Instructions Ringer's solution solution for infusions glass bottle 400 ml
Composition
active ingredients: sodium chloride; potassium chloride; calcium chloride dihydrate;
1 ml of solution contains 8.6 mg of sodium chloride, 0.3 mg of potassium chloride, 0.24 mg of calcium chloride dihydrate (calculated as calcium chloride);
excipient: water for injections.
Dosage form
Solution for infusion.
Main physicochemical properties: transparent colorless liquid. Theoretical osmolarity 309 mOsmol/L.
Pharmacotherapeutic group
Solutions for intravenous administration. Solutions used to correct electrolyte imbalances. ATX code B05B B01.
Pharmacological properties
Pharmacodynamics
Ringer's solution is a source of water and electrolytes. It can induce diuresis depending on the patient's condition.
Sodium, the main cation of extracellular fluid, is involved primarily in the control of water distribution, water balance, and osmotic pressure of body fluids. Sodium is also associated with chlorine and bicarbonate in the regulation of acid-base balance of body fluids.
Potassium, the main cation of intracellular fluid, participates in the utilization of carbohydrates and protein synthesis, and is needed for the regulation of nerve conduction and muscle contraction, especially of the heart.
Chloride, the major extracellular anion, is closely related to sodium metabolism. Changes in the body's acid-base balance are reflected by changes in chloride concentration. Infusion of large amounts of chloride ions can cause loss of bicarbonate ions, leading to acidosis. For this reason, Ringer's solution is buffered with lactate or acetate.
Calcium, an important cation that ensures the formation of bones and teeth (in the form of calcium phosphate and calcium carbonate). In its ionized form, calcium is needed for the functional mechanism of blood clotting, normal heart function, and the regulation of neuromuscular excitability.
Pharmacokinetics
Na+ and Cl- ions administered with Ringer's Solution are subject to the same pharmacokinetics as those administered with food. They are freely distributed in all organs, tissues and intercellular spaces and are excreted by glomerular filtration in the kidneys. In the tubules, significant reabsorption of Na+ and Cl- ions occurs, mainly in the loop of Henle and the distal tubule, including the mechanism of blocking by loop and thiazide diuretics, respectively.
Potassium ions (K+) are freely filtered in the glomerulus, but are almost completely reabsorbed in the proximal tubules, and only 10% of the filtered K+ ions are excreted. Secretion in the distal tubules and collecting ducts can greatly increase K+ elimination. The kidneys have a limited capacity to store K+. Therefore, when the Na+ concentration in the distal tubules is high, K+ loss can be significant and hypokalemia can develop. This explains the presence of K+ in Ringer's solution.
Calcium ion (Ca++) homeostasis is well controlled by hormones and rarely requires clinical intervention with intravenous infusion of a solution.
Indication
It is used for hypovolemia and extracellular dehydration due to prolonged vomiting, diarrhea, significant burns, frostbite, peritonitis, severe infectious diseases, shock, collapse; during surgery and in the postoperative period.
Used for diluting concentrated electrolyte solutions.
Contraindication
- Hypernatremia;
- decompensated heart failure;
- hyperkalemia;
- oliguria and anuria;
- acute renal failure;
- pulmonary edema;
- brain swelling;
- hypercoagulation;
- hyperhydration;
- thrombophlebitis;
- metabolic alkalosis;
- hypercalcemia.
Interaction with other medicinal products and other types of interactions
Sodium retention in the body may increase with the simultaneous use of the following drugs: nonsteroidal anti-inflammatory drugs, androgens, anabolic hormones, estrogens, corticotropin, mineralocorticoids, vasodilators or ganglioblockers.
When used with potassium-sparing diuretics, ACE inhibitors and potassium preparations, the risk of developing hyperkalemia increases.
In combination with cardiac glycosides, the likelihood of their toxic effects increases.
Application features
During prolonged parenteral therapy, it is necessary to determine laboratory parameters and give a clinical assessment of the patient's condition to monitor electrolyte concentrations and water-electrolyte balance every 6 hours (depending on the infusion rate).
The use of intravenous solutions may cause fluid and/or solute overload, hyperhydration, congestion and pulmonary edema. The risk of dilution is inversely proportional to the electrolyte concentration. The risk of solution overload, which causes congestion with peripheral edema and pulmonary edema, is directly proportional to the electrolyte concentration.
Sodium-containing solutions should be used with caution in patients receiving corticosteroids or corticotropin.
The potassium content requires caution when using the solution in patients with heart disease and clinical conditions accompanied by potassium retention in the body.
Calcium administration should be monitored by ECG, especially in patients receiving digitalis. Serum calcium levels do not always reflect tissue calcium levels.
In patients with reduced renal excretory function, administration of the solution may lead to sodium or potassium retention.
The presence of calcium ions requires caution when administered simultaneously with blood products due to the likelihood of coagulation.
Parenteral calcium should be administered with special care to patients receiving cardiac glycosides.
This solution is intended for intravenous administration using sterile equipment. It is recommended to change the intravenous line at least every 24 hours.
The solution should only be used when it is clear and the bottle is airtight.
The physician should also consider the possibility of adverse reactions to drugs used concurrently with Ringer's Solution.
If an adverse reaction occurs, the infusion should be stopped, the patient's condition assessed, and the necessary therapeutic measures prescribed.
Use during pregnancy or breastfeeding
Studies on the use of Ringer's Solution in pregnant women have not been conducted.
It is not known whether this drug is excreted in human milk. Because most drugs are excreted in human milk, caution should be exercised when Ringer's Solution is administered to a nursing woman.
The ability to influence the reaction speed when driving or working with other mechanisms
Information is missing.
Method of administration and doses
The solution is intended for intravenous use only.
The dose is prescribed by a doctor and depends on the patient's age, body weight, clinical condition, and laboratory parameters.
The usual dose for an adult is up to 1-2 liters per day; the maximum dose depends on the state of water and electrolyte balance, cardiovascular system and kidneys.
Infusion rate for adults is 60-80 drops/min or jet.
The solution should be prescribed based on the calculated maintenance or replacement fluid requirements for each patient.
Parenteral products should be inspected visually for particulate matter and discoloration prior to administration.
Children
Studies on the use of Ringer's Solution in children have not been conducted.
Overdose
Administration of too much solution may lead to fluid and electrolyte imbalance (hypervolemia, hypernatremia, hypercalcemia, hyperchloremia) and acid-base imbalance. Treatment is symptomatic.
Adverse reactions
Electrolyte metabolism disorders (potassium, calcium, sodium, chlorine), chloride acidosis, hyperhydration, and changes at the injection site may occur.
In case of adverse reactions, the administration of the solution should be stopped, the patient's condition should be assessed and assistance should be provided.
Expiration date
2 years.
Storage conditions
Store at a temperature not exceeding 25°C. Keep out of the reach of children. Do not freeze.
Incompatibility
To reduce the risk of possible incompatibility arising from mixing this solution with other prescribed additives, the final infusion solution should be inspected for turbidity or precipitation immediately after mixing, prior to use, and periodically during use.
Packaging
200 ml or 400 ml in bottles. 250 ml or 500 ml, or 2500 ml in a container.
Vacation category
According to the recipe.
Producer
LLC "Yuria-Pharm".
Location of the manufacturer and its business address
18030, Ukraine, Cherkasy, Verbovetskogo St., 108. Tel./fax: (044) 281-01-01.
