sodium chloride

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sodium

 [so´de-um]
a chemical element, atomic number 11, atomic weight 22.990, symbol Na. (See Appendix 6.) Sodium is the major cation of the extracellular fluid, constituting 90 to 95 per cent of all cations in the blood plasma and interstitial fluid; it thus determines the osmolality of the extracellular fluid. The serum sodium concentration is normally about 140 mEq/L. If the sodium level and osmolality fall, osmoreceptors in the hypothalamus are stimulated and cause the release of antidiuretic hormone from the posterior lobe of the pituitary gland. This hormone increases the absorption of water in the collecting ducts of the kidneys so that water is conserved while sodium and other electrolytes are excreted in the urine. If the sodium level and osmolality rise, neurons in the thirst center of the hypothalamus are stimulated. The thirsty person then drinks enough water to restore the osmolality of the extracellular fluid to the normal level.



A decrease in the serum sodium concentration (hyponatremia) can occur in a variety of conditions. It is often associated with deficient fluid volume due to diarrhea or vomiting when water is replaced faster than sodium. It can also occur in syndrome of inappropriate antidiuretic hormone, in the late stages of congestive heart failure or cirrhosis of the liver, in acute or chronic renal failure, and in diuretic therapy. An increase in the serum sodium concentration (hypernatremia) occurs when insensible water loss is not replaced by drinking, as in a comatose patient with diabetes insipidus.
sodium acetate a source of sodium ions for hemodialysis and peritoneal dialysis, as well as a systemic and urinary alkalizer.
sodium ascorbate an antiscorbutic vitamin and nutritional supplement for parenteral administration. It is also used as an aid to deferoxamine therapy in the treatment of chronic iron toxicity.
sodium benzoate an antifungal agent also used in a test of liver function.
sodium bicarbonate NaHCO3, a white powder commonly found in households. It has a wide variety of uses in chemistry, in pharmaceuticals, and in consumer products. It is sometimes taken in water as a remedy for acid indigestion but should not be used regularly since when taken in excess it tends to cause alkalosis. It can be mixed with water and applied as a paste for relief of pain in treatment of minor burns and insect bites and stings. A cupful in the bath water may help relieve itching caused by an allergic reaction. Called also baking soda and bicarbonate of soda.
sodium biphosphate monobasic sodium phosphate.
sodium carbonate a compound now used primarily as an alkalizing agent in pharmaceuticals; it has been used as a lotion or bath in the treatment of scaly skin, and as a detergent.
sodium chloride common table salt, a necessary constituent of the body and therefore of the diet, involved in maintaining osmotic tension of blood and tissues; uses include replenishment of electrolytes in the body, irrigation of wounds and body cavities, enema, inhaled mucolytic, topical osmotic ophthalmic agent, and preparation of pharmaceuticals. Called also salt.
sodium citrate a sodium salt of citric acid, used as an anticoagulant for blood or plasma that is to be fractionated or for blood that is to be stored. It is also administered orally as a urinary alkalizer.
dibasic sodium phosphate a salt of phosphoric acid; used alone or in combination with other phosphate compounds, it is given intravenously as an electrolyte replenisher, orally or rectally as a laxative, and orally as a urinary acidifier and for prevention of kidney stones.
sodium ferric gluconate a hematinic used especially in treatment of hemodialysis patients with iron deficiency anemia who are also receiving erythropoietin therapy. Administered by intravenous injection.
sodium fluoride a dental caries preventative used in fluoridation of drinking water or applied topically to teeth. Topical preparations include gels (sodium fluoride and phosphoric acid gel, also called APF gel) and solutions (sodium fluoride and acidulated phosphate topical solution, also called APF solution).
sodium glutamate monosodium glutamate.
sodium hydroxide NaOH, a strongly alkaline and caustic compound; used as an alkalizing agent in pharmaceuticals.
sodium hypochlorite a compound having germicidal, deodorizing, and bleaching properties; used in solution to disinfect utensils, and in diluted form (Dakin's solution) as a local antibacterial.
sodium iodide a compound used as a source of iodine.
sodium lactate a compound used in solution to replenish body fluids and electrolytes.
monobasic sodium phosphate
1. a monosodium salt of phosphoric acid; used in buffer solutions, as a urinary acidifier, as a laxative, and as a source of phosphorus in hypophosphatemia, often in combination with potassium phosphate.
2. a monosodium salt of phosphoric acid; used in buffer solutions. Used alone or in combination with other phosphate compounds, it is given intravenously as an electrolyte replenisher, orally or rectally as a laxative, and orally as a urinary acidifier and for prevention of kidney stones.
sodium monofluorophosphate a dental caries preventative applied topically to the teeth.
sodium nitrite an antidote for cyanide poisoning; also used as a preservative in cured meats and other foods.
sodium nitroprusside an antihypertensive agent used in the treatment of acute congestive heart failure and of hypertensive crisis and to produce controlled hypotension during surgery; also used as a reagent.
sodium phenylbutyrate an agent used as adjunctive treatment to control the hyperammonemia of pediatric urea cycle enzyme disorders.
sodium phosphate any of various compounds of sodium and phosphoric acid; usually specifically dibasic sodium phosphate.
sodium polystyrene sulfonate an ion-exchange resin used for removal of potassium ions in hyperkalemia, administered orally or rectally.
sodium propionate a salt used as an antifungal preservative in foods and pharmaceuticals and as a topical antifungal agent.
sodium salicylate see salicylate.
sodium sulfate a cathartic and laxative.
sodium thiosulfate a compound used intravenously as an antidote for cyanide poisoning, in foot baths for prophylaxis of ringworm, and as a topical antifungal agent for tinea versicolor. Also used in measuring the volume of extracellular body fluid and the renal glomerular filtration rate.

sodium chloride

Minims Sodium Chloride (CA), Slo-Salt, Slow Sodium

Pharmacologic class: Electrolyte supplement

Therapeutic class: Sodium replacement

Pregnancy risk category C

Action

Replaces deficiencies of sodium and chloride and maintains these electrolytes at adequate levels

Availability

Injection: 0.45% sodium chloride-25 ml, 50 ml, 150 ml, 250 ml, 500 ml, 1,000 ml; 0.9% sodium chloride-2 ml, 3 ml, 5 ml, 10 ml, 20 ml, 25 ml, 30 ml, 50 ml, 100 ml, 150 ml, 250 ml, 500 ml, 1,000 ml; 3% sodium chloride-500 ml; 5% sodium chloride-500 ml; 14.6% sodium chloride-20 ml, 40 ml, 200 ml; 23.4% sodium chloride-30 ml, 50 ml, 100 ml, 200 ml

Tablets: 650 mg, 1 g, 2.25 g

Tablets (slow-release): 600 mg

Indications and dosages

Water and sodium chloride replacement; metabolic alkalosis; to dilute or dissolve drugs for I.V., I.M., or subcutaneous use; to flush I.V. catheter; as a priming solution in hemodialysis; to initiate or end blood transfusions

Adults: 0.9% sodium chloride (isotonic solution) with dosage individualized

Hydrating solution; hyperosmolar diabetes

Adults: 0.45% sodium chloride (hypotonic solution) with dosage individualized

Rapid fluid and electrolyte replacement in hyponatremia and hypochloremia; severe sodium depletion; drastic body water dilution after excessive water intake

Adults: 3% or 5% sodium chloride (hypertonic solution) with dosage individualized, given by slow I.V. infusion with close monitoring of electrolyte levels

Heat cramps caused by excessive perspiration

Adults: See product label.

Contraindications

• Normal or elevated electrolyte levels (with 3% and 5% solutions)

• Fluid retention

Precautions

Use cautiously in:

• renal impairment, heart failure, edema or sodium retention, hypoproteinemia

• surgical patients.

Administration

Be aware that sodium chloride injection is a high-alert drug.

• Dilute I.V. dose per product label. Infuse slow I.V. to minimize risk of pulmonary edema.

Don't confuse normal saline solution for injection with concentrates meant for use in total parenteral nutrition.

• Avoid salt tablets for heat cramps; they may pass through GI tract undigested, causing vomiting and potassium loss.

Adverse reactions

CV: edema (when given too rapidly or in excess), thrombophlebitis, heart failure exacerbation

Metabolic: fluid and electrolyte disturbances (such as hypernatremia and hyperphosphatemia), aggravation of existing metabolic acidosis (with excessive infusion)

Respiratory: pulmonary edema

Other: pain, swelling, local tenderness, abscess, or tissue necrosis at I.V. site

Interactions

Drug-diagnostic tests. Phosphate, potassium, sodium: increased levels

Patient monitoring

• Monitor electrolyte levels and blood chemistry results.

Watch for signs and symptoms of pulmonary edema or worsening heart failure.

• Carefully monitor vital signs, fluid balance, weight, and cardiovascular status.

• Assess injection site closely to help prevent tissue necrosis and thrombophlebitis.

Patient teaching

Teach patient to recognize and immediately report serious adverse reactions, such as breathing problems or swelling.

• Instruct patient to report pain, tenderness, or swelling at injection site.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.

so·di·um chlo·ride

the chief ionic component of blood and other bodily fluids, and urine; used to make isotonic and physiologic saline solutions, in the treatment of salt depletion, and topically for inflammatory lesions.
Synonym(s): common salt

so·di·um chlo·ride

(sōdē-ŭm klōrīd)
Major ionic component of blood, urine, and other bodily fluids; used to make isotonic and physiologic saline solutions, to treat salt depletion, and topically for inflammatory lesions.
Synonym(s): common salt.

sodium chloride

Common salt. A compound ubiquitous in the body. Used in the preparation of SALINE. The drug is on the WHO official list.

saline, physiological 

A 0.9% sterile solution of sodium chloride in water. This concentration of sodium chloride is considered approximately isotonic with the tears. It is used to store and rinse soft contact lenses, to irrigate the eye, etc. Syn. normal saline; NaCl 0.9%. See eyewash; irrigation; isotonic solution.

so·di·um chlo·ride

(sōdē-ŭm klōrīd)
Chief ionic component of blood, urine, and other body fluids; used to make isotonic and physiologic saline solutions, in the treatment of salt depletion, and topically for inflammatory lesions.
Synonym(s): common salt.