Sodium chloride

Sodium chloride is a drug that has a detoxifying and rehydrating effect.

[ 1 ], [ 2 ]

Indications Sodium chloride

The drug is a saline solution and is used in situations where the body loses an excessively large amount of extracellular fluid. It is used in the development of conditions as a result of which the flow of this fluid is sharply limited:

• dyspeptic manifestations associated with poisoning;
• diarrhea or vomiting;
• burns covering large areas of the body;
• cholera;
• hypochloremia or hyponatremia, which leads to dehydration.

In addition, the solution is also used for external treatment - it can be used to wash the eyes and nose, as well as wounds. Along with this, it is prescribed for inhalation procedures and moisturizing dressings.

The drug can also be used to perform forced diuresis procedures – to treat intoxication or constipation, as well as endogenous bleeding (inside the gastrointestinal tract or lungs).

Indications may also require the use of sodium chloride as a solvent for drugs administered parenterally.

[ 3 ], [ 4 ]

Release form

It is released as a 0.9% solution - inside ampoules of 5, 10 or 20 ml. This substance is used to dilute injection drugs. In addition, the same solution is produced in vials of 100, 200 or 400 or 1000 ml. In this form, the drug is used externally, as well as for enemas and intravenous drip injections.

A 10% solution of the medication is also produced, which is available in 200 or 400 ml bottles.

For oral administration, tablets of 0.9 g are also available.

Another form of release is a nasal spray, produced in 10 ml bottles.

[ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ]

Pharmacodynamics

The drug has the ability to replenish the deficiency of the element Na in the body, which occurs against the background of various diseases. Sodium chloride also increases the volume of fluid circulating inside the vessels.

Such characteristics are due to the fact that the solution contains chloride ions, as well as sodium. These elements can pass through the cell wall using various mechanisms of movement (among them the NaK pump). Sodium is also an important participant in the processes of impulse conduction through neurons, and in addition to this, in the processes of renal metabolism and electrophysiological processes occurring in the heart.

It has been found that sodium chloride helps maintain constant pressure inside the blood plasma, as well as extracellular fluid. If the body is healthy, the required amount of these combined elements enters it with food products, but if there are any disorders (severe burns, vomiting and diarrhea among them), their increased excretion is observed. As a result, the body begins to experience a deficiency of these substances, due to which the blood thickens, there is a disruption in the work of the nervous system and blood flow, and in addition, spasms and cramps appear in the smooth muscles.

With timely introduction of the medicinal NaCl solution into the blood, the balance of water and electrolytes is restored. But, since the level of osmotic pressure exerted by the solution corresponds to the plasma pressure indicators, it cannot be retained inside the vessels, so it is quickly excreted from the body. As a result, after 1 hour from the injection, a maximum of half of the injected solution is retained inside the vessels. Because of this, in case of blood loss, this remedy cannot be maximally effective.

The medicine also has a detoxifying and plasma-substituting effect.

After intravenous injection of the hypertonic form of the solution, an increase in the diuresis process is observed, as well as restoration of the deficiency of the elements Na and Cl in the body.

[ 10 ], [ 11 ]

Pharmacokinetics

The excretion of the solution from the body is carried out mainly by the kidneys. A small part of the sodium is excreted with feces and is also excreted with sweat.

[ 12 ]

Dosing and administration

The saline solution of the medicine must be administered subcutaneously or intravenously.

Usually, patients are prescribed an intravenous drip. Before the procedure, the drip with the medicinal solution must be heated to a temperature of 36-38 degrees. The volume of solution administered to a person depends on his condition, and at the same time on the amount of fluid lost by the body. In addition, when selecting a dose, it is necessary to take into account the patient's weight and age.

On average, 500 ml of the medicinal substance is allowed to be administered per day. The average rate of administration is 540 ml/hour. In case of severe poisoning, the volume of the administered drug can reach 3000 ml. If necessary, injections of 500 ml of the solution are allowed, which are administered at a rate of 70 drops/minute.

Children's daily portions are 20-100 ml/kg. The dosage size depends on the age and weight of the child. It is necessary to take into account that in case of long-term use of the solution, it will be necessary to monitor the electrolyte levels in the urine with plasma.

To dilute drugs administered to patients through a dropper, it is necessary to use within 50-250 ml of the drug per 1 portion of such a drug. The injection features in these cases are determined by the drug being dissolved.

The hypertonic solution must be administered intravenously by jet method.

In case of using drugs to quickly replenish the deficiency of NaCl ions, it is necessary to administer the medicine by drip method (in a dose of 100 ml).

To perform a rectal enema to cause bowel movement, a 5% solution of the drug (100 ml dose) must be administered. In addition, 3000 ml of saline solution of the drug can be administered during the day.

Hypertonic enemas should be used slowly in the following cases: increased intracranial pressure, edema in the heart or kidneys, and hypertension. The dose administered should be between 10 and 30 ml. It is prohibited to perform such an enema if the patient has inflammation or erosion inside the large intestine.

Purulent wounds should be washed according to the doctor's prescribed scheme. Compresses soaked in the solution should be applied directly to the area with damage or wound. Such compresses help remove pus and destroy pathogenic microbes.

The spray should be instilled into the nose, after cleaning it. The dose for adults is 2 drops in each nostril, and for a child - 1 drop. The spray can be used both for therapy and as a preventive measure (in this case, the solution should be instilled for approximately 20 days).

In the form of inhalations, the drug is used to eliminate colds. In such cases, the solution should be mixed with bronchodilators. Inhalations should be performed 3 times a day, each procedure for 10 minutes.

If it is absolutely necessary, it is possible to prepare a saline solution yourself. In this case, you need to dissolve 1 teaspoon of regular salt in 1 liter of boiled water. If you need to prepare a certain amount of liquid (for example, a portion of salt is 50 g), you need to take all the necessary measurements. Such a solution can be used locally, for inhalation with rinsing, and also for enemas. But under no circumstances is it allowed to use a self-prepared solution for intravenous injections or treatment of eyes or open wounds.

[ 15 ], [ 16 ]

Use Sodium chloride during pregnancy

Pregnant women can be given a drip with the solution only if there is an extremely serious disorder (for example, moderate or severe toxicosis, and also gestosis). A healthy pregnant woman receives the substances contained in the solution with food. It should also be taken into account that with an excess of sodium chloride in the body, the patient may develop edema.

Contraindications

Main contraindications:

• the patient has hypokalemia or hyperchloremia/natremia;
• acidosis or hyperhydria of extracellular nature;
• pulmonary or cerebral edema;
• acute stage of left ventricular failure;
• the occurrence of circulatory disorders, against the background of which pulmonary or cerebral edema may develop;
• use of GCS in high doses.

The drug should be used with caution by people with peripheral edema, elevated blood pressure, decompensated CHF, chronic renal failure and preeclampsia, as well as by people who have been diagnosed with other conditions that lead to the development of Na retention in the body.

When using the drug as a solvent for other drugs, the above contraindications must also be taken into account.

[ 13 ]

Side effects Sodium chloride

The use of the drug may provoke the development of such side effects: hyperhydria, acidosis or hypokalemia. But with the correct use of the drug, the occurrence of negative reactions is unlikely.

When using a 0.9% solution of the drug as the main solvent, side effects are determined by the indications of those drugs for the dilution of which the solution is used.

If any complications develop, you should immediately consult your doctor.

[ 14 ]

Overdose

As a result of drug intoxication, the patient may experience vomiting with nausea or diarrhea, and in addition, fever, abdominal pain, and increased heart rate may develop. At the same time, due to overdose, blood pressure may increase, pulmonary or peripheral edema, muscle cramps, renal failure, dizziness, a feeling of weakness, generalized cramps, and a state of coma may develop. Hypernatremia may occur as a result of excessive injection of the drug.

Due to drug poisoning, hyperchloremic acidosis sometimes develops.

When using the substance as a solvent for other drugs, overdose is often caused by the properties of the drugs that are dissolved with sodium chloride.

If a large dose of the drug is accidentally administered, the procedure must be stopped immediately and it must be determined whether the person has any adverse reactions. If so, symptomatic therapy is used.

[ 17 ], [ 18 ], [ 19 ]

Interactions with other drugs

Sodium chloride can be combined with many drugs. It is this quality of the drug that determines that it is often used as a solvent for other drugs.

When diluting other drugs, it is necessary to monitor the visual compatibility of substances, identifying the presence of sediment, as well as changes in the shade of the solution, etc.

The drug has poor compatibility with norepinephrine.

In case of combined use with corticosteroids, regular monitoring of blood electrolyte levels is required.

When used together with spirapril or enalapril, their antihypertensive properties are weakened.

The drug is incompatible with filgrastim, a substance that stimulates leukopoiesis, and also with the polypeptide antibiotic polymyxin B.

There is information that saline solution can increase the bioavailability of other drugs.

After diluting antibiotics in the form of lyophilisate using a solution, they are completely absorbed into the body.

[ 20 ], [ 21 ]

Storage conditions

Sodium chloride must be stored in a place inaccessible to children and protected from moisture, inside a completely closed container. The temperature mark should not exceed 25°C. When using a sealed container for storage, freezing will not affect the medicinal properties of the drug.

[ 22 ], [ 23 ], [ 24 ], [ 25 ], [ 26 ]

Special instructions

Reviews

Sodium chloride receives many reviews, most of which are positive - the medicine is considered quite useful. In particular, they often write about the nasal spray - it is considered effective in eliminating a runny nose, as well as in its prevention. The drug perfectly moisturizes the nasal mucosa, helping to speed up the recovery process.

Shelf life

Sodium chloride in the form of a 0.9% solution (in ampoules) can be used for 5 years from the date of manufacture of the medicinal product. A 0.9% solution (in vials) - for 1 year, and a 10% solution (vials) - for 2 years.

[ 27 ], [ 28 ], [ 29 ], [ 30 ], [ 31 ]