SODIUM CHLORIDE

Posology The dosage of this solution depends on the age, weight, clinical and biological (acid- base balance) conditions of the patient, concomitant therapy and in particular the patient's hydration state. 5 L of 4% glucose). 8 g/kg/h (20 ml/kg/h of 4% glucose), but may be only half this in critically ill patients.

5 ml/kg/h). Elderly A reduced volume and rate of infusion may be necessary to avoid circulatory overload. Patients with cardiac and renal impairment A reduced volume and rate of infusion may be necessary to avoid circulatory overload.

18% and Glucose 4% Solution is restricted to specialist paediatric settings such as renal, liver, cardiac, high dependency or intensive care units, where there is expert medical supervision. The dosage depends on the age, weight, clinical and biological (acid-base balance) conditions of the patient, and concomitant therapy and should be determined by the expert.

The child must be carefully monitored throughout treatment. Method of administration Intravenous use. Monitoring Adequate urine flow must be ensured and careful monitoring of fluid balance, plasma and urinary electrolyte concentrations are essential.

Fluid balance, serum glucose, serum sodium and other electrolytes may need to be monitored before and during administration, especially in patients with increased non- osmotic vasopressin release (syndrome of inappropriate antidiuretic hormone secretion, SIADH) and in patients co-medicated with vasopressin agonist drugs due to the risk of hyponatraemia.

Monitoring of serum sodium is particularly important for physiologically hypotonic fluids. 8).

4). Thrombosis of the chosen vein may occur with intravenous infusion. If the infusion is protracted then another vein should be selected after 12 to 24 hours. 9% and Glucose 5% include venous irritation and thrombophlebitis. Unduly rapid, or excessive, administration may lead to pulmonary oedema.

Post Marketing Adverse reactions:

Metabolism and nutrition disorders – severe hyponatraemia, which could lead to death, has been reported. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.

It allows the continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

When used for routine maintenance, a source of potassium to meet daily needs (1 mmol/kg/day) may be required. 18% and Glucose 4% should not be administered rapidly or for prolonged periods particularly in infants and the elderly. 18% and Glucose 4% will increase potassium loss, potassium supplements should also be administered.

18% and Glucose 4% should be administered with caution in patients with diabetic mellitus; the amount of infused glucose should be calculated and insulin requirements modified as appropriate. Serum potassium may also need adjustment.

Patients receiving fluid replacement therapy should be monitored. During the catabolic phase of the response to illness or injury, there is an increase in antidiuretic hormone, cortisol, and aldosterone secretion, especially if there has been any reduction in blood or extracellular fluid volume.

These lead to retention of sodium and water and loss of potassium, which should be accounted for when administering a hypotonic solution. 18% and Glucose 4% is given or the infusion is given too rapidly. Clinical monitoring should include checks of serum electrolytes (including potassium), glucose level, and the acid-base and water balance.

Inadequate monitoring may lead to fluid and electrolyte disturbances such as hyponatraemia. Hyponatraemia can lead to headache, nausea, seizures, lethargy, coma, cerebral oedema and death, therefore acute symptomatic hyponatraemic encephalopathy is considered a medical emergency.

18% and Glucose 4% Solution in the paediatric population <16 years of age is restricted to specialist paediatric settings under expert medical supervision. The dosage depends on the age, weight, clinical and biological (acid-base balance) conditions of the patient, concomitant therapy and should be determined by the expert.

Glucose intravenous infusions are usually isotonic solutions. 2). Depending on the tonicity of the solution, the volume and rate of infusion and depending on a patient's underlying clinical condition and capability to metabolize glucose, intravenous administration of glucose can cause electrolyte disturbances most importantly hypo- or hyperosmotic hyponatraemia.

1. • Hyperhydration states • Hyponatraemia • Acute ischaemic stroke • Head trauma (first 24 hours) • Rehydration in hyperemesis gravidarum. Paediatric Population This product should not be used in children except in paediatric specialist settings (such as renal, hepatic and cardiac units, high dependency units and intensive care units) under expert medical supervision.