Ringer's solution

Ringer's solution – means for recovery of electrolytic balance at blood loss and other depressed cases.

Pharmacological action

Drug makes up for loss of liquid, promotes desintoxication, recovers electrolytic balance of an organism. Effectively, but quickly fills the volume of the circulating blood (VCB) as quickly leaves in extravasated space. Effect of solution of Ringer on recovery of OTsK proceeds no more than 30-40 minutes that needs to be considered when rendering the emergency help.

Disintoxication action of this means is based on effect of fluidifying and increase in volume of blood that promotes decrease in concentration of toxins in blood.

Composition of solution of Ringer

As a part of Ringer's solution the following connections contain (at the rate on 1 l of solution):

Active agents:

• NaCl - 8,6g;
• Calcium chloride _(CaCl2) - 0,33g;
• Potassium chloride (KCl) - 0,3g.

Excipients:

• Sodium hydroxide (NaOH);
• Hydrochloric acid (HCl);
• Water for injections.

In terms of chemical units as a part of Ringer's solution (1 l) ions contain:

• Sodium (Na+) - 147 mmol;
• Potassium (K+) - 4 mmol;
• Calcium (Ca2+) - 2,25mmol;
• Cl-155,6mmol.

Theoretical osmolarity of substance: 309 ¼«ß¼«½ý/l.

Release form

Drug represents colourless transparent solution, at opacification and/or loss of a deposit means is not subject to use.

Is issued in the following forms:

• In the soft polyethylene bottles intended for a dropper. Capacity of 1 bottle of 500 ml, on 10 bottles in a box;
• In glass bottles with a capacity of 200 and 400 ml, in packaging of 1, 15 or 28 bottles.

Indications to use of solution of Ringer

According to the instruction Ringer's solution intends for use in practice of rendering acute management at the following states:

• Collapse, shock of various etiology;
• Thermal injuries (burns, frostbites);
• Electric trauma;
• Intestinal fistula;
• Intestinal impassability;
• The poisonings of any etiology which are followed by persistent vomiting;
• The heavy course of acute intestinal infections with the expressed diarrheal syndrome, with the subsequent development of dehydration of an organism;
• Acute peritonitis;
• Medical plasma exchange;
• The alkalosis of metabolic genesis accompanied with dehydration.

Application instruction of solution of Ringer

This medicinal substance is intended for parenteral administration. According to the instruction Ringer's solution is entered intravenously kapelno, establishing speed on average of 60-80 drops a minute (250ml/h), or struyno (during rendering the emergency help with a regidratation).

The daily dose for children is established at the rate from 5 to 10 ml on 1 kg of body weight, rate of administering from 30 to 60 drops in a minute, according to the emergency indications the dosage can be increased to 20-30¼½/kg.

The daily dose for adults – from calculation 10-20ml on 1 kg of body weight, according to the emergency indications can be increased to 30-50¼½/kg.

In general the daily dose makes from 2 to 6% of body weight.

The course of treatment is established in an individual order, averages from 3 to 5 days.

Special instructions

• In need of prolonged use of solution of Ringer control of a diuresis and electrolytes of a blood plasma is required;
• In need of jet introduction of large volume of this medicinal substance control of electrolytes of plasma and рН is required to blood (risk of development of acidosis);
• Perhaps undesirable influence with other medicinal substances, for example NPVS, cardiac glycosides therefore in need of parallel use of solution of Ringer and other drugs the doctor has to be informed of the carried-out therapy.

Side effects

When using according to the instruction Ringer's solution is transferred well. Side effects of drug are connected generally with its overdose. Development of the following undesirable effects is possible:

• Hypopotassemia (decrease in level of potassium in plasma);
• Overhydratation;
• Allergic reactions.

For elimination of side effect it is usually enough to reduce a drug dosage, in case of development of an allergy – to interrupt administration of solution of Ringer and to hold the desensibilizing events.

Contraindications to use

Ringer's solution is contraindicated in the presence of the following pathology:

• The increased individual sensitivity to drug;
• Gipernatiyemiya (increase in level of sodium in plasma);
• Hyperchloremia (increase in level of chlorine in plasma);
• Wet brain;
• Fluid lungs;
• Renal failure;
• Heart failure in a decompensation stage;
• Acidosis;
• Reception of glucocorticosteroids.

During pregnancy and feeding by a breast use of solution of Ringer is perhaps strict according to vital indications, data on its safety, as well as on its toxicity at these states are absent.

Rules and periods of storage

To store at the air temperature of 15-25 °C, out of access of direct sunshine, in tight packaging within 2 years. To protect from hit in hands of children.

Preliminary freezing is not an obstacle to use on condition of absence of damage of packaging and preservation of transparency of solution after defrosting.

Issue in a drugstore it is strict according to the recipe, drug is not intended for independent use.