassium Chloride + Sodium Chloride + Sodium Lactate (Lactated Ringers solution) is used for:
Mainly used as a fluid and electrolyte replenisher in hypovolaemia caused by trauma, surgery, haemorrage and burn. Diarrhea, dehydration,Water and electrolytes imbalance, Alkalinizing agent, Diabetic coma, Cholera
Adult Dose
Dosage is dependent upon the age, weight and clinical condition of the patient as well as laboratory determinations.
The recommended flow rate is up to 100-drops/minute/70 kg body weight.
In burn patients the dose is according to the Parkland formula : 4ml/kg body weight/% of Body surface area (BSA) burn (e.g. for a 30% BSA burn of a person having 60 kg body weight, 4 x 60x30ml = 7200 ml of Lactoride would be required in 24 hours). Half of this within 8 hr, the remainder over 16 hr.
Child Dose
Renal Dose
Administration
Contra Indications
Hypersensitivity.
Precautions
It should not be administered rapidly or for prolonged periods. Since the solution contains different electrolytes, it should be infused with caution in patients where electrolyte imbalance may cause detrimental effects; e.g. in pregnancy, renal impairment, heart failure, pulmonary congestion, etc. or to patients receiving potassium sparing diuretics.
Pressurizing intravenous solutions contained in flexible plastic containers to increase flow rates can result in air embolism if the residual air in the container is not fully evacuated prior to administration.
Use of a vented intravenous administration set with the vent in the open position could result in air embolism. Vented intravenous administration sets with the vent in the open position should not be used with flexible plastic containers.
Clinical evaluation and periodic laboratory determinations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid base balance during prolonged parenteral therapy or whenever the condition of the patient warrants such evaluation.
Caution must be exercised in the administration of Ringer’s Injection, USP to patients receiving corticosteroids or corticotropin.
Pregnancy-Lactation
Interactions
Side Effects
Side effects of Calcium Chloride + Potassium Chloride + Sodium Chloride + Sodium Lactate (Lactated Ringers solution) :
Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypervolemia.
If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures, and save the remainder of the fluid for examination if deemed necessary.
Mode of Action
Calcium chloride is used to prevent or treat negative calcium balance. It also regulates action potential excitation threshold to facilitate nerve and muscle performance.
Potassium chloride is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion.
Sodium chloride is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives.
Sodium lactate is a sterile, nonpyrogenic solution that is used for fluid and electrolyte replenishment. It has metabolic alkalinising ability and is capable of inducing diuresis depending on the clinical condition of the patient.