Standard Solutions -NISF Normal Saline

0.45% Sodium Chloride Injection U.S.P.

Therapeutic Class

Hypotonic crystalloid salt solution

Description and Composition

A clear, colorless solution each 1000 ml. of which contains:

Indications

• Management of diabetic ketoacidosis particularly in infants and children.
• Prevention and management of contrast-induced nephropathy.
• Management of acute renal failure secondary to rhabdomyolysis.
• Environmental emergencies such as heat stroke.
• Used as a vehicle for medications such as sodium bicarbonate in severe metabolic acidosis and magnesium sulphate in the management of preterm labor.

Dosage and Administration

Nisf Normal Saline should be administered according to the clinical condition of the patient, age, and body weight.

For management of contrast-induced nephropathy, 0.45% saline is infused at a rate of 1 ml/kg/hour. Infusion is started 1-2 hours before contrast and continued for up to 24 hours, depending upon the duration of diuresis attained.

In the management of acute renal failure secondary to rhabdomyolysis, in adults, 1000 ml. of 0.45% saline is used to dilute 44 mEq. of sodium bicarbonate and infused at the rate of 100 ml/hour.

Duration of Action and Excretion

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

Adverse Effects

• Fluid overload, congestive heart failure, and hypertension.
• Edema and electrolyte imbalance.

Contraindications

• Congestive heart failure and hypernatremia.

Precautions

• The sodium chloride content of Nisf Normal Saline is 4.5 grams/L. Care is therefore required in those cases where salt intake is restricted, such as in hypertensive patients.
• 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.
• Monitor E.C.G. continuously.
• Frequently monitor vital signs.
• Frequently auscultate breath sounds for rales.

Tonicity and Osmolarity

Hypotonic solution having a tonicity of 77.

Hypo-osmotic solution (154 mOsm/L)

Caloric Value

Nil

Pharmaceutical Precautions

• Store at room temperature. Protect from sunlight.
• Do not use if the bottle is leaking, the solution is cloudy, or contains foreign matter.
• Discard unused portion.
• Keep all medicines out of the reach of children.

Packaging

1000ml in Plabottle.

Pharmacological Effects

• Expands circulating volume by approximating sodium content of the blood.
• Each liter provides 77 mEq of sodium and 77 mEq of chloride.
• The pH range is 3.5 - 7.5.