Hypertonic Solution

Uses

Calcium chloride is an ionic compound used for the treatment of hypocalcemia and hyperkalemia, and as an antidote to magnesium intoxication due to overdosage of magnesium sulfate.

For the treatment of hypocalcemia in those conditions requiring a prompt increase in blood plasma calcium levels, for the treatment of magnesium intoxication due to overdosage of magnesium sulfate, and used to combat the deleterious effects of hyperkalemia as measured by electrocardiographic (ECG), pending correction of the increased potassium level in the extracellular fluid.

Magnesium chloride is an ionic compound and source of magnesium used for electrolyte replenishment and conditions associated with magnesium deficiencies.

Magnesium chloride is used in several medical and topical (skin related) applications. Magnesium chloride usp, anhydrous uses as electrolyte replenisher, pharmaceutic necessity for hemodialysis and peritoneal dialysis fluids.

Sodium Chloride Nasal Drops is used for dry nasal membranes including dry nose resulting from cold and allergy medications. It moistens dry nasal passages from dry climates or from airplane travel, may help dissolve mucus from study noses and clears the nose after surgery. This sterile saline solution is also used to cleanse various parts of the body (wounds, body cavities) and medical equipment (e.g., bandages, catheters, drainage tubes). It is also used as a mixing solution (diluent) for other medications used to irrigate the body (e.g., bacitracin, polymyxin).

Hypertonic Solution is also used to associated treatment for these conditions: Acute Renal Failure (ARF), Chronic Renal Failure (CRF), Dehydration, Dehydration Hypertonic, Dry Mouth, Electrolyte depletion, End-stage Chronic Kidney Failure, Fluid Loss, Hyperkalemia, Hypocalcemia, Hypocalcemic tetany, Hypovolaemia, Isotonic Dehydration, Shock, Hypovolemic, Beta blocker overdose, Calcium channel blocker overdose, Continuous Renal Replacement Therapy, Electrolyte replacement, Haemodiafiltration, Hemodialysis Treatment, Hemofiltration, Irrigation therapy, Parenteral Nutrition, Peritoneal dialysis therapy, Plasma Volume Replacement, Urine alkalinization therapy, Distension of the joints, Extraocular irrigation, Fluid and electrolyte maintenance therapy, Induction of cardiac arrest, Irrigation of the jointsElectrolyte imbalance, Magnesium Deficiency, Mild Metabolic acidosis, Automated peritoneal dialysis, Continuous Renal Replacement Therapy, Continuous ambulatory peritoneal dialysis therapy, Fluid replacement therapy, Hemodialysis Treatment, Irrigation therapy, Organ Preservation, Parenteral rehydration therapy, Peritoneal dialysis therapy, Total parenteral nutrition therapy, Urine alkalinization therapy, Fluid and electrolyte maintenance therapyAllergic Rhinitis (AR), Corneal Edema, Dehydration, Dehydration Hypertonic, Fluid Loss, Hemodilution, Hypertension Intracranial, Hypokalemia, Hyponatremia, Hypotonic Dehydration, Hypovolaemia, Increased Intra Ocular Pressure (IOP), Inflammation of the Nasal Mucosa, Isotonic Dehydration, Metabolic Acidosis, Nasal Congestion, Nasal irritation, Oliguria caused by Acute Renal Failure (ARF), Potassium deficiency, Sinusitis, Skin Irritation, Sodium Depletion, Dryness of the nose, Hypochloremic state, Mild Metabolic acidosis, Mild, moderate Metabolic Acidosis, Electrolyte replacement, Fluid replacement therapy, Heart-Lung-Machine, Oral rehydration therapy, Parenteral Nutrition, Parenteral rehydration therapy, Peritoneal dialysis therapy, Plasma Volume Replacement, Regional Citrate Anticoagulation (RCA), Renal Replacement Therapies, Urine alkalinization therapy, Wound irrigation therapy, Ear wax removal, Fluid and electrolyte maintenance therapy, Increased renal excretion of toxic substances, Maintenance source of fluid and electrolytes, Parenteral drug administration, Reducing brain mass

How Hypertonic Solution works

Calcium chloride in water dissociates to provide calcium (Ca²⁺) and chloride (Cl^-) ions. They are normal constituents of the body fluids and are dependent on various physiological mechanisms for maintenance of balance between intake and output. For hyperkalemia, the influx of calcium helps restore the normal gradient between threshold potential and resting membrane potential.

Mechanism of action of magnesium chloride studied in 10 adult volunteers. Results suggested magnesium ion in duodenum is relatively weak stimulus to pancreas and gall bladder. It is weak stimulant to cholecystokinin release and inhibits net jejunal water absorption. The oral administration of a single 800 mg dose of magnesium chloride in healthy volunteers resulted in a diminished rate of intraluminal lipid and protein digestion. The most pronounced effect of magnesium chloride, however, was a decreased gastric emptying rate of both test meals. After correction for gastric emptying, no differences were noted in intraluminal lipid or protein digestion. Therefore, the lower lipid levels noted after magnesium supplementation are unlikely to be the result of altered lipid assimilation. Magnesium chloride slows gastric emptying but does not influence lipid digestion.

Sodium and chloride — major electrolytes of the fluid compartment outside of cells (i.e., extracellular) — work together to control extracellular volume and blood pressure. Disturbances in sodium concentrations in the extracellular fluid are associated with disorders of water balance.

Dosage

Hypertonic Solution dosage

Infants, children & adults: 2-6 drops into each nostril as needed daily

Use in Children: Safe for pediatrics

Side Effects

No side Effects are expected to occur. However stinging, sneezing, increased nasal discharge, or salty taste may occur in some cases.

Toxicity

Too rapid injection may produce lowering of blood pressure and cardiac syncope. Persistent hypercalcemia from overdosage of calcium is unlikely because of rapid excretion.

Mouse LD50 775mg/kg (intraperitoneal) Mouse LD50 : 7600mg/kg (oral) Rat LD 50 : 8100mg/kg (oral) Rat LD50 176mg/kg (intravenous) Severe toxicity occurs most often after intravenous infusions. It can also occur after chronic excessive oral doses, often in patients with renal insufficiency. Early manifestations are lethargy, hyporeflexia, followed by weakness, paralysis, hypotension, ECG changes (prolonged PR and QRS intervals), CNS depression, seizures, and respiratory depression. In overdose, magnesium impairs neuromuscular transmission, manifested as weakness and hyporeflexia.

The rare inadvertent intravascular administration or rapid intravascular absorption of hypertonic sodium chloride can cause a shift of tissue fluids into the vascular bed, resulting in hypervolemia, electrolyte disturbances, circulatory failure, pulmonary embolism, or augmented hypertension.

Volume of Distribution

Bone (50% to 60%); extracellular fluid (1% to 2%)

The volume of distribution is 0.64 L/kg.

Elimination Route

Oral: Inversely proportional to amount ingested; 40% to 60% under controlled dietary conditions; 15% to 36% at higher doses

Absorption of sodium in the small intestine plays an important role in the absorption of chloride, amino acids, glucose, and water. Chloride, in the form of hydrochloric acid (HCl), is also an important component of gastric juice, which aids the digestion and absorption of many nutrients.

Half Life

Elimination half-life has been reported to be 27.7 hours following an overdose of 400 mEq magnesium in an adult.

17 minutes

Clearance

Maximum magnesium clearance is directly proportional to creatinine clearance.

Elimination Route

Approximately 80% of body calcium is excreted in the feces as insoluble salts; urinary excretion accounts for the remaining 20%.

Magnesium is excreted in urine. Unabsorbed magnesium is excreted in feces

Substantially excreted by the kidneys.

Pregnancy & Breastfeeding use

It is unknown if this medication passes into breast milk. Consult with your doctor before breast-feeding.

Contraindication

Tell your doctor about your medical history, especially of heart problems (e.g., congestive heart failure), lung problems (pulmonary edema), kidney problems, low levels of potassium (hypokalemia), high levels of sodium (hypernatremia), and any allergies.

Innovators Monograph

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