Electrolytes Used in the Replacement Therapy: Sodium chloride, Potassium chloride, Calcium gluconate and Oral Rehydration Salt (ORS) : Pharmaguideline

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Electrolytes Used in the Replacement Therapy: Sodium chloride, Potassium chloride, Calcium gluconate and Oral Rehydration Salt (ORS)

To achieve normal body fluid volume and composition, a replacement of body fluids must be performed.

Electrolyte replacement therapy

To achieve normal body fluid volume and composition, a replacement of body fluids must be performed. Volume contraction is life-threatening because it compromises the circulatory system, causes blood volumes to drop, heart output to decrease, and microcirculation to become impaired. An infusion of sodium chloride solution is indicated when volume depletion leads to life-threatening conditions. Cholera has been successfully treated with intravenous administration at a rate of 100 ml per minute for the first 1000 ml of blood.

Sodium chloride replacement

Sodium chloride: NaCl (molecular weight – 58.44)

It does not contain any added substances. It appears to be in a white crystalline powder or a colorless cubic form while having a saline taste. Along with this, it is slightly soluble in boiling water while fully soluble in water at room temperature. It is slightly soluble in alcohol and fully soluble in glycerine.

Use: it is widely used as a flavor enhancer, fluid and electrolyte replenisher, and manufacturer of isotonic solutions. Typically, isotonic solutions are used in moist dressings to irrigate cavities in the body or tissues. The administration of hypotonic solutions is used when patients are incapable of taking fluids or nutrients orally for a period of one to three days. There is excess sodium loss when using hypertonic solutions/injections.

Potassium chloride replacement

Potassium chloride: KCl (Molecular weight – 74.56)

Calculated using the dried substance, the potassium chloride content is not less than 99 %. Crystals of it are white crystalline solids, cubic. In water, it is less soluble than sodium chloride, and in boiling water, it is slightly more soluble. It is also soluble in glycerine, although it is insoluble in alcohol.

Use: In potassium deficiency, fibromyalgia, myasthenia gravis, electrolyte replenisher is prescribed.

Contraindication: renal impairment.

Calcium replacement

Calcium: Ca2+ (Molecular weight 308.30)

At least 97% and at least 103% of Calcium Chloride dihydrate are contained within Calcium Chloride. In its powder form, it is a white, odorless substance that is soluble in water but nearly insoluble in alcohol.

Use: Calcium supplementation for calcium deficiency is an excellent method.

Oral rehydration salt (ORS)

The oral rehydration solution (ORS) contains potassium chloride and sodium citrate along with glucose sodium chloride and sodium chloride. The tablets are to be dissolved in the requisite volume of water and to be used to prevent and treat dehydration associated with diarrhea, including to maintain hydration levels. To effectively treat diarrhea, WHO and UNICEF recommend using ORS and zinc together.1,2 ORS replaces the essential fluids and salts lost through diarrhea. This means zinc reduces the length and severity of episodes and shortens the time to recurrence. Children with diarrhea can be treated with ORS and zinc, which is highly effective and inexpensive, and could prevent deaths in 93% of cases.

Packaging and labeling

Aluminum foil sachets with multiple layers should be used to package ORS since the product can be compromised by highly humid conditions. A combination of polyethylene (on the inside), aluminum (on the middle), and polyester (on the outside) have proved to be an effective pack for ORS. However, the stability of the product is also influenced by these conditions: the raw material must be dry, the sealing must be perfect, and the final product must be stored correctly.

The packaging should include the following information:
  • Mass of the total net mass of each constituent, as well as its contents, expressed in grams;
  • Reconstitution of the solution with water;
  • Directions for preparing the solution and administering it;
  • The solution should be discarded after 24 hours if unused.


At room temperature, ORS is stable and doesn't need to be stored in a cold chain.
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Ankur Choudhary is India's first professional pharmaceutical blogger, author and founder of pharmaguideline.com, a widely-read pharmaceutical blog since 2008. Sign-up for the free email updates for your daily dose of pharmaceutical tips.
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