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What is Sodium Chloride
Sodium and chloride are the principle cation and anion, respectively, of extracellular fluid.
They play a major role in fluid regulation and tissue hydration. Sodium chloride is available in a variety of concentrations and dosage forms. It has a plethora of indications, but is commonly used in intravenous (IV) maintenance fluids and as an isotonic crystalloid for volume resuscitation in dehydration and shock.
Hypertonic sodium chloride may be used for intracranial hypertension management in adults, although Brain Trauma Foundation guidelines do not make specific recommendations regarding its use.
Hypertonic saline is also used intravenously to correct acute, symptomatic hyponatremia and via nebulization to increase mucociliary clearance and improve lung function in patients with cystic fibrosis.
Sodium and water regulation is an intricate balance and systemic administration of sodium chloride solutions should be handled with care. Potential complications include fluid overload, pulmonary edema, and intraventricular hemorrhage (particularly in neonates).
Rapid correction of hyponatremia may result in severe electrolyte abnormalities and neurologic deficits; adherence to recommended correction rates is essential.This drug was approved by the FDA in 1951.
Indications & Dosage
- anaphylactic shock
- bronchiolitis
- cardiogenic shock
- cardiopulmonary resuscitation
- cystic fibrosis
- dehydration
- diabetic ketoacidosis
- hyponatremia
- hypovolemia
- increased intracranial pressure
- mucolysis
- nasal congestion
- nutritional supplementation
- ocular inflammation
- septic shock
Sodium content and osmolarity:
- 0.9% sodium chloride solution = 154 mEq/L (0.154 mEq/mL) sodium; osmolarity of 308 mOsm/L.
- 3% sodium chloride solution = 513 mEq/L (0.513 mEq/mL) sodium; osmolarity of 1,027 mOsm/L.
- 23.4% sodium chloride solution = 4,000 mEq/L (4 mEq/mL) sodium; osmolarity of 8,008 mOsm/L.
- 1 gram sodium chloride tablet = 17.1 mEq sodium/tablet.
Side Effects
- anorexia
- bronchospasm
- central pontine myelinolysis
- chest pain (unspecified)
- chills
- coma
- cough
- dehydration
- dyspnea
- edema
- encephalopathy
- erythema
- fever
- flushing
- heart failure
- hemolysis
- hemoptysis
- hepatomegaly
- hoarseness
- hyperchloremia
- hyperchloremic acidosis
- hypernatremia
- hypertension
- hypokalemia
- hyponatremia
- hypotension
- increased intracranial pressure
- infection
- infusion-related reactions
- injection site reaction
- intraventricular hemorrhage
- nausea
- ocular irritation
- ocular pain
- oliguria
- pharyngitis
- phlebitis
- pruritus
- pulmonary edema
- rash
- renal failure (unspecified)
- seizures
- sinus tachycardia
- sinusitis
- sneezing
- sodium retention
- thrombosis
- tremor
- urticaria
- visual impairment
- weakness
Monitoring Parameters
- laboratory monitoring not necessary
- serum creatinine/BUN
- serum electrolytes
Contraindications
- alcoholism
- breast-feeding
- cardiac disease
- children
- diabetic ketoacidosis
- edema
- females
- geriatric
- heart failure
- hemolysis
- hepatic disease
- hyperaldosteronism
- hyperchloremia
- hypernatremia
- hypertension
- hypervolemia
- hyponatremia
- hypoxemia
- infants
- malnutrition
- metabolic acidosis
- neonates
- pregnancy
- premature neonates
- renal artery stenosis
- renal disease
- renal failure
- renal impairment
- requires an experienced clinician
- visual impairment
Interactions
- Azelastine; Fluticasone
- Beclomethasone
- Benzalkonium Chloride
- Betamethasone
- Budesonide
- Budesonide; Formoterol
- Ciclesonide
- Corticosteroids
- Corticotropin, ACTH
- Cortisone
- Deflazacort
- Dexamethasone
- Fludrocortisone
- Flunisolide
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Hydrocortisone
- Lithium
- Methylprednisolone
- Mometasone
- Prednisolone
- Prednisone
- Tolvaptan
- Triamcinolone
