Sodium Chloride Injection (various)
Prescription and OTC oral preparations:
Minims Sodium Chloride (CAN), Saline from Otrivin (CAN), Salinex (CAN), Sodium Chloride Tablets
Pregnancy Category C
Sodium chloride is the principal salt involved in the maintenance of plasma tonicity; important for maintaining plasma volume, promoting membrane stability and electrolyte balance.
- Treatment of hyponatremia
- Dilution and reconstitution of parenteral drugs
- Hydration and replacement of fluid loss
- Contraindications: hypernatremia, fluid retention, pregnancy, any condition when increased sodium or chloride could be detrimental.
- Use cautiously with impaired renal function, CHF, edematous or sodium-retaining states, lactation, surgical patients.
Available Forms: Tablets--650 mg; 1, 2.25 g; injections--various preparations
1---2 g PO tid.
Isotonic (replacement) 1 L administered over 1 h; hypotonic (0.45%; hydration) 1---2 L over 1---2 h; hypertonic (3---5%; treatment of hyponatremia) 100 mL over 1 h.
Safety and efficacy not determined; replacement must be monitored closely and based on clinical response.
Geriatric and Renal Impaired:
Reduce dosage, and carefully monitor base deficit and clinical response.
|IV||Immediate||End of infusion|
Metabolism: T1/2: unknown
Distribution: Crosses placenta; enters breast milk
- Preparation: Concentrated sodium chloride must be further diluted before use; other preparations may be given as provided; change infusion q24h; use only if solution is clear.
- Infusion: Administer by IV direct injection slowly; continuous infusion should be regulated with close monitoring of electrolytes and response.
- Incompatibilities: Do not mix with amphotericin B, mannitol.
- GI: Anorexia, nausea, abdominal distention
- Hematologic: Hypernatremia, fluid overload
- Local: Chemical cellulitis, tissue necrosis, ulceration and sloughing at the site ofinfiltration, pain at site of injection (parenteral)
History: Hypernatremia, fluid retention, pregnancy, impaired renal function, CHF, edematous or sodium-retaining states, lactation, surgical patients
Physical: Skin color, turgor; injection sites; P, rhythm, peripheral edema; bowel sounds, abdominal exam; urinary output; serum electrolytes, urinalysis, renal function tests
- Monitor serum electrolytes carefully before and during administration. Administer slowly. Rapid infusion can result in pain and irritation at injection site.
- Give parenteral preparations by IV route.
- Monitor IV injection sites carefully; if infiltration occurs, promptly elevate the site, apply warm soaks, and if needed, arrange for the local injection of lidocaine or hyaluronidase to prevent sloughing.
- Monitor surgical patients for postoperative salt intolerance (weakness, dehydration, disorientation, nausea, distention, oliguria); if this occurs, discontinue infusion and provide supportive measures.
- Assess patients taking oral tablets for actual salt loss; excessive use of these tablets can cause hypernatremia.
Drug-specific teaching points
- Take these tablets only as prescribed.
- Have periodic blood tests and medical evaluations.
- Report irritability, confusion, tremors, swelling of extremities, difficulty breathing, black or tarry stools.
Adverse effects in Italic are most common; those in Bold are life-threatening.