COMPOSITION :
Ringer Lactate Infusion, each 500 ml contains :
Sodium Chloride 3 g
Potassium Chloride 0.15 g
Calcium Chloride Dihydrate 0.1 g
Sodium Lactate 1.55 g
Water for Injection ad 500 ml
Osmolarity : 278 mOsm/l.
Na + : 130 mEq/l
K + : 4 mEq/l
Ca ++ : 2.7 mEq/l
Cl - : 109 mEq/l
Lactate - : 28 mEq/l
PHARMACOLOGY :
Ringer Lactate Infusion is a clear solution, colorless, sterile and non pyrogen is available in 500 ml plastic bottle.
The most important advantages of Ringer Lactate Infusion are electrolyte composition and the concentration are very similar to those contained in the extracellular fluid. Sodium is the major cation of blood plasma and determine the osmotic pressure. Chloride is the major anion in blood plasma. Potassium is the most important cation in intracellular and serves for nerve and muscle conduction. These electrolytes are needed to replace fluid loss from dehydration, hypovolemic shock including hemorrhagic shock. Lactate content contained as much as 28 mEq/l is intended as a Bicarbonate precursor as in the following reaction :
NaCH 3CHOHCOO + H 2O + CO 2 → Na + + HCO 3 - + CH 3CHOHCOOH
(Sodium Lactate)
(Lactate Acid)
With the presence of these Bicarbonate or Lactate, Ringer Lactate Infusion is very well used in cases of diarrhea which are usually accompanied by metabolic acidosis, because bicarbonate wasted through feces. This electrolyte composition is also an option in the resuscitation of patients with other various condition, such as dengue fever with shock, hemorrhage shock.
Sodium Chloride is the principal salt involved in maintaining the osmotic tension of the blood and tissue.
Changes in Sodium and Chloride levels change this osmotic tension and hence influence the movement of fluids and diffusion of salt in cellular tissue.
Sodium Chloride is the salt which is involved in the maintenace of osmotic pressure, blood and tissue osmoses.
Potassium Chloride provides Potassium ions to the body.
Potassium is the principal cation of intracellular fluid and is intimately involved in cell function and metabolism. It is essential for carbohydrate metabolism, glycogen storage and for protein synthesis.
Like Sodium it is involved in maintaining transmembrane potential and profoundly affects muscles, including the myocardium.
Potassium Chloride is a salt for prevention or treatment of hypokalaemia accompanied by hypochloraemia.
Similarly, Calcium Chloride provides Calcium ions.
Calcium in volved in the maintenance of normal muscle and nerve function, normal cardiac function as well as normal blood clotting.
Calcium Chloride is a salt which can be used for maintenance of normal muscle and nerve function.
Sodium Lactate after absorption is metabolized in 1 - 2 hours to Bicarbonate, it then behaves as endogenous bicarbonate, exerting an alkalinizing effect.
In the absence of bicarbonate deficiency, it is excreted by the kidney.
Urine becomes less acidic with accompanying diuresis.
Sodium Lactate is a salt which can be used in metabolic emergency acidosis
INDICATIONS :
- Fluid and electrolyte replenisher, blood volume expansion (temporary), systemic alkalizer and specifically used on the state of acidosis which accompanied by dehydration.
- Replacement of extracellular fluid loss (isotonic dehydration).
- Salt depletion.
- Light metabolic acidosis.
- Electrolyte substitution in burns.
DOSAGE AND ADMINISTRATION :
Dose usage adjusted by the need and patient condition individually.
Dosage and drop rate
Intravenous injection with speed flow suggestion as follows :
a. 2.5 ml/kgBW/hour
b. 60 drops/70 kgBW/minute
c. 180 ml/70 kgBW/hour
Route of administration :
IV
PRESENTATION :
Ringer Lactate Infusion
