Sodium Chloride + Sodium Lactate + Calcium chloride + Magnesium chloride (CAPD solutions)
Indications
Sodium Chloride + Sodium Lactate + Calcium chloride + Magnesium chloride (CAPD solutions) is used for:
Continuous ambulatory peritoneal dialysis (CAPD)
Adult Dose
Adults:
As CAPD:
The usual dose is 2,000 ml solution four times daily depending on body weight and kidney function. Smaller or larger doses can be administered as appropriate (dose given merely as a guide, dosage must be adjusted for the individual patient).
Bags are exchanged over 24 hours. After 4 –8 hours retention time the solution is drained off.
Child Dose
Renal Dose
Administration
Contra Indications
Patients with excessive obesity and in pregnancy.
Precautions
It is used for peritoneal dialysis purposes only.
Pregnancy-Lactation
Interactions
Sodium Chloride: May affect serum concentrations of lithium.
Sodium Lactate: Caution when used in patients receiving corticosteroids or corticotropin.
Calcium chloride: Co-administration of high Ca doses with thiazide diuretics may result in milk-alkali syndrome and hypercalcaemia. May potentiate digoxin toxicity. Decreases effects of calcium-channel blockers. Enhanced absorption with calcitriol (a vit D metabolite).
Magnesium chloride: Oral magnesium salts may decrease absorption of bisphosphonates, quinolone antibiotics and tetracycline derivatives; admin should be separated apart if concomitant use is required. Magnesium-containing products may reduce absorption of eltrombopag by 70%; separate admin by at least 4 hr. Calcitriol may increase serum concentrations of Magnesium salts. Magnesium salts may decrease serum concentrations of mycophenolate if used concurrently; monitor for reduced effects of mycophenolate. Concomitant use of trientine and magnesium salt may reduce serum concentrations of both agents.
Adverse Effects
Side effects of Sodium Chloride + Sodium Lactate + Calcium chloride + Magnesium chloride (CAPD solutions) :
During dialysis amino acids and water soluble vitamins may be lost. Fluid and electrolyte imbalance, hypovolemia, hypotension or muscle cramping may occur.
Mechanism of Action
Sodium lactate is a sterile, nonpyrogenic solution that is used for fluid and electrolyte replenishment. It has metabolic alkalinising ability and is capable of inducing diuresis depending on the clinical condition of the patient.
Calcium chloride is used to prevent or treat negative calcium balance. It also regulates action potential excitation threshold to facilitate nerve and muscle performance.
Sodium chloride is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives.
Magnessium Chloride: Acts as cofactor in numerous enzymatic reactions involving protein synthesis and carbohydrate metabolism; depresses CNS, blocks peripheral neuromuscular transmission, produces anticonvulsant effects.