Sodium Chloride
Jeneng merek: Dey-Pak
Kelas obat:
Agen Antineoplastik
Panganggone Sodium Chloride
Hidrasi
Pangopènan utawa panggantos natrium klorida lan banyu kanggo hidrasi.
Nyegah kram otot lan sujud panas sekunder kanggo mundhut cairan saka kringet sing berlebihan nalika kena suhu dhuwur.
Keseimbangan Elektrolit
Nyegah utawa nambani kekurangan ion natrium lan klorida (contone, disebabake diuresis sing berlebihan utawa watesan uyah sing berlebihan).
Pengganti cairan ekstraselular (injeksi natrium klorida isotonik [0,9%)).
Manajemen alkalosis metabolik ing ngarsane mundhut cairan lan deplesi sodium entheng (injeksi natrium klorida 0,9%).
Manajemen kekurangan natrium klorida sing abot (contone, ana gagal jantung, gangguan ginjel, sajrone operasi, sawise operasi) nalika pemugaran elektrolit kanthi cepet penting (hipertonik [3 utawa 5%] injeksi natrium klorida).
Manajemen hiponatremia lan hipokloremia akibat saka administrasi cairan tanpa sodium sajrone terapi cairan lan elektrolit (injeksi natrium klorida 3 utawa 5%).
Pengelolaan cairan ekstraselular sing ekstrem sawise asupan banyu sing berlebihan (contone, asil saka pirang-pirang enemas utawa perfusi larutan irigasi menyang sinus vena sing mbukak nalika reseksi prostat transurethral) (injeksi natrium klorida 3 utawa 5%).
Pengobatan darurat kanggo nyuda natrium klorida sing abot amarga kringet, muntah, diare, lan kondisi liyane (injeksi natrium klorida 3 utawa 5%).
Umum, solusi natrium klorida isotonik digunakake kanggo ngganti parenteral mundhut klorida sing padha karo utawa ngluwihi mundhut natrium; solusi natrium klorida hipotonik digunakake kanggo pangopènan parenteral syarat hidrasi nalika mung jumlah cilik saka uyah sing dikarepake; solusi natrium klorida hipertonik digunakake kanggo repletion ing sindrom deplesi uyah sing abot.
Diabetes Hiperosmolar
Manajemen diabetes hiperosmolar (hipotonik [0,45%] injeksi natrium klorida).
Assessment of Renal Function
Assessment of renal function status (0,45% sodium chloride injection).
Agen Priming
Cairan priming kanggo prosedur hemodialisis (injeksi natrium klorida 0,9%).
Miwiti lan mungkasi transfusi getih tanpa hemolisis RBC (injeksi natrium klorida isotonik 0,9%).
Diluent
Bantuan farmasi, pengencer, lan sistem pangiriman kanggo infus aditif obat sing kompatibel.
Pengukuran Oputput Jantung
Pengukuran output jantung kanthi metode termodilusi (injeksi natrium klorida 0,9% minangka sistem Thermoject).
Panganggoan Respiratori lan Trakea
Inhalasi liwat nebulisasi, pengenceran obat sing cocog kanggo nebulisasi, lan lavage trakea lan irigasi (solusi inhalasi natrium klorida 0,9%).
Cystic Fibrosis
Sawijining inhalasi kanggo pasien fibrosis kistik kanggo ngasilake percepatan sing terus-terusan ngresiki mukus lan ningkatake fungsi paru-paru† [off-label] (solusi natrium klorida 7%).
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Carane nggunakake Sodium Chloride
Umum
Administrasi
Administrasi oral, kanthi infus IV, intravaskular minangka cairan priming, utawa minangka inhalasi oral liwat nebulisasi.
Administrasi solusi thermodilution mung liwat kateter thermodilution; aja disuntik nganggo rute liya.
Injeksi natrium klorida bakteriostatik ora kanggo inhalasi.
Administrasi IV
Kanggo informasi kompatibilitas solusi lan obat, deleng Kompatibilitas ing ngisor Stabilitas.
Administrasi solusi 3 lan 5% liwat vena periferal gedhe kanthi jarum cilik sing dipasang kanthi apik; nggunakake ati-ati supaya ora infiltrasi.
Injeksi natrium klorida 14,6 lan 23,4% mung sawise diencerake.
Sawetara manufaktur nyaranake nggunakake saringan pungkasan.
Buang bagean solusi sing ora digunakake sing bebas pengawet utawa mung kanggo panggunaan siji.
DilutionSadurungé administrasi IV, encer injeksi natrium klorida 14,6 lan 23,4% (2,5 utawa 4 mEq/mL saben natrium lan klorida) kanthi larutan IV sing kompatibel. Jumlah pengenceran ditemtokake dening kabutuhan individu pasien. Konsentrasi natrium klorida ≤5% natrium klorida wis diwenehake.
Natrium klorida 23,4% injeksi: Bagi jumlah mEqs natrium klorida sing dibutuhake kanthi 4 kanggo ngetung volume (mL) natrium klorida. Tarik jumlah kasebut lan transfer menyang solusi parenteral (contone, injeksi dextrose 5%).
Nalika ngencerake obat aditif, takon informasi resep sing diiringi aditif. (Deleng Kompatibilitas ing Stabilitas.)
Tingkat AdministrasiNatrium klorida 3 utawa infus 5%: Atur solusi kanthi alon; maksimal 100 ml/jam.
Administrasi Intravaskular
Administrasi intravaskular minangka cairan priming ing prosedur hemodialisis.
Injeksi liwat Thermodilution Catheter
Kanggo pangukuran output jantung, injeksi natrium klorida 0,9% (ing sistem Thermoject) es utawa ing suhu kamar liwat kateter termodilusi.
Konsultasi informasi resep kanggo informasi administrasi lengkap.
Dosis
Nemtokake dosis adhedhasar umur, bobot, kondisi klinis, lan keseimbangan cairan, elektrolit, lan asam-basa pasien.
Kisaran osmolaritas fisiologis normal kira-kira 280-310 mOsm/L. Administrasi larutan hipertonik sing substansial (≥600 mOsm/L) bisa nyebabake karusakan vena.
Tabel 1. Konsentrasi Ion lan Osmolaritas Natrium Klorida 0,45–5% InjeksisabcdejlSolusi Injeksi Natrium Klorida
Kandungan Natrium lan Klorida (mEq/L saben)
Anggaran Osmolaritas Dietung (mOsm/L)
0,45% Injeksi Natrium klorida (solusi hipotonik)
77
154
0,9% Injeksi Natrium klorida (saline normal)
154
308
Injeksi natrium klorida 3% (solusi hipertonik)
513
1025
5% Injeksi Natrium klorida (solusi hipertonik)
855
1710
Kudu diencerake sadurunge administrasi.
Tabel 2. Konsentrasi Ion lan Osmolaritas saka Sodium Chloride Aditif SolutionsaghSodium Chloride Additive Solution
Sodium and Chloride Content (mEq/mL of each)
Estimasi Kalkulasi Osmolaritas (mOsm/L)
Injeksi Natrium klorida 14,6%
2,5
5000
23,4% Injeksi Natrium Klorida
4
8000
Pasien Anak
Natrium Bakteriostatik injeksi klorida wis contraindicated ing neonates. (Deleng Toksisitas Alkohol Benzyl lan deleng Panggunaan Pediatrik ing Ati-ati.)
Dosis Biasa IVBocah: Nemtokake dosis adhedhasar bobot pasien, kondisi klinis, lan tes laboratorium.
Dewasa
Dosis Biasa Oral1-2 g diwenehi kaping 3 saben dina.
IVPersyaratan natrium lan klorida wong diwasa sing dicukupi dening 1 L natrium klorida 0,9% injeksi saben dina; Utawa, 1-2 L injeksi natrium klorida 0,45% saben dina.
3 utawa 5% injeksi natrium klorida: Kaping pisanan, 100 mL infus alon-alon sajrone wektu 1 jam.
Temtokake kabutuhan dosis tambahan adhedhasar konsentrasi elektrolit serum, kalebu klorida lan bikarbonat.
Aditif Kekurangan Natrium Klorida ing Cairan Parenteral IVSodium klorida 14,6 lan 23,4% solusi aditif: Dosis ditemtokake dening kabutuhan individu pasien.
Pangukuran Output Jantung IV0,9% (Thermoject) solusi: 1–10 mL kaya sing dibutuhake. Gunakake volume paling cilik sing dibutuhake kanggo ngasilake kurva sing nyukupi.
Watesan Resep
Dewasa
Dosis Biasa IV3 utawa 5% injeksi natrium klorida: Maksimum 100 mL sing diwenehake liwat periode 1 jam. Maksimum 400 mL ing 24 jam.
Populasi Khusus
Gagal Hepatik
Pilih dosis kanthi ati-ati banget ing sirosis. (Deleng Cacat Hepatik ing Cautions.)
Gangguan Ginjal
Pilih dosis kanthi ati-ati banget ing fungsi ginjel sing suda utawa insufisiensi ginjel sing abot; monitor konsentrasi sodium. (Deleng Kerusakan Ginjal ing Cautions.)
Pasien Geriatrik
Pilih dosis kanthi ati-ati, biasane diwiwiti ing ujung ngisor saka kisaran biasa, amarga nyuda umur ing ati, ginjel. , lan / utawa fungsi jantung lan penyakit bebarengan utawa terapi obat. (Deleng Panggunaan Geriatrik ing Caution.)
Pènget
Kontraindikasi
Pènget/PanandhapPènget
Panggunaan Bedah lan Pasca Bedhah
Aja nggunakake sajrone lan sanalika sawise operasi, kajaba ana faktor sing nyebabake nyuda uyah. Amarga retensi ginjel saka uyah sajrone operasi, administrasi elektrolit tambahan bisa nyebabake retensi cairan, edema, lan kakehan sirkulasi. Ngawasi tandha-tandha intoleransi uyah pasca operasi (contone, dehidrasi seluler, kelemahane, disorientasi, anoreksia, mual, distensi, ambegan jero, oliguria, BUN tambah).
Isi SodiumPirsani tabel konsentrasi ion lan osmolaritas ing ngisor Dosis lan Administrasi kanggo informasi isi sodium tartamtu.
Risiko retensi sodium; ati-ati nalika menehi solusi sing ngemot sodium kanggo pasien sing nandhang hipervolemia, obstruksi saluran kemih, dekompensasi jantung sing bakal teka utawa jujur, utawa insufficiency ginjel utawa jantung (kanthi utawa tanpa CHF); kanggo pasien geriatrik; utawa ing negara klinis kanthi retensi sodium kanthi edema. (Deleng Populasi Spesifik ing Caution.)
Isi AluminiumSawetara preparat ngemot aluminium; bisa tekan tingkat beracun kanthi administrasi parenteral sing dawa yen fungsi ginjel cacat, kalebu ing neonatus durung wayahe. Yen pasien kasebut nampa aluminium parenteral kanthi jumlah> 4-5 mcg / kg saben dina, aluminium bisa nglumpukake tingkat sing ana gandhengane karo keracunan CNS lan balung. Muatan jaringan bisa kedadeyan ing tingkat administrasi sing luwih murah. (Deleng Panganggone Pediatrik ing Ati-ati.)
Reaksi Situs InfusSitus infus lan reaksi liyane (contone, demam, infeksi ing situs injeksi, trombosis vena, hipervolemia, ekstravasasi, flebitis sing ngluwihi saka situs injeksi) bisa. Bisa kedadeyan amarga solusi (contone, kontaminasi) utawa teknik administrasi.
Gejala bisa kedadeyan amarga kaluwihan utawa defisit 1 utawa luwih ion ing larutan; ngawasi konsentrasi elektrolit asring. (Deleng Gangguan Elektrolit ing Cautions.)
Injeksi natrium klorida 3 lan 5% banget hipertonik; bisa nyebabake nyeri lokal utawa iritasi utawa karusakan vena. (Deleng Administrasi IV ing Dosis lan Administrasi.)
Yen ana efek ala, mandhegake infus; ngevaluasi pasien lan nggawe langkah terapeutik sing cocog; simpen sisa cairan kanggo pemeriksaan, yen perlu.
Kakehan Cairan lan/utawa SolutKamungkinan kakehan cairan lan/utawa solute sawise administrasi IV nyebabake pengenceran elektrolit serum, overhidrasi, kondisi kongestif, utawa edema paru.
Infuse solusi 3 lan 5% alon-alon kanthi pengamatan konstan pasien kanggo nyegah edema paru. Resiko kakehan solute lan kahanan kongestif sing nyebabake edema perifer lan / utawa paru-paru sebanding langsung karo konsentrasi elektrolit sing diwenehake.
Toksisitas Utama
Toksisitas Alkohol BenzylRisiko keracunan alkohol benzyl ing neonatus kanthi nggunakake preparat sing ngandhut alkohol benzyl. (Deleng Panganggone Pediatrik ing Caution.)
Pancegahan Umum
Gangguan ElektrolitMinangka kondisi pasien njamin lan sajrone terapi sing dawa, evaluasi owah-owahan ing keseimbangan cairan, konsentrasi elektrolit, lan keseimbangan asam-basa, sacara klinis lan liwat tekad laboratorium. Bisa uga mbutuhake tambahan elektrolit utawa terapi liyane sing cocog.
Kamungkinan hipokalemia kanthi administrasi larutan bebas kalium sing berlebihan utawa suwe.
Kamungkinan hipernatremia kanthi administrasi natrium klorida IV sing berlebihan. Hypernatremia bisa digandhengake karo edema lan exacerbation saka CHF sekunder kanggo retensi banyu.
Risiko hipernatremia dadakan lan komplikasi (contone, kejut jantung, gangguan CNS, hemolisis ekstensif, nekrosis kortikal ginjel) saka injeksi langsung utawa penyerapan larutan natrium klorida sing ora disengaja. Solusi hipertonik diencerke sadurunge administrasi. (Deleng Pengenceran ing Dosis lan Administrasi.)
Yen infus ing jumlah gedhe, ion klorida bisa nyebabake ion bikarbonat ilang, sing nyebabake efek acidifying.
Pasien kanthi mundhut elektrolit sing signifikan (contone, amarga nyedhot nasogastrik, muntah, diare, utawa saluran fistula GI) bisa uga mbutuhake suplemen elektrolit tambahan.
Populasi Tertentu
KandhutanKategori C.
LaktasiOra dingerteni yen natrium klorida disebarake menyang susu manungsa. Ati-ati yen digunakake ing wanita nursing.
Panggunaan PediatrikAman lan khasiat injeksi natrium klorida durung ditetepake; Nanging, panggunaan larutan natrium klorida ing pasien pediatrik dirujuk ing literatur medis.
Gunakake kanthi ati-ati ing neonatus lan bayi cilik; volume cairan bisa mengaruhi keseimbangan cairan lan elektrolit.
Sawetara preparat ngemot aluminium, sing bisa dadi beracun ing neonatus prematur lan ing wong sing duwe fungsi ginjel cacat. Neonatus prematur ana ing risiko tartamtu amarga ginjel durung diwasa lan amarga mbutuhake solusi kalsium lan fosfat sing akeh, sing ngemot aluminium. (Waca Konten Aluminium ing Ati-ati.)
Injeksi natrium klorida bakteriostatik sing ngemot benzyl alkohol minangka pengawet (agen antimikroba) ora kena digunakake kanggo ngencerake utawa reconstituting obat kanggo administrasi ing neonatus, utawa kanggo siram kateter intravaskular ing neonatus. .
Jumlah alkohol benzyl sing akeh (yaiku, 100-400 mg / kg saben dina) wis digandhengake karo keracunan ing neonatus. Sawetara kematian wis dilapurake ing neonatus sing bobote <2,5 kg sing natrium klorida bakteriostatik kanggo injeksi sing ngemot alkohol benzyl 0,9% digunakake kanggo siram kateter IV; sawetara neonates iki nampa tambahan alkohol benzyl nalika injeksi natrium klorida bakteriostatik digunakake kanggo dilute utawa reconstitute obatan.
Geriatric PanganggoneOra ana beda substansial ing safety lan khasiat relatif kanggo wong diwasa enom. Secara substansial diilangi dening ginjel; ngawasi fungsi ginjel amarga pasien geriatrik luwih cenderung ngalami penurunan fungsi ginjel. (Deleng Pasien Geriatrik ing Dosis lan Administrasi lan uga deleng Konten Sodium ing Ati-ati.)
Gangguan HepatikGunakake kanthi ati-ati banget, yen kabeh, ing pasien karo sirosis ati.
Gagal GinjalGunakake kanthi ati-ati banget, yen kabeh, ing pasien kanthi insufisiensi ginjel sing abot. Risiko retensi sodium ing pasien kanthi fungsi ginjel sing kurang. Monitor fungsi ginjal. (Deleng Gagal Ginjal ing Dosis lan Administrasi lan uga deleng Konten Sodium ing Ati-ati.)
Apa obatan liyane bakal mengaruhi Sodium Chloride
Obat Spesifik
Obat
Interaksi
Komentar
Kortikosteroid
Kamungkinan risiko retensi sodium
Gunakake kanthi ati-ati
Kortikotropin
Kamungkinan risiko retensi sodium
Gunakake kanthi ati-ati
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