Drug Guide

Generic Name

Sodium Chloride

Brand Names Bacteriostatic Sodium Chloride 0.9%, Sodium Chloride 0.9% In Plastic Container, Sodium Chloride 0.45% In Plastic Container, Sodium Chloride 14.6%, Sodium Chloride 23.4%, Sodium Chloride 3% In Plastic Container, Sodium Chloride 5% In Plastic Container, Sodium Chloride 0.9% In Plastic Thermoject Kit For Cardiac Output Use, Sodium Chloride 0.9% In Sterile Plastic Container, Sodium Chloride 23.4% In Plastic Container, Sodium Chloride 0.9%, Broncho Saline

Classification

Therapeutic: Electrolyte replenisher, fluid replacement

Pharmacological: Saline solution (isotonic, hypertonic, hypotonic)

FDA Approved Indications

Fluid and electrolyte replenishment in dehydration, hypovolemia, or electrolyte imbalance
Diluent for medications
Wound irrigation
Pulmonary lavage (e.g., Broncho Saline)

Mechanism of Action

Provides sodium and chloride ions to support electrolyte balance and rehydration, matching plasma electrolyte composition when isotonic.

Dosage and Administration

Adult: As prescribed for specific indications; typically, IV infusion or irrigation at recommended rates.

Pediatric: Dosing based on weight, clinical condition, and physician instructions.

Geriatric: Adjustments not typically required but monitor for volume overload.

Renal Impairment: Use cautiously; monitor electrolyte levels and fluid status.

Hepatic Impairment: Use with caution; monitor for fluid and electrolyte balance.

Pharmacokinetics

Absorption: Rapidly absorbed when administered IV.

Distribution: Distributes freely within total body water.

Metabolism: Not metabolized; remains as sodium and chloride ions.

Excretion: Excreted via kidneys.

Half Life: Dependent on renal function and volume of distribution.

Contraindications

Known hypersensitivity to sodium chloride or saline solutions.
Severe hypernatremia or hyperchloremia.
Fluid overload or edema in heart or renal failure.

Precautions

Use with caution in patients with hypertension, heart failure, or edema.
Monitor serum sodium and chloride levels frequently.
Avoid rapid infusion to prevent osmotic shifts and cerebral edema.

Adverse Reactions - Common

Swelling or edema (Common)
Hypernatremia or hyperchloremia (Common)

Adverse Reactions - Serious

Fluid overload leading to pulmonary edema (Serious)
Electrolyte imbalance causing cardiac arrhythmias (Serious)

Drug-Drug Interactions

May enhance or diminish effects of medications affected by electrolyte changes, e.g., diuretics, corticosteroids.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor vital signs, cardiovascular status, serum electrolytes, and fluid balance.

Diagnoses:

Risk for electrolyte imbalance
Fluid volume excess or deficit

Implementation: Administer IV solutions using aseptic technique, monitor infusion site, and adjust rate as prescribed.

Evaluation: Assess for signs of effective fluid and electrolyte replenishment and watch for adverse effects.

Patient/Family Teaching

Report any swelling, discomfort, or unusual symptoms.
Ensure understanding of the purpose of saline therapy.
Follow instructions for medication and fluid intake as directed.

Special Considerations

Black Box Warnings:

None

Genetic Factors: None

Lab Test Interference: May alter serum electrolyte measurements, especially sodium and chloride.

Overdose Management

Signs/Symptoms: Signs of fluid overload, hypernatremia, or hyperchloremia such as swelling, confusion, seizures.

Treatment: Discontinue infusion, manage airway and breathing, correct electrolyte imbalances with appropriate fluids or medications, support vital functions.

Storage and Handling

Storage: Store in a cool, dry place at controlled room temperature.

Stability: Stable until expiration date when stored properly.