Page 26 - FAR 222 Laboratory Manual V2 2019

FAR 222/3 Dosage Form II Semester 1/ 2019-2020

APPENDICES
IV infusion types:
1. Crystalloid: small molecules flow easily across cell membranes
Isotonic
Type Use Precaution
0.9% NaCl (NS) -treat low extracellular fluid, fluid vol deficit from
154mEq/L Na & Cl hemorrhage, severe vomiting/diarrhea, heavy
ea drainage from GI suction/fistulas/wounds
-shock
-mild hyponatremia
-metabolic acidosis e.g. diabetic ketoacidosis
-resuscitation
-only fluid for blood products
Lactated Ringer’s -most physiologically adaptable fluid: electrolyte -Lactic acidosis: LR
solution or Hartmann most closely related to the composition metabolise in liver,
solution -1 line for resuscitation converting lactate to
st
130 Na mOsm/L -replace GLT fluid losses e.g. diarrhea or bicarbonate
4 K vomiting -severe real
3 Ca -fistula drainage impairment
109 Cl -fluid losses due to burns/trauma -pH>7.5
rd
28 HCO3 -acute blood loss/hypovolemia due to 3 space
273 mOsm/L fluid shifts
5% dextrose in water 170 calories/L Renal failure
50g/L Cerebral edema
278 mOsm/L Resuscitation
Early postoperative
period
Ringer’s solution Similar to LR but no lactate

Hypotonic
-lower serum osmolality within vascular space—fluid shirt from intravascular space to intracellular
& interstitial spaces – hydrate cells
Type Use Precaution
0.45%, 0.33%, 0.2% NaCl Hypernatremia Increased ICP-cerebral
edema
2.5% dextrose Hypersomolar hyperglycemic state Avoid in liver disease,
Diabetic ketoacidosis trauma, burns

Hypertonic
->=375 mOsm/L, volume expander, draw water out of intracellular space
Type Use Precaution
3% NaCl Severe hypornatremia Intravascular fluid volume
Cerebral edema overload, pulmonary edema
5% dextrose with NS (D5NS) Replace Na, Cl, calories

2. Colloid solution:
High oncotic pressure
-expand intravascular volume – draw fluid from interstitial space into intravascular compartment
=hypertonic crystalloids but less total vol & long duration od action because molecules remain
within intravascular space longer
Type Use Contraindication
5% albumin (human Volume expander Severe anemia
albumin solution) Moderate protein replacement Heart failure
Hemodynamic instability in shock Albumin sensitivity
state ACEI withheld at least 24
hrs
Hydroxyethalstarches Vol expander
Contain Na Cl

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