Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/drugs/713
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Ringer's (Irrigant)
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| dailymed-instance:dosage |
The dose is dependent upon the capacity or surface area of
the structure to be irrigated and the nature of the procedure. When used as
a vehicle for other drugs, the manufacturer's recommendations should
be followed. Parenteral drug products should be inspected
visually for particulate matter and discoloration prior to administration,
whenever solution container permits. See PRECAUTIONS.
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| dailymed-instance:descripti... |
These products are sterile, nonpyrogenic solutions of electrolytes
in water for injection intended only for sterile irrigation, washing and rinsing
purposes. Each 100 mL of Ringer's Irrigation,
USP contains: Sodium chloride 860 mg; potassium chloride 30 mg; calcium chloride
dihydrate 33 mg. The pH is 5.7 (5.0���7.5). The solution is isotonic
(309 mOsmol/liter, calc.) and has the following electrolyte content (mEq/liter):
Na147.5; K4; Ca4.5; Cl156. The
solution contains no bacteriostat, antimicrobial agent or added buffer and
is intended only for use as single-dose or short procedure irrigation. When
smaller volumes are required the unused portion should be discarded. Ringer's
Irrigation, USP may be classified as a sterile irrigant, wash, rinse and pharmaceutical
vehicle. Calcium Chloride, USP is chemically designated
calcium chloride dihydrate (CaCl���2HO), 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. Water
for Injection, USP is chemically designated HO. The
semi-rigid container is fabricated from a specially formulated polyolefin.
It is a copolymer of ethylene and propylene. The container requires no vapor
barrier to maintain the proper drug concentration. Solutions
in contact with the plastic container may leach out certain chemical components
from the plastic in very small amounts; however, biological testing was supportive
of the safety of the plastic container materials. 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... |
Ringer's Irrigation, USP exerts a mechanical cleansing
action for sterile irrigation of body cavities, tissues or wounds, indwelling
urethral catheters and surgical drainage tubes, and for washing, rinsing or
soaking surgical dressings, instruments and laboratory specimens. It also
serves as a vehicle for drugs used for irrigation or other pharmaceutical
preparations. Ringer's Irrigation, USP provides
an isotonic irrigation with the same ionic constituents as Ringer's
Injection, USP, a modification of Ringer's solution (also called Ringer's
mixture) originally used only as a topical physiologic salt solution. Ringer's
Irrigation, USP is considered generally compatible with living tissues and
organs. 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 the chief cation of body cells (160 mEq/liter of intracellular
water). It is found in low concentration in plasma and extracellular fluids
(3.5 to 5.0 mEq/liter in a healthy adult). 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. 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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| dailymed-instance:activeIng... | |
| dailymed-instance:contraind... |
NOT FOR INJECTION BY USUAL PARENTERAL ROUTES. An
electrolyte solution should not be used for irrigation during electrosurgical
procedures.
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| dailymed-instance:supply |
Ringer's Irrigation, USP is supplied in a single-dose
1000 mL semi-rigid irrigation container (List No. 6140). Exposure
of pharmaceutical products to heat should be minimized. Avoid excessive heat.
Protect from freezing. It is recommended that the product be stored at room
temperature (25��C). HOSPIRA, INC., LAKE FOREST,
IL 60045 USA
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| dailymed-instance:activeMoi... | |
| dailymed-instance:inactiveI... | |
| dailymed-instance:precautio... |
Do not use for irrigation that may result in absorption into
the blood. Caution should be observed when the solution
is used for continuous irrigation or allowed to���dwell���inside
body cavities because of possible absorption into the blood stream and the
production of circulatory overload. Aseptic technique
is essential with the use of sterile solutions for irrigation of body cavities,
wounds and urethral catheters or for wetting dressings that come in contact
with body tissues. When used as a���pour���irrigation, no part of the contents should be allowed to contact the surface
below the outer protected thread area of the semi-rigid wide mouth container.
When used for irrigation via irrigation equipment, the administration set
should be attached promptly. Unused portions should be discarded and a fresh
container of appropriate size used for the start-up of each cycle or repeat
procedure. For repeated irrigations of urethral catheters, a separate container
should be used for each patient. Do not administer unless
solution is clear, seal is intact and container is undamaged. Discard unused
portion.<br/>Drug Interactions: Additives may be incompatible. Consult with pharmacist, if
available. When introducing additives, use aseptic technique, mix thoroughly
and do not store.<br/>Carcinogenesis, Mutagenesis, Impairment of Fertility:: Studies with Ringer's Irrigation, USP have not been
performed to evaluate carcinogenic potential, mutagenic potential, or effects
on fertility.<br/>Nursing Mothers:: Caution should be exercised when Ringer's Irrigation,
USP is administered to a nursing woman.<br/>Pregnancy:: Teratogenic Effects. Pregnancy Category C. Animal reproduction studies
have not been conducted with Ringer's Irrigation, USP. It is also not
known whether Ringer's Irrigation, USP can cause fetal harm when administered
to a pregnant woman or can affect reproduction capacity. Ringer's Irrigation,
USP should be given to a pregnant woman only if clearly needed.<br/>Pediatric Use:: Safety and effectiveness in pediatric patients have not been
established.<br/>Geriatric Use:: Clinical studies of Ringer's Irrigation have not been
performed to determine whether patients over 65 years 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, 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, potassium chloride and calcium chloride
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| dailymed-instance:fullName |
Ringer's (Irrigant)
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| dailymed-instance:adverseRe... |
Possible adverse effects arising from the irrigation of body
cavities, tissues, or indwelling catheters and tubes are usually avoidable
when proper procedures are followed. Displaced catheters or drainage tubes
can lead to irrigation or infiltration of unintended structures or cavities.
Excessive volume or pressure during irrigation of closed cavities may cause
undue distention or disruption of tissues. Accidental contamination from careless
technique may transmit infection. Should any adverse reaction occur, discontinue
the irrigant, evaluate the patient, institute appropriate therapeutic countermeasures
and save the remainder of the fluidfor examination if deemed necessary.
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| dailymed-instance:warning |
FOR IRRIGATION ONLY. NOT FOR INJECTION. Irrigating
fluids have been demonstrated to enter the systemic circulation in relatively
large volumes; thus this irrigation must be regarded as a systemic drug. Absorption
of large amounts 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. Do
not heat over 66��C (150��F).
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| dailymed-instance:indicatio... |
Ringer's Irrigation, USP is indicated for all general
irrigation, washing and rinsing purposes which permit use of a sterile, nonpyrogenic
electrolyte solution.
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| dailymed-instance:name |
Ringer's
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