Drug Guide
Various electrolyte solutions (including Calcium Chloride, Dextrose, Lactic Acid, Magnesium Chloride, Potassium Chloride, Sodium Bicarbonate, Sodium Chloride) in various formulations and proprietary names such as Prismasol Bk, Prismasol Bgk, Prismasol B22gk.
Classification
Therapeutic: Electrolyte and fluid replacement
Pharmacological: Electrolyte solutions and acid-base balance adjustment
FDA Approved Indications
- Electrolyte repletion
- Fluid management in surgical and critical care settings
- Correction of electrolyte imbalances
Mechanism of Action
Provides essential electrolytes and buffers to maintain or restore electrolyte and fluid balance, and pH regulation.
Dosage and Administration
Adult: Administer as per physician’s order for specific electrolyte or fluid deficit.
Pediatric: Use with caution; dosage based on age and clinical condition.
Geriatric: Adjustments based on renal function and electrolyte status.
Renal Impairment: Careful monitoring; adjust doses to avoid hyperkalemia, hypernatremia, or other imbalances.
Hepatic Impairment: Use with caution; monitor electrolyte levels.
Pharmacokinetics
Absorption: Not applicable; administered intravenously.
Distribution: DISTRIBUTED throughout body fluids; specific distribution depends on electrolyte and solution composition.
Metabolism: Electrolytes are regulated via renal and gastrointestinal routes.
Excretion: Renal excretion of electrolytes.
Half Life: Varies; dependent on electrolyte balance and renal function.
Contraindications
- Hyperkalemia
- Hypernatremia
- Heart failure with volume overload
- Renal failure without dialysis
- Allergy to component ingredients
Precautions
- Monitor electrolyte levels closely during administration.
- Use with caution in patients with impaired renal function, cardiac disease, or electrolyte disturbances.
Adverse Reactions - Common
- Injection site phlebitis or irritation (Common)
- Electrolyte imbalance leading to arrhythmia or neurological symptoms (Uncommon)
Adverse Reactions - Serious
- Hyperkalemia, hypernatremia, or other severe electrolyte disturbances (Rare)
- Anaphylaxis (very rare) (Rare)
Drug-Drug Interactions
- Potentiation or antagonism of other electrolytes or drugs affecting cardiac conduction (digoxin, diuretics)
Drug-Food Interactions
- Limited data; generally not significant
Drug-Herb Interactions
- Limited data; consult clinical guidelines
Nursing Implications
Assessment: Monitor vital signs, heart rhythm, and serum electrolyte levels before, during, and after infusion.
Diagnoses:
- Risk for electrolyte imbalance
- Risk for fluid volume overload
Implementation: Administer IV solutions via infusion pump as ordered, ensuring proper rate.
Evaluation: Assess patient’s response, electrolyte levels, and signs of adverse reactions.
Patient/Family Teaching
- Report symptoms of abnormal heartbeat, swelling, or difficulty breathing.
- Keep vein access site clean and dry.
- Follow hospital protocols for IV infusion care.
Special Considerations
Black Box Warnings:
- None specific for these solutions, but caution in patients with cardiovascular or renal disease.
Genetic Factors: None known.
Lab Test Interference: Electrolyte solutions can affect lab tests measuring serum electrolytes.
Overdose Management
Signs/Symptoms: Electrolyte disturbances, including hyperkalemia, hypernatremia, or acid-base imbalance.
Treatment: Discontinue infusion, correct electrolyte imbalances with appropriate medications, and provide supportive care.
Storage and Handling
Storage: Store at room temperature away from direct light and moisture.
Stability: Stable for the duration of the labeled shelf life when stored properly.