|
|
RINGER’S SOLUTION FOR INJECTION
(Compound Sodium Chloride Injection B.P.C.)
Therapeutic Class
- Isotonic crystalloid solution.
Description and Composition
A clear, colorless solution, each 1000 ml. of which contains:
Calcium Chloride 2H2O 0.32 grams
Potassium Chloride 0.30 grams
Sodium Chloride 8.60 grams
Water for Injections q.s.
Pharmacological Effects
- Ringer’s Solution for Injection has an electrolyte composition closer to that of plasma as compared to normal saline.
- The chloride concentration of this solution is unphysiological and can cause hyperchloremia and hyperchloremic acidosis.
- It expands circulating blood volume by approximating the fluid and electrolyte composition of the blood.
- The solution does not contain bicarbonate ions and infusion of large quantities may cause dilutional acidosis.
- Provides the following electrolytes in each liter of fluid:
Sodium 147 mEq.
Chloride 156 mEq.
Potassium 4 mEq.
Calcium 2.2 mEq.
- The pH range is 5.0 - 7.5.
Indications
- Hypovolemic states including dehydration and hemorrhage.
- Supply or replenishment of chloride.
- Trauma.
- Burns
- Environmental emergencies such as severe perspiration leading to dehydration and heat stroke.
- The use of Ringer’s Solution is now limited to those cases only, in which Lactated Ringer’s Injection (Ringolact) is not suitable such as alkalosis and disturbances of lactic acid metabolism.
Dosage and Administration
The dose is dependent upon the age, weight and clinical condition of the patient. The infusion rate should be adjusted to provide 300-500 ml./hour (about 75-125 drops/minute) for adults.
Duration of Action and Excretion
Passes out of the blood stream quite rapidly, especially when normal renal function and renal blood flow are present.
Adverse Effects
- Fluid overload.
- Congestive heart failure.
- Hyperchloremic and dilutional acidosis.
Contraindications
- Congestive heart failure.
- Renal failure.
Precautions
- Care is required in patients with cardiac failure, renal failure and in cases where salt intake is restricted as the solution contains sodium chloride 8.6 grams/Liter.
- Caution should be exercised in patients with hypertonic dehydration.
- Monitor E.C.G. continuously.
- Frequently monitor blood pressure, pulse rate and respiratory rate.
- Frequently auscultate breath sounds for rales.
Tonicity and Osmolarity
Isotonic solution having a tonicity of 153.
Isosmotic solution (309 mOsm/L)
Caloric Value
Nil
Pharmaceutical Precautions
- Ringer’s Solution for Injection should not be mixed with citric acid added blood, and preparations containing phosphoric acid or carbonic acid, as the calcium content of this solution may form precipitates with these acids.
- Store at room temperature. Protect from sunlight.
- Do not use if bottle is leaking, solution is cloudy or contains foreign matter.
- Discard unused portion.
- Keep all medicines out of the reach of children.
Packaging
500ml in Plabottle.
|
|