Electrolytes used for Replacement Therapy

dexeroso's version from 2017-06-18 01:08

Sodium Replacement

Question Answer
Sodium Chloride, USP 0.9% w/v (Isotonic) Used as wet dressings, irrigating body cavities or tissues, and as injections when fluid and electrolytes have been depleted.
Table salt – Contains silicates (prevent caking and adds to the product’s pouring qualities), KI (to prevent goiter)
Sodium Chloride As effective as blood plasma in the emergency treatment of shock from serious burns and other injuries”
Hypotonic Solutions (NaCl)Administered for maintenance therapy when patients are unable to take fluid and nutrients orally for 1-3 days.
Dextrose (Glucose)Caloric source
Hypertonic SolutionsUsed when there is loss of sodium in an excess water.

Potassium Replacement

Question Answer
Potassium Chloride, USPDOC for oral replacement of potassium (preferably as a solution) • Irritating to the GIT, therefore it must be well diluted.
KCl Tablets (Kalium Durules ®)USP requires it to be enteric-coated (can cause ulceration)
KClIV– Serum potassium concentration, ECG and urinary output must be monitored!
Potassium Chloride • Indicated in the treatment of familial periodic paralysis • Meniere’s syndrome • Antidote in digitalis intoxication • Adjunct drug for Myasthenia Gravis • Effective as diuretic

Calcium Replacement

Question Answer
Calcium ChlorideCaCl2.2H2O:– Calcium Monohydrogen Phosphate – Secondary Calcium Phosphate – Dicalcium Phosphate
Calcium Chloride• Irritating to the veins, therefore, should be injected slowly. • Contraindicated in hypocalcemia associated with renal insufficiency • Calcium source in many commercially available electrolyte replacement and maintenance solutions.
Calcium Gluconate Treatment of choice for hypocalcemia
Dibasic Calcium Phosphate• Given orally as a source of Ca and P (1:1); most frequently recommended for oral consumption as an electrolyte replenisher. • Insoluble in water, but soluble in acid (rxn?)
Tribasic Calcium PhosphateCa3(PO4)2 – Variable mixture of phosphates equivalent to nlt 90% Ca3(PO4)2
Tribasic Calcium PhosphateTricalcium phosphate; tertiary calcium phosphate; precipitated calcium phosphate
Tribasic Calcium PhosphateUse – Oral source of Ca and P – Antacid

Magnesium Replacement

Question Answer
Magnesium Sulfate• Used as a CNS depressant in the treatment of: – Eclampsia – Severe cases of hypomagnesemia (+ tremors and seizures) – Magnesium-deficient alcoholics • Overtreatment can cause: – Respiratory paralysis and cardiac depression – Antidote: Calcium salts (gluconate)
Calcium salts (gluconate)Antidote for overdose:MgSO4
Magnesium SulfateEpsom Salt
Magnesium SulfateAntidote for barium, barbiturate poisoning.
Magnesium Sulfate Injection– Depressant – Seasickness, hypertension, tetanus spasm, and convulsions. – Used in paroxysmal auricular and ventricular tachycardia by the IV route. – Cathartic (15 g) – Anticonvulsant (1g) (mg)

Physiological Acid-Base Balance

Question Answer
Normal Acid-Base Balance• The buffer system (body fluids and RBCs) • The pulmonary excretion of excess carbon dioxide • The renal excretion of either acid or base, whichever is excess.
Major Buffer System• Bicarbonate/CarbonicAcid • Monohydrogen Phosphate/Dihydrogen Phosphate
Hemoglobin– Most effective single system for buffering carbonic acid.
Respiratory Control – Lungs • Help regulated acid-base balance by eliminating or retaining carbon dioxide • pH may be regulated by altering the rate and depth of respirations • Changes in pH are rapid, occurring within minutes • Normal CO2 level: 35-45 mmHg
Renal Control – Kidney• Long-term regulator of acid-base balance • Slower to respond; may take hours or days to correct pH • Kidneys maintain balance by excreting or conserving bicarbonate and hydrogen ions • Normal bicarbonate level: 22-26 mEq/L
Acid-Base ImbalancesAcidosis:Alkalosis
Acidosis– High blood [H+] – Low blood pH, <7.35
Alkalosis– Low blood [H+] – High blood pH, >7.45