Electrolyte Solutions - PLABOLYTE-M
(5% Dextrose and Electrolytes Injection)
Therapeutic Class
- Hypotonic solution with electrolytes and carbohydrate source.
Description and Composition
A clear, colorless or slightly yellowish solution each 1000 ml. of which contains:
| Calcium Chloride 2H2O | 0.22 grams |
| Potassium Chloride | 1.50 grams |
| Sodium Chloride | 2.16 grams |
| Sodium Acetate 3H2O | 3.13 grams |
| Anhydrous Dextrose | 50.00 grams |
| Water for Injections | q.s. |
Indications
- Recommended as a maintenance solution for children with hyponatremic dehydration, such as due to severe diarrhea.
- Indicated in adults whose oral intake of water and electrolytes are insufficient due to various conditions.
- Recommended as a maintenance solution in adults during the late post-operative period as it also supplies some amount of energy.
- Especially useful in conditions requiring high amounts of potassium, such as maintenance phase of diarrhea and late post-operative period.
Dosage and Administration
The dose is dependent upon the age, weight, and clinical condition of the patient and the quantity of water and electrolytes lost from the body. However, the usual adult dosage is 500-1000 ml. at one time by intravenous drip infusion. The infusion rate should be adjusted to provide 300-500 ml./hour (about 75-125 drops/minute) for adults, and 50-100 ml/hour ( about 12-25 drops/minute) for children. For non-diabetics, the infusion rate of dextrose should not exceed 4mg/kg/minute. At this rate the hepatic glucose production is minimized and peripheral glucose uptake maximized.
Duration of Action and Excretion
Glucose use depends on metabolic rate. It is stored in the liver and muscle as glycogen. Water use depends on clinical state of patient, body temperature and renal function. Excreted through the skin, lungs, and kidneys.
Adverse Effects
- Hyperglycemia.
- Fluid overload.
- Hyperkalemia.
Contraindications
- Patients with hyperkalemia.
- Elevated blood glucose concentrations.
Precautions
- To avoid hyperkalemia, it is advisable to use the solution only when the urine output is more than 500 ml/24 hours or more than 20 ml/hour.
- In non-urgent situations the rate of potassium administration should not exceed 10 mEq/hour. In urgent conditions the rate may be increased up to 40 mEq/hour. In this circumstance cardiac monitoring is advisable.
- The solution should be used with care in patients with renal failure, oliguria, or azotemia.
- Care is required in patients with Addisons Disease without hyperkalemia.
- Caution should be exercised in severe burns without hyperkalemia, in cardiac failure and in diabetics.
- Monitoring of serum electrolytes and blood sugar levels is recommended during therapy.
- Since the tonicity is low, avoid using in head injury patients.
- Use sterile technique in venipuncture and equipment assembly.
- Monitor E.C.G. continuously.
- Monitor blood pressure, pulse rate and respiratory rate frequently.
Tonicity and Osmolarity
- Hypotonic solution, having a tonicity of 83.
- Hyper-osmolar solution (442 mOsm/L)
Caloric Value
187 kCal/Liter
Pharmaceutical Precautions
- Plabolyte-M should not be mixed with citric acid added blood, and preparations containing phosphoric acid or carbonic acid, as the calcium content of this solution may form precipitates with these acids.
- 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
500ml and 1000ml in Plabottle.
Pharmacological Effects
- Plabolyte-M is a maintenance solution with high amounts of potassium in a homogenized form. It provides electrolytes along with calories for some metabolic needs and supplies daily requirements of water and electrolytes. Composition of this solution is based on the calculations made from daily water and electrolyte requirements of children suffering from hyponatremic dehydration and from average daily water and electrolyte requirements of normal adults.
- Each 100mL provides 5 grams of Dextrose and each gram of Dextrose Monohydrate provides 3.4kCal. Depending on the presence of insulin, glucose enters cells and is broken down to pyruvate. With adequate oxygen, it enters the Kreb's cycle in the mitochondria and is converted into energy (A.T.P.), CO2 and H2O. The brain does not require insulin for glucose metabolism. Spares body protein by providing carbohydrate for metabolism,
- Provides the following electrolytes in each liter of fluid:
Sodium 60 mEq. Chloride 60 mEq. Potassium 20 mEq. Calcium 3 mEq. Bicarbonate(as Lactate) 23 mEq. - Osmolarity of Plabolyte-M is 442 mOsm/L. The fluid is hypotonic but hyperosmolar.
- The pH range is 4.5 – 6.5.