DESCRIPTION
Oral rehydration therapy (ORT) is a fluid replacement strategy used to prevent or treat dehydration. Dehydration is most commonly caused by diarrhea. It involves drinking water with modest amounts of sugar and salt added, while continuing to eat. When diarrhea is severe or long-lasting, the therapy also includes supplemental zinc. Caretakers are taught the signs of dehydration and/or worsening dehydration. The World Health Organization and UNICEF specify indications, preparations and procedures for ORT A white crystal or crystalline powder used as an electrolyte replenisher, in the treatment of hypokalemia, in buffer solutions, and in fertilizers and explosives.
CHEMICAL FORMULA
potassium chloride.
COMPOSITION
Sodium Chloride 0.52 Gm + Dextrose 2.70 Gm + Potassium Cl 0.30 Gm + Sodium Citrate 0.52 Gm
INDICATION
Oral rehydration therapy is a treatment for the symptoms of dehydration and rehydration in burns in resource-limited settings. ORT is less invasive than the other strategies for fluid replacement, specifically intravenous (IV) fluid replacement. Mild to moderate dehydration in children seen in an emergency department is best treated with ORT. ORT in combination with anti-nausea drugs is indicated for vomiting patients as a strategy to be able to take fluid orally. In an emergency department setting, vomiting, dehydrated patients take these drugs as soon as possible to enable taking fluid by mouth sooner. Persons taking ORT should eat within 6 hours and return to their full diet within 24–48 hours. For use as an electrolyte replenisher and in the treatment of hypokalemia.
PHARMACODYNAMICS
The potassium ion is in the principle intracellular cation of most body tissues. Potassium ions participate in a number of essential physiological processes including the maintenance of intracellular tonicity, the transmission of nerve impulses, the contraction of cardiac, skeletal and smooth muscle, and the maintenance of normal renal function. The intracellular concentration of potassium is approximately 150 to 160 mEq per liter. The normal adult plasma concentration is 3.5 to 5 mEq per liter. An active ion transport system maintains this gradient across the plasma membrane. Potassium is a normal dietary constituent and under steady-state conditions the amount of potassium absorbed from the gastrointestinal tract is equal to the amount excreted in the urine. The usual dietary intake of potassium is 50 to 100 mEq per day. Potassium depletion will occur whenever the rate of potassium loss through renal excretion and/or loss from the gastrointestinal tract exceeds the rate of potassium intake. Such depletion usually develops as a consequence of therapy with diuretics, primarily or secondary hyperaldosteronism, diabetic ketoacidosis, or inadequate replacement of potassium in patients on prolonged parenteral nutrition. Depletion can develop rapidly with severe diarrhea, especially if associated with vomiting. Potassium depletion due to these causes is usually accompanied by concomitant loss of chloride and is manifested by hypokalemia and metabolic alkalosis. Potassium depletion may produce weakness, fatigue, disturbances of cardiac rhythm (primarily ectopic beats), prominent U-waves in the electrocardiogram, and, in advanced cases, flaccid paralysis and/or impaired ability to concentrate urine. If potassium depletion associated with metabolic alkalosis cannot be managed by correcting the fundamental cause of the deficiency, e.g., where the patient requires long-term diuretic therapy, supplemental potassium in the form of high potassium food or potassium chloride may be able to restore normal potassium levels. In rare circumstances (e.g., patients with renal tubular acidosis) potassium depletion may be associated with metabolic acidosis and hyperchloremia. In such patients, potassium replacement should be accomplished with potassium salts other than the chloride, such as potassium bicarbonate, potassium citrate, potassium acetate, or potassium gluconate.
MECHANISM
Supplemental potassium in the form of high potassium food or potassium chloride may be able to restore normal potassium levels.
ABSORPTION
Potassium is a normal dietary constituent and under steady-state conditions the amount of potassium absorbed from the gastrointestinal tract is equal to the amount excreted in the urine.
TOXICITY
The administration of oral potassium salts to persons with normal excretory mechanisms for potassium rarely causes serious hyperkalemia. However, if excretory mechanisms are impaired, of if potassium is administered too rapidly intravenously, potentially fatal hyperkalemia can result. It is important to recognize that hyperkalemia is usually asymptomatic and may be manifested only by an increased serum potassium concentration (6.5-8.0 mEq/L) and characteristic electrocardiographic changes (peaking of T-waves, loss of P-wave, depression of S-T segment, and prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9-12 mEq/L).
FOOD INTERACTIONS
Take with a full glass of water Take after a full meal.