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Oral SolutionsOral Rehydration SolutionRx:NaCl 0.3gKCl 0.2gSodiumbicarbonate 0.3gGlucose 2g The pharmacokinetics and therapeutic values of the substance are asfollows:
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Glucose facilitates the absorption of sodium ( and hence water) on a 1:1 molar basis in the small intestine,
 
although cereal-based formulations may also be used.
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Sodium and potassium are needed to replace the body lossesof these essential ions during diarrhea and vomiting.
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Citrate or bicarbonate correct the acidosis that occurs as aresult of diarrhea and dehydration. They also enhance thesodium absorption in the small intestine.
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Sometimes, another additive added to the formula such as flavoringand coloring agent, but the ingredients used for flavouring ORS mustbe among those listed as “Generally Recognized as Safe” for theirintended use by the US Food and Drug Administration (FDA) or by theUS Flavour Extract Manufacturer’s Association (FEMA). Theresponsibility for demonstrating the clinical efficacy, safety andchemical stability of such products remains with the manufacturer.
Degredation of ORS-bicarbonate:
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 The formulation should be stored in a sealed aluminium laminate,under temperature less than 40˚C, the shelf-life of ORS-bicarbonatecan easily extend to 2-3 years.If this mixture is exposed to heat and high humidity, an acceleratedchemical interaction between the sodium bicarbonate and the glucosemay lead to their decomposition, which result in the discoloration of the product from white to yellow and later to brow. This discoloration
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Oral rehydration Salts (ORS) A joint UNICEF/WHO update July 1996 Revised March 2002.
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ORAL REHYDRATION SALTS Planning, establishment and operation WHO, unicef. Reprinted in 1998
 
closely parallels the degree of decomposition of the two chemical andthus provides an easy way of checking the stability of the product forconsumption. Whereas a light yellow color indicates a slightdecomposition of glucose and sodium bicarbonate, which still allowsconsumption, the appearance of a dark brown color means that anadvanced state of decomposition ( up to 40% or more) has beenreached.It's preferable to discard a product in this case.Another way to avoid the decomposition of ORS-bicarbonate intropical countries is to use chemically treated sodium hydrogencarbonate (encapsulated). However, its use may increase the priceand make the country dependent for its purchases on a very limitednumber of manufactures in the world.
Pharmaceutical Forms:
 They are most commonly available as oral powders (oral rehydrationsalts) that are reconstituted with water before use, but effervescenttablets and ready-to-use oral solutions are also available.
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Precautions:
Oral rehydration salts or effervescent tablets should be reconstitutedonly with water and at the volume stated. Fresh drinking water isgenerally appropriate, but freshly boiled and cooled water is preferredwhen the solution is for infants or when drinking water is notavailable. The solution should not be boiled after it is prepared. Otheringredients such as sugar should not be added. Unused solutionshould be stored in a refrigerator and discarded within 24 hours of preparation.Oral rehydration solutions are not appropriate for patients withgastrointestinal obstruction, oliguric
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or anuric
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renal failure, or whenparenteral rehydration therapy is indicated as in severe dehydrationor intractable vomiting.
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Martindale.
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Scarcity of urine secretion in relation to the intake of fluids into the body (Medicine(.
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Inability to form urine: inability of the kidneys to form urine, so that toxic waste builds up in theblood.
 
Uses and Administration:
Oral rehydration solutions are used for oral replacement of electrolytes and fluids in patients with dehydration, particularly thatassociated with acute diarrhoea of various aetiologies. The dosage of oral rehydration solutions should be tailored to theindividual based on body-weight and the stage and severity of thecondition. The initial aim of treatment is to rehydrate the patient, and,subsequently, to maintain hydration by replacing any further lossesdue to continuing diarrhoea and vomiting and normal losses fromrespiration, sweating, and urination. Initial rehydration should berapid, over 3 to 4 hours, unless the patient is hypernatraemic, inwhich case rehydration over 12 hours is appropriate.For adults, a usual dose of 200 to 400 mL of oral rehydration solutionfor every loose motion has been suggested. The dosage for children is200 mL for every loose motion, and for infants is 1 to 1.5 times theirusual feed volume. Normal feeding can continue after the initial fluiddeficit has been corrected. Breast feeding should continue betweenadministrations of oral rehydration solution.Notes to remember:
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ORS first used and proved 1969 recommended and distributeby UNICEF and WHO.
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Using Trisodium citrate dihydrate instead of NaHCO3, toimprove the stability of ORS in heat and humid country.
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ORS-citrate results in less stool-out especially in the highoutput diarrhea (cholera), and the direct effect of thetrisodium citrate is increasing the Intestinal absorption of Naand H
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O. But the best choose (ORS-carbonate or ORS-citrate)is based on the stability to be maintained, and the weather orthe country.
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 The loss of potassium ions in the body hasn't effect on thenerves but actually it will affect the heart pressure before thenerves.
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Acidosis could affects the brain cells and the kidneys.
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 The pH decreases because of the destruction of the glucoseinto ketones.
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chetanfirke

HI THANKZXXXXXXXXXXXX FOR SHARING YOUR DATA

reply06 / 21 / 2009
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