WARNINGS
4) is not indicated for the treatment of hypochloraemic hypokalaemic alkalosis. 4) is not indicated for the primary treatment of severe metabolic acidosis neither for the treatment of hypomagnesaemia. Use in Patients with or at Risk for and from Hypermagnaesemia Parenteral magnesium salts should be used with caution in less severe degrees of renal impairment and in patients with myasthenia gravis.
Patients should be monitored for clinical signs of excess magnesium, particularly when being treated for eclampsia. 4) contains no calcium, and an increase in plasma pH due to its alkalinizing effect may lower the concentration of ionized (not protein-bound) calcium.
4) should be administered with particular caution to patients with hypocalcaemia. Use in Patients with or at Risk for Hyperkalaemia Solutions containing potassium salts should be administered with caution to patients with cardiac disease or conditions predisposing to hyperkalaemia such as renal or adrenocortical insufficiency, acute dehydration, or extensive tissue destruction as occurs with severe burns.
The plasma potassium level of the patient should be particularly closely monitored in patients at risk of hyperkalaemia. 5). 4) solution has a potassium concentration similar to the concentration in plasma, it is insufficient to produce a useful effect in case of severe potassium deficiency and therefore it should not be used for this purpose.
Fluid balance/renal function. Risk of Fluid and/or Solute Overload and Electrolyte Disturbances The patient’s clinical status and laboratory parameters (fluid balance, blood and urine electrolytes as well as acid-base balance) must be monitored during use of this solution.
4) can cause − fluid and/or solute overload resulting in overhydration/hypervolaemia therefore high volume infusion must be used under specific monitoring in patients with cardiac, pulmonary or renal failure. High volume infusion must be used under specific monitoring in patients with cardiac or pulmonary failure and in patients with non-osmotic vasopressin release (including SIADH), due to the risk of hospital-acquired hyponatraemia (see below).
g. 5) are at particular risk of acute hyponatraemia upon infusion of hypotonic fluids. Acute hyponatraemia can lead to acute hyponatraemic encephalopathy (cerebral oedema) characterized by headache, nausea, seizures, lethargy and vomiting.
Patients with cerebral oedema are at particular risk of severe, irreversible and life-threatening brain injury. g. meningitis, intracranial bleeding, cerebral contusion and brain oedema) are at particular risk of the severe and life-threatening brain swelling caused by acute hyponatraemia.
4) should be administered with particular caution to hypervolaemic or overhydrated patients. 5 – Interactions with other Medicinal Products and forms of interaction). 4) should be administered with particular caution to patients with severe renal impairment.
4) may result in sodium and/or potassium or magnesium retention. 4) should be administered with particular caution to patients with alkalosis or at risk for alkalosis. 4) can result in metabolic alkalosis because of the presence of acetate and gluconate ions.
4). The infusion must be stopped immediately if any signs or symptoms of a suspected hypersensitivity reaction develop. Appropriate therapeutic countermeasures must be instituted as clinically indicated. Administration Administration in the postoperative period shortly after recovery from neuromuscular block should be used with caution since magnesium salts can lead to recurarisation effect.
When used concomitantly with parenteral nutrition, electrolyte supply should be taken into account and adjusted accordingly. PRECAUTIONS Interference with laboratory tests for gluconate containing solutions There have been reports of false-positive test results using the Bio-Rad Laboratories Platelia […]