Standard Solutions

- PLASALINE

(0.9% Sodium Chloride Intravenous Infusion B.P.) (Normal Saline)

Therapeutic Class

Isotonic crystalloid salt solution

Description and Composition

A clear, colorless solution each 1000 ml. of which contains:
Sodium Chloride B.P. 9.0 grams
Water for Injections q.s.

Indications

Trauma
Hypovolemic states such as prolonged vomiting.
Environmental emergencies
Diabetic ketoacidosis.
H.H.N.C.
Also useful for dilution of medications, as flushing agent for rapid I.V. medication administration and irrigation solution for eyes and wounds and bladder wash after prostate surgery.
Can be used in children to keep vein open.
Management of hypercalcemia. Depending on the condition of the patient, initially 1-2 liters may be administered within 4-8 hours. This helps to increase calcium excretion in the urine. Further therapy with lesser amounts may be continued for 2-3 days with monitoring of serum calcium and vital signs.

Dosage and Administration

Plasaline should be administered according to the clinical condition of the patient, age and body weight.
Diabetic ketoacidosis (DKA) and hyperglycemic, hyperosmolar, non-ketotic coma (H.H.N.C.) may require 500 – 1000mL/hour if blood glucose is greatly elevated and patients are hypotensive and/or dehydrated.

Duration of Action and Excretion

Passes out of the blood stream quite rapidly, especially when normal renal function and renal blood flow are present.

Adverse Effects

Fluid overload and congestive heart failure.
Edema.
Electrolyte imbalance.
Hyperchloremic acidosis.
Hypertension.

Contraindications

Congestive heart failure.

Precautions

The sodium chloride content of Plasaline is 9.0 grams/L. Care is therefore required in those cases where salt intake is restricted, such as in hypertensive patients.
In patients where sodium losses exceed chloride losses, it can cause hyperchloremia and hyperchloremic acidosis.
Infusion of large volumes may cause dilutional acidosis due to the dilution of the bicarbonate concentration in the plasma (as the preparation does not contain bicarbonate).
Care is required in conditions where hypokalemia and/or hypocalcemia exists or may arise as the infusion of the product can decrease the concentration of these electrolytes.
Caution should be exercised in patients with renal failure and in those with reduced urinary output due to obstructive urinary tract diseases.
Continuous infusion of Plasaline may cause hypernatremia, unless free water is supplied along with it.
Monitor E.C.G. continuously.
Frequently monitor vital signs.
Frequently auscultate breath sounds for rales.

Tonicity and Osmolarity Isotonic solution having a tonicity of 150.

Isosmotic solution (308 mOsm/L)

Caloric Value

Nil

Pharmaceutical Precautions

Normal Saline is compatible with almost all drugs. Therefore it can be safely mixed and used with other injectable medicines. However data sheet of the medication should be referred to, before admixture.
Store at room temperature. Protect from sunlight.
Do not use if bottle is leaking, solution is cloudy or contains foreign matter.
Discard unused portion.
Keep all medicines out of the reach of children.

Packaging

100ml. in polyolefin plastic bottles to minimize drug-plastic interactions and with Specific Pilfer Proof Filter (SPPF) Cap to facilitate addition of medications without compromising sterility of the product.
500ml and 1000ml in Plabottle.

Pharmacological Effects

Expands circulating volume by approximating sodium content of the blood.
Each liter provides 150 mEq of sodium and 150 mEq of chloride.
The pH range is 3.5 - 7.5.

PLASALINE