Potassium Chloride, Sodium Lactate, Sodium Chloride

Instruction manual

For medical use of the drug

Darrow solution

(darrow’s solution)

Structure:

Active substances: sodium chloride, potassium chloride, sodium lactate;

100 ml of the solution contains: sodium chloride - 0.4 g; potassium chloride - 0.267 g; sodium lactate –0.594 g;

ionic composition per 1000 ml of solution: Na⁺- 121 mmol, K⁺- 36 mmol, Cl^—- 104 mmol, lactate –53 mmol;

excipient: water for injection.

Dosage form.

Solution for infusion.

Basic physical and chemical properties: transparent, colorless liquid; theoretical osmolarity - 314 mosmol / l; pH 5.5–7.5.

Pharmacotherapeutic group.

Plasma replacement and perfusion solutions. solutions used to correct electrolyte imbalance. electrolytes.

Code ATX B05V B01.

Pharmacological properties.

Pharmacodynamics

Isoosmotic electrolyte solution with a high content of potassium and lactate. The latter in the liver transforms into bicarbonate, which gives the solution alkaline properties. In the absence of violations of the functional state of the liver and with sufficient supply of oxygen to the cells, lactate acts as an energy source.

Pharmacokinetics

With intravenous administration, the components of the drug are rapidly excreted by the kidneys. Lactate is metabolized in the liver.

Clinical characteristics.

Indications.

Correction of violations of the water-electrolyte balance during dehydration, which is accompanied by hypokalemia and acidosis; with prolonged administration of oral diuretics, which is accompanied by a loss of potassium; to restore the water-electrolyte balance in preparing patients for surgery, in the intra- and postoperative period.

Contraindications

Hypervolemia, hypernatremia (including due to the use of corticosteroids), hyperkalemia, hyperchloremia, acute and hypertonic dehydration, pulmonary edema, decompensated heart failure, eclampsia, severe dysfunction of the heart and / or kidneys, liver failure (due to a decrease in the formation of bicarbonate from lactate), thrombophlebitis, conditions with increased blood coagulability, decompensated heart defects.

Alkalosis, lactic acidosis, severe arterial hypertension, oliguria, anuria, cerebral edema, hypersensitivity to the components of the drug.

Special security measures.

With the introduction of large volumes, when the concentration of potassium in the blood serum reaches a high level (6.5-8 mmol / l), hyperkalemia may occur with a violation of the heart rhythm.

Interaction with other drugs and other types of interactions.

When using potassium-sparing diuretics, angiotensin-converting enzyme inhibitors (APF) and potassium preparations, the risk of developing hyperkalemia is increased.

The drug is incompatible with cefamandol, amphotericin, ethyl alcohol, thiopental, aminocaproic acid, metaraminol, ampicillin, vibramycin and monocycline.

It is not recommended to use the drug as a means for breeding antibiotics that are administered by infusion, as well as for breeding anti-inflammatory drugs.

It is possible to increase the delay in sodium in the body while using such drugs: non-steroidal anti-inflammatory drugs, androgens, anabolic hormones, estrogens, corticotropin, mineralocorticoids, vasodilators or ganglion blockers.

Due to the presence of lactate, which alkalizes the pH, the drug should be used with caution while the use of drugs whose renal elimination depends on pH. The renal clearance of salicylates, barbiturates, lithium may decrease, and sympathomimetics and stimulants (such as dexamphetamine sulfate, fenfluramine hydrochloride) may increase.

Features of the application.

Blood should be monitored for electrolyte content, pH and pCO2 changes, and water balance control.

Due to the content of sodium ions, the drug should be used with caution in elderly patients, patients with arterial hypertension, renal and cardiovascular failure, with congestive heart failure, especially in the postoperative period, as well as in patients with clinical conditions that are accompanied by sodium retention and edema patients with hypoxia.

"Darrow solution" containing sodium should be used with caution in patients who receive corticosteroids or corticotropin.

Potassium content requires caution when applying the solution to patients with heart disease and clinical conditions, which are accompanied by a delay in potassium in the body.

When using potassium preparations, cardiac activity should be monitored using an ECG, especially in patients who receive cardiac glycosides.

In patients with reduced excretory function of the kidneys, the appointment of "Darrow solution" can lead to a delay in sodium or potassium in the body.

Darrow Solution is not used as a solvent for blood products.

When conducting infusion therapy with a drug, it is necessary to determine laboratory parameters and give a clinical assessment of the patients condition based on monitoring the concentration of electrolytes, water-electrolyte balance, pH and pCO₂, lactate (during massive infusions).

The use of intravenous solutions can cause overloading with a liquid and / or solution, hyperhydration, congestion and pulmonary edema. The risk of dilution develops inversely with the concentration of electrolytes. The risk of developing a solution overload that causes congestion with peripheral edema and pulmonary edema is directly proportional to the concentration of electrolytes.

In case of any manifestations of a hypersensitivity reaction, immediately stop the solution and conduct the necessary treatment.

Since the drug contains sodium lactate, it should be used with extreme caution in patients prone to hypernatremia (for example, with adrenocortical insufficiency, diabetes insipidus or massive tissue damage) or in patients with heart disease.

Use during pregnancy or lactation.

The drug should be used during pregnancy only in cases where the expected benefit of treatment exceeds the possible risk to the fetus.

The ability to influence the reaction rate when driving vehicles or other mechanisms.

Data are not available due to the use of the drug exclusively in a hospital setting.

Dosage and administration.

Introduce intravenously in a daily dose from 100 ml to 2 liters. the dose is prescribed by the doctor depending on the condition of the patient, the course of the disease, indicators of the state of water-electrolyte balance.

The maximum rate of administration is 20-30 drops per minute.

The duration of treatment depends on the condition of the patient and is determined individually by the doctor.

Children.

Do not use in pediatrics due to lack of clinical trials.

Overdose.

The introduction of a large volume of the solution or too rapid administration can lead to cardiopulmonary decompensation, disruption of the water-electrolyte balance (hypervolemia, hypernatremia, hyperkalemia, hyperchloremia) and / or acid-base balance (alkalosis). in this case, the administration of the drug should be stopped immediately. conduct symptomatic therapy.

Adverse Reactions

Electrolyte imbalance: a change in the level of electrolytes in the blood serum (hyperkalemia, hypernatremia, hyperchloremia); metabolic alkalosis; chloride acidosis.

General reactions of the body: hypervolemia; overhydration; allergic or anaphylactic reactions (fever, itching, coughing, sneezing, shortness of breath, localized or generalized urticaria, angioedema); panic attack; paresthesia; heart rhythm disturbances, an increase in the number of extrasystoles.

Adverse reactions may occur at the injection site: inflammation, swelling, rashes, itching, erythema, pain, burning, numbness at the infusion site, thrombophlebitis.

Rapid administration of the drug can cause acute circulatory failure and pulmonary edema.

In case of adverse reactions, the administration of the solution should be discontinued, the patients condition assessed and appropriate assistance provided.

Shelf life.

5 years.

Storage conditions.

Store at a temperature not exceeding 25 ° C out of the reach of children.

Incompatibility.

The solution should not be mixed with other drugs.

Packaging.

200 ml or 400 ml in bottles.

Vacation category.

On prescription.

Manufacturer.

Private joint-stock company "infusion".

The location of the manufacturer and the address of the place of business.

Ukraine, 23219, Vinnitsa region, Vinnitsa district, s. Vinnytsia farms, st. Nemirovskoe highway, 84a.