Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/drugs/1825
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Lactated Ringer's (Injection, Solution)
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dailymed-instance:dosage |
The dose is dependent upon the age, weight and clinical
condition of the patient. Drug Interactions Additives may be
incompatible. Consult with pharmacist, if available. When introducing
additives, use aseptic technique, mix thoroughly and do not store. The presence of calcium limits their compatibility with
certain drugs that form precipitates of calcium salts, and also prohibits
their simultaneous infusion through the same administration set as
blood because of the likelihood of coagulation. Parenteral drug products should be inspected visually for particulate
matter and discoloration prior to administration, whenever solution
and container permit. See PRECAUTIONS.
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dailymed-instance:descripti... |
Lactated Ringer's Injection, USP is a sterile,
nonpyrogenic solution containing isotonic concentrations of electrolytes
in water for injection. It is administered by intravenous infusion
for parenteral replacement of extracellular losses of fluid and electrolytes. Each 100 mL of Lactated Ringer's Injection, USP
contains sodium chloride 600 mg, sodium lactate, anhydrous 310 mg,
potassium chloride 30 mg and calcium chloride, dihydrate 20 mg. May
contain hydrochloric acid and/or sodium hydroxide for pH adjustment.
A liter provides 9 calories (from lactate), sodium (Na), 130 mEq, potassium (K) 4 mEq, calcium (Ca) 3 mEq, chloride (Cl) 109 mEq and lactate [CHCH(OH) COO] 28 mEq. The electrolyte content
is isotonic (273 mOsmol/liter, calc.) in relation to the extracellular
fluid (approx. 280 mOsmol/liter). The pH of the solution is 6.6 (6.0
to 7.5). This solution contains no bacteriostat,
antimicrobial agent or added buffer (except for pH adjustment) and
is intended only for use as a single-dose injection. When smaller
doses are required the unused portion should be discarded. Lactated Ringer's Injection, USP is a parenteral
fluid, nutrient and/or electrolyte replenisher. Calcium Chloride, USP is chemically designated calcium chloride,
dihydrate (CaCl���2 HO), white fragments
or granules freely soluble in water. Potassium
Chloride, USP is chemically designated KCl, a white granular powder
freely soluble in water. Sodium Chloride, USP
is chemically designated NaCl, a white crystalline powder freely soluble
in water. Sodium Lactate, USP is chemically
designated monosodium lactate [CHCH(OH)COONa], a 60% aqueous
solution miscible in water. It has the following
structural formula: Water for Injection, USP is chemically designated HO. The flexible plastic container is fabricated from a clear
multilayer plastic film (FC97). Exposure to temperatures above 25��C/77��F
during transport and storage will lead to minor losses in moisture
content. Higher temperatures lead to greater losses. It is unlikely
that these minor losses will lead to clinically significant changes
within the expiration period.
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dailymed-instance:clinicalP... |
When administered intravenously, these solutions
provide sources of water and electrolytes. Their electrolyte content
resembles that of the principal ionic constituents of normal plasma
and the solutions therefore are suitable for parenteral replacement
of extracellular losses of fluid and electrolytes. Calcium chloride in water dissociates to provide calcium (Ca) and chloride (Cl) ions. They are normal
constituents of the body fluids and are dependent on various physiologic
mechanisms for maintenance of balance between intake and output. Approximately
80% of body calcium is excreted in the feces as insoluble salts; urinary
excretion accounts for the remaining 20%. Potassium
chloride in water dissociates to provide potassium (K)
and chloride (Cl) ions. Potassium is found in low
concentration in plasma and extracellular fluids (3.5 to 5.0 mEq/liter
in a healthy adult). It is the chief cation of body cells (160 mEq/liter
of intracellular water). Potassium plays an important role in electrolyte
balance. Normally about 80 to 90% of the potassium intake is excreted
in the urine; the remainder in the stools and to a small extent, in
the perspiration. The kidney does not conserve potassium well so that
during fasting or in patients on a potassium-free diet, potassium
loss from the body continues resulting in potassium depletion. Sodium chloride in water dissociates to provide sodium
(Na) and chloride (Cl) ions. Sodium
(Na) is the principal cation of the extracellular fluid
and plays a large part in the therapy of fluid and electrolyte disturbances.
Chloride (Cl) has an integral role in buffering
action when oxygen and carbon dioxide exchange occurs in the red blood
cells. The distribution and excretion of sodium (Na) and
chloride (Cl) are largely under the control of
the kidney which maintains a balance between intake and output. Sodium lactate provides sodium (Na) and lactate
(CHO) ions.
The lactate anion is in equilibrium with pyruvate and has an alkalizing
effect resulting from simultaneous removal by the liver of lactate
and hydrogen ions. In the liver, lactate is metabolized to glycogen
which is ultimately converted to carbon dioxide and water by oxidative
metabolism. The sodium (Na) ion combines with bicarbonate
ion produced from carbon dioxide of the body and thus retains bicarbonate
to combat metabolic acidosis (bicarbonate deficiency). The normal
plasma level of lactate ranges from 0.9 to 1.9 mEq/liter. Water is an essential constituent of all body tissues
and accounts for approximately 70% of total body weight. Average normal
adult daily requirement ranges from two to three liters (1.0 to 1.5
liters each for insensible water loss by perspiration and urine production). Water balance is maintained by various regulatory mechanisms.
Water distribution depends primarily on the concentration of electrolytes
in the body compartments and sodium (Na) plays a major
role in maintaining physiologic equilibrium.
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Solutions containing lactate are NOT FOR USE IN THE
TREATMENT OF LACTIC ACIDOSIS.
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dailymed-instance:supply |
Lactated Ringer's Injection, USP is supplied
in single-dose flexible plastic containers as follows: Store at 20 to 25��C (68 to 77��F). [See
USP Controlled Room Temperature.] Protect from freezing. U.S. patent 4,344,472 May, 2006
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dailymed-instance:precautio... |
Clinical evaluation and periodic laboratory determinations
are necessary to monitor changes in fluid balance, electrolyte concentrations
and acid-base balance during prolonged parenteral therapy or whenever
the condition of the patient warrants such evaluation. Caution must be exercised in the administration of parenteral
fluids, especially those containing sodium ions, to patients receiving
corticosteroids or corticotropin. Potassium
containing solutions should be used with caution in the presence of
cardiac disease, particularly in digitalized patients or in the presence
of renal disease. Solutions containing lactate
ions should be used with caution as excess administration may result
in metabolic alkalosis. Do not administer unless
solution is clear and container is undamaged. Discard unused portion.<br/>Pregnancy:: Teratogenic effects Pregnancy Category
C. Animal reproduction studies have not been conducted with
Lactated Ringer's Injection, USP. It is also not known whether
these injections can cause fetal harm when administered to a pregnant
woman or can affect reproduction capacity. These injections should
be given to a pregnant woman only if clearly needed.<br/>Pediatric Use:: The safety and effectiveness in the pediatric population
are based on the similarity of the clinical conditions of the pediatric
and adult populations. In neonates or very small infants the volume
of fluid may affect fluid and electrolyte balance.<br/>Geriatric Use:: Clinical studies of Lactated Ringer's Injection,
USP did not include sufficient numbers of subjects aged 65 and over
to determine whether they respond differently from younger subjects.
Other reported clinical experience has not identified differences
in responses between elderly and younger patients. In general, dose
selection for an elderly patient should be cautious, usually starting
at the low end of the dosing range, reflecting the greater frequency
of decreased hepatic, renal, or cardiac function, and of concomitant
disease or other drug therapy. This drug is
known to be substantially excreted by the kidney, and the risk of
toxic reactions to this drug may be greater in patients with impaired
renal function. Because elderly patients are more likely to have decreased
renal function, care should be taken in dose selection, and it may
be useful to monitor renal function.
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dailymed-instance:overdosag... |
In the event of overhydration or solute overload,
re-evaluate the patient and institute appropriate corrective measures.
See WARNINGS, PRECAUTIONS, and ADVERSE REACTIONS.
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dailymed-instance:genericMe... |
Sodium chloride, sodium lactate, potassium chloride, and calcium
chloride
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dailymed-instance:fullName |
Lactated Ringer's (Injection, Solution)
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dailymed-instance:adverseRe... |
Reactions which may occur because of the solution
or the technique of administration include febrile response, infection
at the site of injection, venous thrombosis or phlebitis extending
from the site of injection, extravasation and hypervolemia. If an adverse reaction does occur, discontinue the infusion,
evaluate the patient, institute appropriate therapeutic countermeasures
and save the remainder of the fluid for examination if deemed necessary.
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dailymed-instance:warning |
Solutions containing calcium ions should not be administered
simultaneously through the same administration set as blood because
of the likelihood of coagulation. Solutions
which contain potassium should be used with great care, if at all,
in patients with hyperkalemia, severe renal failure and in conditions
in which potassium retention is present. Solutions
containing sodium ions should be used with great care, if at all,
in patients with congestive heart failure, severe renal insufficiency
and in clinical states in which there exists edema with sodium retention. In patients with diminished renal function, administration
of solutions containing sodium or potassium ions may result in sodium
or potassium retention. Solutions containing
lactate ions should be used with great care in patients with metabolic
or respiratory alkalosis. The administration of lactate ions should
be done with great care where there is an increased level or an impaired
utilization of lactate ions, as in severe hepatic insufficiency. The intravenous administration of these solutions can
cause fluid and/or solute overloading resulting in dilution of serum
electrolyte concentrations, overhydration, congested states or pulmonary
edema. The risk of dilutional states is inversely proportional to
the electrolyte concentrations of administered parenteral solutions. The risk of solute overload causing congested states with
peripheral and pulmonary edema is directly proportional to the electrolyte
concentrations of such solutions.
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dailymed-instance:indicatio... |
These solutions are indicated for parenteral replacement
of extracellular losses of fluid and electrolytes, as required bythe clinical condition of the patient.
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dailymed-instance:name |
Lactated Ringer's
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