{
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/indication" : [ {
      "value" : "These solutions are indicated for parenteral replacement\nof extracellular losses of fluid and electrolytes, as required bythe clinical condition of the patient.",
      "type" : "literal"
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/genericMedicine" : [ {
      "value" : "Sodium chloride, sodium lactate, potassium chloride, and calcium\nchloride",
      "type" : "literal"
    } ],
    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/supply" : [ {
      "value" : "Lactated Ringer's Injection, USP is supplied\nin single-dose flexible plastic containers as follows: Store at 20 to 25��C (68 to 77��F). [See\nUSP Controlled Room Temperature.] Protect from freezing. U.S. patent 4,344,472 May, 2006",
      "type" : "literal"
    } ],
    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/fullName" : [ {
      "value" : "Lactated Ringer's (Injection, Solution)",
      "type" : "literal"
    } ],
    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/clinicalPharmacology" : [ {
      "value" : "When administered intravenously, these solutions\nprovide sources of water and electrolytes. Their electrolyte content\nresembles that of the principal ionic constituents of normal plasma\nand the solutions therefore are suitable for parenteral replacement\nof extracellular losses of fluid and electrolytes. Calcium chloride in water dissociates to provide calcium (Ca) and chloride (Cl) ions. They are normal\nconstituents of the body fluids and are dependent on various physiologic\nmechanisms for maintenance of balance between intake and output. Approximately\n80% of body calcium is excreted in the feces as insoluble salts; urinary\nexcretion accounts for the remaining 20%. Potassium\nchloride in water dissociates to provide potassium (K)\nand chloride (Cl) ions. Potassium is found in low\nconcentration in plasma and extracellular fluids (3.5 to 5.0 mEq/liter\nin a healthy adult). It is the chief cation of body cells (160 mEq/liter\nof intracellular water). Potassium plays an important role in electrolyte\nbalance. Normally about 80 to 90% of the potassium intake is excreted\nin the urine; the remainder in the stools and to a small extent, in\nthe perspiration. The kidney does not conserve potassium well so that\nduring fasting or in patients on a potassium-free diet, potassium\nloss from the body continues resulting in potassium depletion. Sodium chloride in water dissociates to provide sodium\n(Na) and chloride (Cl) ions. Sodium\n(Na) is the principal cation of the extracellular fluid\nand plays a large part in the therapy of fluid and electrolyte disturbances.\nChloride (Cl) has an integral role in buffering\naction when oxygen and carbon dioxide exchange occurs in the red blood\ncells. The distribution and excretion of sodium (Na) and\nchloride (Cl) are largely under the control of\nthe kidney which maintains a balance between intake and output. Sodium lactate provides sodium (Na) and lactate\n(CHO) ions.\nThe lactate anion is in equilibrium with pyruvate and has an alkalizing\neffect resulting from simultaneous removal by the liver of lactate\nand hydrogen ions. In the liver, lactate is metabolized to glycogen\nwhich is ultimately converted to carbon dioxide and water by oxidative\nmetabolism. The sodium (Na) ion combines with bicarbonate\nion produced from carbon dioxide of the body and thus retains bicarbonate\nto combat metabolic acidosis (bicarbonate deficiency). The normal\nplasma level of lactate ranges from 0.9 to 1.9 mEq/liter. Water is an essential constituent of all body tissues\nand accounts for approximately 70% of total body weight. Average normal\nadult daily requirement ranges from two to three liters (1.0 to 1.5\nliters each for insensible water loss by perspiration and urine production). Water balance is maintained by various regulatory mechanisms.\nWater distribution depends primarily on the concentration of electrolytes\nin the body compartments and sodium (Na) plays a major\nrole in maintaining physiologic equilibrium.",
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/warning" : [ {
      "value" : "Solutions containing calcium ions should not be administered\nsimultaneously through the same administration set as blood because\nof the likelihood of coagulation. Solutions\nwhich contain potassium should be used with great care, if at all,\nin patients with hyperkalemia, severe renal failure and in conditions\nin which potassium retention is present. Solutions\ncontaining sodium ions should be used with great care, if at all,\nin patients with congestive heart failure, severe renal insufficiency\nand in clinical states in which there exists edema with sodium retention. In patients with diminished renal function, administration\nof solutions containing sodium or potassium ions may result in sodium\nor potassium retention. Solutions containing\nlactate ions should be used with great care in patients with metabolic\nor respiratory alkalosis. The administration of lactate ions should\nbe done with great care where there is an increased level or an impaired\nutilization of lactate ions, as in severe hepatic insufficiency. The intravenous administration of these solutions can\ncause fluid and/or solute overloading resulting in dilution of serum\nelectrolyte concentrations, overhydration, congested states or pulmonary\nedema. The risk of dilutional states is inversely proportional to\nthe electrolyte concentrations of administered parenteral solutions. The risk of solute overload causing congested states with\nperipheral and pulmonary edema is directly proportional to the electrolyte\nconcentrations of such solutions.",
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    "http://www.w3.org/2000/01/rdf-schema#label" : [ {
      "value" : "Lactated Ringer's (Injection, Solution)",
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/activeIngredient" : [ {
      "value" : "http://www4.wiwiss.fu-berlin.de/dailymed/resource/ingredient/Sodium_Chloride",
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/dosage" : [ {
      "value" : "The dose is dependent upon the age, weight and clinical\ncondition of the patient. Drug Interactions Additives may be\nincompatible. Consult with pharmacist, if available. When introducing\nadditives, use aseptic technique, mix thoroughly and do not store. The presence of calcium limits their compatibility with\ncertain drugs that form precipitates of calcium salts, and also prohibits\ntheir simultaneous infusion through the same administration set as\nblood because of the likelihood of coagulation. Parenteral drug products should be inspected visually for particulate\nmatter and discoloration prior to administration, whenever solution\nand container permit. See PRECAUTIONS.",
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/inactiveIngredient" : [ {
      "value" : "http://www4.wiwiss.fu-berlin.de/dailymed/resource/ingredient/Water",
      "type" : "uri"
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      "value" : "http://www4.wiwiss.fu-berlin.de/dailymed/resource/ingredient/Hydrochloric_Acid",
      "type" : "uri"
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      "value" : "http://www4.wiwiss.fu-berlin.de/dailymed/resource/ingredient/Sodium_Hydroxide",
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/name" : [ {
      "value" : "Lactated Ringer's",
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/routeOfAdministration" : [ {
      "value" : "http://www4.wiwiss.fu-berlin.de/dailymed/resource/routeOfAdministration/Intravenous",
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/activeMoiety" : [ {
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/representedOrganization" : [ {
      "value" : "http://www4.wiwiss.fu-berlin.de/dailymed/resource/organization/Hospira%2C_Inc.",
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/adverseReaction" : [ {
      "value" : "Reactions which may occur because of the solution\nor the technique of administration include febrile response, infection\nat the site of injection, venous thrombosis or phlebitis extending\nfrom the site of injection, extravasation and hypervolemia. If an adverse reaction does occur, discontinue the infusion,\nevaluate the patient, institute appropriate therapeutic countermeasures\nand save the remainder of the fluid for examination if deemed necessary.",
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      "value" : "http://www4.wiwiss.fu-berlin.de/drugbank/vocab/resource/class/Offer",
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/contraindication" : [ {
      "value" : "Solutions containing lactate are NOT FOR USE IN THE\nTREATMENT OF LACTIC ACIDOSIS.",
      "type" : "literal"
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/precaution" : [ {
      "value" : "Clinical evaluation and periodic laboratory determinations\nare necessary to monitor changes in fluid balance, electrolyte concentrations\nand acid-base balance during prolonged parenteral therapy or whenever\nthe condition of the patient warrants such evaluation. Caution must be exercised in the administration of parenteral\nfluids, especially those containing sodium ions, to patients receiving\ncorticosteroids or corticotropin. Potassium\ncontaining solutions should be used with caution in the presence of\ncardiac disease, particularly in digitalized patients or in the presence\nof renal disease. Solutions containing lactate\nions should be used with caution as excess administration may result\nin metabolic alkalosis. Do not administer unless\nsolution is clear and container is undamaged. Discard unused portion.<br/>Pregnancy:: Teratogenic effects Pregnancy Category\nC. Animal reproduction studies have not been conducted with\nLactated Ringer's Injection, USP. It is also not known whether\nthese injections can cause fetal harm when administered to a pregnant\nwoman or can affect reproduction capacity. These injections should\nbe given to a pregnant woman only if clearly needed.<br/>Pediatric Use:: The safety and effectiveness in the pediatric population\nare based on the similarity of the clinical conditions of the pediatric\nand adult populations. In neonates or very small infants the volume\nof fluid may affect fluid and electrolyte balance.<br/>Geriatric Use:: Clinical studies of Lactated Ringer's Injection,\nUSP did not include sufficient numbers of subjects aged 65 and over\nto determine whether they respond differently from younger subjects.\nOther reported clinical experience has not identified differences\nin responses between elderly and younger patients. In general, dose\nselection for an elderly patient should be cautious, usually starting\nat the low end of the dosing range, reflecting the greater frequency\nof decreased hepatic, renal, or cardiac function, and of concomitant\ndisease or other drug therapy. This drug is\nknown to be substantially excreted by the kidney, and the risk of\ntoxic reactions to this drug may be greater in patients with impaired\nrenal function. Because elderly patients are more likely to have decreased\nrenal function, care should be taken in dose selection, and it may\nbe useful to monitor renal function.",
      "type" : "literal"
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/description" : [ {
      "value" : "Lactated Ringer's Injection, USP is a sterile,\nnonpyrogenic solution containing isotonic concentrations of electrolytes\nin water for injection. It is administered by intravenous infusion\nfor parenteral replacement of extracellular losses of fluid and electrolytes. Each 100 mL of Lactated Ringer's Injection, USP\ncontains sodium chloride 600 mg, sodium lactate, anhydrous 310 mg,\npotassium chloride 30 mg and calcium chloride, dihydrate 20 mg. May\ncontain hydrochloric acid and/or sodium hydroxide for pH adjustment.\nA 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\nis isotonic (273 mOsmol/liter, calc.) in relation to the extracellular\nfluid (approx. 280 mOsmol/liter). The pH of the solution is 6.6 (6.0\nto 7.5). This solution contains no bacteriostat,\nantimicrobial agent or added buffer (except for pH adjustment) and\nis intended only for use as a single-dose injection. When smaller\ndoses are required the unused portion should be discarded. Lactated Ringer's Injection, USP is a parenteral\nfluid, nutrient and/or electrolyte replenisher. Calcium Chloride, USP is chemically designated calcium chloride,\ndihydrate (CaCl���2 HO), white fragments\nor granules freely soluble in water. Potassium\nChloride, USP is chemically designated KCl, a white granular powder\nfreely soluble in water. Sodium Chloride, USP\nis chemically designated NaCl, a white crystalline powder freely soluble\nin water. Sodium Lactate, USP is chemically\ndesignated monosodium lactate [CHCH(OH)COONa], a 60% aqueous\nsolution miscible in water. It has the following\nstructural formula: Water for Injection, USP is chemically designated HO. The flexible plastic container is fabricated from a clear\nmultilayer plastic film (FC97). Exposure to temperatures above 25��C/77��F\nduring transport and storage will lead to minor losses in moisture\ncontent. Higher temperatures lead to greater losses. It is unlikely\nthat these minor losses will lead to clinically significant changes\nwithin the expiration period.",
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    "http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/overdosage" : [ {
      "value" : "In the event of overhydration or solute overload,\nre-evaluate the patient and institute appropriate corrective measures.\nSee WARNINGS, PRECAUTIONS, and ADVERSE REACTIONS.",
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