What's the alias of Ringer's solution? What is the alias of compound glucose and sodium chloride?

Drug name: sodium lactate Ringer injection

Alias: sodium lactate Ringer injection

Physical and chemical properties: 1000ml contains the following components:

6.0g of sodium chloride and 0.2g of calcium chloride.

Potassium chloride 0.3g sodium lactate 3. 1 g

Description: This product is a colorless and clear liquid.

Pharmacological action:

The electrolyte composition of this product is similar to that of extracellular fluid, which can ensure the supplement of electrolyte and water. When surgical invasion and shock occur, the circulating blood volume is lost due to bleeding, and a large amount of extracellular fluid is identified. For such a large amount of body fluid loss, this product with electrolytes similar to plasma and extracellular fluid is the most suitable and has a good prognosis. In addition, the sodium lactate contained in this product becomes HCO3- after metabolism in the body, which can regulate acidosis.

Toxicity:

Acute toxicity LD50

Rabbit (intravenous drip 100 ml/kg/hour) >: 600 ml/kg.

Functions and uses:

Adjust body fluids, electrolytes and acid-base balance, and prevent acidosis, blood loss, intraoperative bleeding, water shortage and electrolyte disorder.

Usage and dosage:

Intravenous drip of 500 ~ 1000ml for ordinary adults.

Administration speed: 300~500ml per hour for ordinary adults.

According to age, weight and symptoms, it can be increased or decreased appropriately.

Storage: sealed storage

Validity: five years

Adverse reactions and precautions:

note:

The following patients are disabled:

1. Lactic patients

Use with caution in the following patients:

1. Patients with renal insufficiency due to renal diseases

2. Patients with cardiac insufficiency

3. Patients with severe liver disease

4. Hypertonic dehydration patients

5. Patients with decreased urine volume due to occlusive urinary tract disease.

Side effects:

Brain edema, pulmonary edema and peripheral edema may occur when a large number of drugs are administered rapidly.

Compatibility description:

1. This product contains calcium salt. When it is mixed with citric acid and blood, it will cause blood coagulation, so use it carefully.

2. Mixing with phosphate ions and carbonate ions can produce precipitation, and it is not suitable for simultaneous use with such preparations.

Drug Name Glucose and Sodium Chloride Injection

English name glucosandsodiumchloride injection

Drug alias

This product is a compound preparation containing 5% glucose and 0.9% sodium chloride.

Character; Role; letter

This product is a colorless and clear liquid.

Pharmacology and toxicology

Glucose is one of the main sources of human heat. Sodium and chlorine are important electrolytes in the body, which mainly exist in extracellular fluid and play a very important role in maintaining the normal volume and osmotic pressure of blood and extracellular fluid.

pharmacokinetics

After glucose enters the body, the utilization capacity of normal human body is 6 mg/kg per minute.

indicate

Replenish calories and body fluids. Used for various reasons caused by insufficient food or loss of a large amount of body fluids.

dosage

The usage and dosage of glucose and sodium chloride should be considered at the same time:

I. Usage and dosage of glucose:

1. When patients who supplement heat energy eat little or can't eat for some reasons, they can generally give 10% ~ 25% glucose injection intravenously and supplement body fluids at the same time. Calculate the dose of glucose according to the required heat energy.

2. Glucose is the most important energy supply for total parenteral nutrition therapy. In non-protein heat energy, the ratio of heat provided by glucose and fat is 2: 1. The specific dosage depends on the clinical heat demand. According to the needs of fluid replacement, glucose can be mixed into different concentrations of 25% ~ 50%, and insulin can be added if necessary. Every 5 ~ 10g glucose plus 1 unit routine insulin. Because hypertonic solution is often used in this product, which is very irritating to veins, fat emulsion needs to be infused, and deep veins, such as subclavian vein and internal jugular vein, are generally selected.

3. Hypoglycemia, severe cases can be given 20 ~ 40 ml of 50% glucose injection first.

4. Hungry ketosis can be basically controlled by intravenous infusion of 5 ~ 25% glucose injection every day 100g.

5. Water loss: 5% glucose injection is injected intravenously to reduce isotonic water loss.

6. The application of 10 ~ 25% injection for hyperkalemia, with 1 unit of routine insulin infusion every 2 ~ 4g of glucose, can reduce the serum potassium concentration. However, this therapy only allows extracellular potassium ions to enter cells, and the total potassium content in the body remains unchanged. If potassium excretion measures are not taken, hyperkalemia may still occur again.

7. Tissue dehydration hypertonic solution (generally 50% glucose injection) is injected intravenously for 20 ~ 50ml. But the effect is short-lived. Clinical attention should be paid to prevent hyperglycemia, which is rarely used at present. When used to adjust the osmotic pressure of peritoneal dialysate, 20ml 50% 50% glucose injection (10g glucose) can increase the osmotic pressure of 1L peritoneal dialysate by 55mOsm/kgH2O. That is to say, every time the glucose concentration in dialysate increases by 65438 0%, the osmotic pressure increases by 55mOsm/kgH2O.

2. Use and dosage of sodium chloride:

1. Hypertonic water loss Hypertonic water loss increases the osmotic concentration of brain cells and cerebrospinal fluid in patients with hypertonic water loss. If the sodium concentration and osmotic concentration in plasma and extracellular fluid drop too fast after treatment, brain edema can be caused. Therefore, it is generally believed that within 48 hours after the start of treatment, the plasma sodium concentration decreased less than 0.5mmol/L per hour.

If the patient has shock, sodium chloride injection should be given first, and colloid should be supplemented as appropriate. After the shock is corrected, the blood sodium >: 155mmol/L and the plasma osmotic concentration >: 350mOsm/L, and 0.6% hypotonic sodium chloride injection can be given. When plasma osmotic concentration

The amount of liquid to be replenished (L)=—————————×0.6× body weight (Kg)

Blood sodium concentration (mmol/L)

Generally, make up half the amount on the first day, and make up the remaining amount in the next 2 ~ 3 days, and adjust according to the cardiopulmonary and renal functions.

2. The principle of isotonic water loss is to give isotonic solution, such as 0.9% sodium chloride injection or compound sodium chloride injection, but the chlorine concentration of the above solution is obviously higher than that of plasma, which can cause hyperchloremia if used alone in large quantities, so 0.9% sodium chloride injection can be mixed with 1.25% sodium bicarbonate or1.86% (1/. The chlorine concentration of the latter is 107mmol/L, which can correct metabolic acidosis. The supplement can be calculated according to the body weight or hematocrit as a reference.

① According to body weight: fluid replacement (L)= (weight loss (kg) ×142)/154;

② Calculated by hematocrit: fluid replacement (L)= (actual hematocrit-normal hematocrit× body weight (kg)×0.2)/ normal hematocrit. Normal hematocrit is 48% in men and 42% in women.

3. Hypoosmotic dehydration When hypoosmotic dehydration is serious, the solute in brain cells decreases to maintain the cell volume. If the treatment makes the sodium concentration and osmotic concentration of plasma and extracellular fluid increase rapidly, it can cause brain cell damage. Generally speaking, when the blood sodium is lower than 1.20 mmol/L, the treatment can make the blood sodium increase at the rate of 0.5mmol/L per hour, not exceeding 1.5mmol/L per hour. When the blood sodium is lower than 1.20 mmol/L or central nervous system symptoms appear, 3% ~ 5% sodium chloride injection can be given slowly. Generally, it is necessary to raise the blood sodium concentration above 1.20 mmol/L within 6 hours. Sodium supplement amount (mmol/L)=[ 142- actual blood sodium concentration (mmol/L)]× body weight (kg)×0.2. When the blood sodium rises above 120 ~ 125 mmol/L, isotonic solution can be used or hypertonic glucose injection or 10% sodium chloride injection can be added to the isotonic solution as appropriate.

4. Low chlorine alkalosis is given 0.9% sodium chloride injection or compound sodium chloride injection (Ringer's solution) 500 ~ 1000 ml, and the dosage will depend on the alkalosis.

counteraction

1. Too much and too fast infusion will cause water and sodium retention, causing edema, elevated blood pressure, increased heart rate, chest tightness, dyspnea and even acute left heart failure.

2. Improper administration of hypertonic sodium chloride can lead to hypernatremia.

3. Too much and too fast administration of hypotonic sodium chloride will cause hemolysis and brain edema.

4. Phlebitis: It occurs when hypertonic glucose injection is dripped. The incidence of phlebitis decreased after intravenous drip.

5. Injecting high concentration solution will cause local swelling and pain if it extravasates.

6. Reactive hypoglycemia: it is prone to insulin overdose, original hypoglycemia tendency, sudden stop of total parenteral nutrition treatment and other comprehensive factors.

7. Hyperglycemia non-ketotic coma: more common in diabetes, stress state, use of high-dose glucocorticoid, hypertonic glucose solution for peritoneal dialysis of uremia patients and total intravenous nutrition treatment.

8. Electrolyte disorder: Long-term simple glucose supplementation is prone to hypokalemia, hyponatremia and hypophosphatemia.

Contraindications

(1) patients with brain, kidney and heart dysfunction;

(2) Patients with low plasma protein;

(3) patients with uncontrolled diabetes and ketoacidosis;

(4) Hypertonic dehydration patients;

(5) Hyperglycemia and hyperosmotic state.

Matters needing attention

(1) Use with caution in the following situations: ① Edema diseases, such as nephrotic syndrome, liver cirrhosis, ascites, congestive heart failure, acute left heart failure, brain edema, idiopathic edema, etc.; ② In the oliguria stage of acute renal failure, the urine volume of chronic renal failure decreased, and the response to diuretics was poor; ③ Hypertension; ④ Hypokalemia; ⑤ The amount and speed of fluid replacement for the elderly and children should be strictly controlled.

(2) Follow-up examination: ① Serum sodium, potassium and chlorine concentrations; ② Blood acid-base balance index. ③ renal function; ④ Blood pressure and cardiopulmonary function.

(3) Injecting too much glucose during delivery can stimulate fetal insulin secretion, leading to postpartum hypoglycemia.

(4) Use with caution in the following situations: ① Patients with periodic paralysis and hypokalemia; ② Stress or glucocorticoid can easily induce hyperglycemia; ③ Edema, severe cardiac and renal insufficiency and ascites due to liver cirrhosis are easy to cause water retention, so the infusion volume should be controlled; People with cardiac insufficiency should especially control the dripping speed.

Medication for pregnant and lactating women

No special attention.

Children's medication

The quantity and speed of rehydration should be strictly controlled.

Medication for elderly patients

The quantity and speed of rehydration should be strictly controlled.

excessive

Can cause hypernatremia and hypokalemia, and can cause the loss of bicarbonate.

standard

(1) 100ml: 5g of glucose and 0.9g of sodium chloride.

(2) 100 ml: glucose 10 g, sodium chloride 0.9 g.

(3) 250ml: glucose12.5g, sodium chloride 2.25g.

(4)250ml: 25g of glucose and 2.25g of sodium chloride.

(5) 500ml: 25g of glucose and 4.5g of sodium chloride.

(6) 500ml: 50g of glucose and 4.5g of sodium chloride.

(7) 1000ml: 50g of glucose and 9g of sodium chloride.

store

Sealed storage.