Sodium Chloride

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

  1. anorexia
  2. bronchospasm
  3. central pontine myelinolysis
  4. chest pain (unspecified)
  5. chills
  6. coma
  7. cough
  8. dehydration
  9. dyspnea
  10. edema
  11. encephalopathy
  12. erythema
  13. fever
  14. flushing
  15. heart failure
  16. hemolysis
  17. hemoptysis
  18. hepatomegaly
  19. hoarseness
  20. hyperchloremia
  21. hyperchloremic acidosis
  22. hypernatremia
  23. hypertension
  24. hypokalemia
  25. hyponatremia
  26. hypotension
  27. increased intracranial pressure
  28. infection
  29. infusion-related reactions
  30. injection site reaction
  31. intraventricular hemorrhage
  32. nausea
  33. ocular irritation
  34. ocular pain
  35. oliguria
  36. pharyngitis
  37. phlebitis
  38. pruritus
  39. pulmonary edema
  40. rash
  41. renal failure (unspecified)
  42. seizures
  43. sinus tachycardia
  44. sinusitis
  45. sneezing
  46. sodium retention
  47. thrombosis
  48. tremor
  49. urticaria
  50. visual impairment
  51. 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
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