FLUID THERAPY & ECBOLICS

Dr. Jibachha Sah, Lecturer, M.V.Sc ( Veterinary Pharmacology)

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 WELCOME TO MY PRESENTATION
AUTONOMIC AND SYSTEMIC PHARMACOLOGY VPT-322 Sixth semester lecturer note

FLUID THERAPY & ECBOLICS

Dr.Jibachha Sah, Lecturer, M.V.Sc ( Veterinary Pharmacology)

College of Veterinary Science, NPI, Bhartpur, Chitwan,Nepal

Email:jibachhashah@gmail.com,mobile:00977-9845024121

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 01 Introduction
Fluid therapy

02 Types of fluid
Used of different types of fluid

TABLE OF CONTENTS 03 Fluid compartments

Introduction to extracellular & intracellular fluid compartment

04 Fluid calculation
Calculation of fluid in different age groups

05 Ecbolic
Definition, indication, pharmacokinetics, dosage, admiration

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 SECTION 1
INTRODUCTION

Intravenous therapy (IV) is a therapy that delivers fluids directly into a veinThe intravenous route of
administration can be used for injections (with a syringe at higher pressures) or infusions (typically using only
the pressure supplied by gravity). Intravenous infusions are commonly referred to as drips. Intravenous
therapy may be used for fluid replacement (such as correcting dehydration), to correct electrolyte imbalances,
to deliver medications, and for blood transfusions.
Fluid Therapy is the administration of fluids to a
patient as a treatment or preventative measure. It can
be administered via an intravenous, intraperitoneal,
intraosseous (inject direct in to the marrow of the
bone), subcutaneous and oral routes. 60% of total
bodyweight is accounted for by the total body water.

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 Issues
influencing IV
fluid
prescriptions
Organ/System Considerations when prescribing IV fluids
Cardiac Increased vulnerability to fluid and sodium overload with consequent congestive failure.
dysfunction

Renal disease Impaired clearance or excessive losses of both fluids and electrolytes in both acute and chronic kidney disease.

Gastrointestinal High losses of both fluid and electrolytes are seen in many GI problems, and patients with ileus can sequester large volumes of electrolyte rich fluid.
problems
Liver disease Very abnormal fluid and electrolyte handling with a tendency for marked sodium and water retention due to complex pathophysiological changes including
hyper-aldosteronism. Moderate to severe renal impairment is seen in many patients – the hepato-renal syndrome).
Respiratory High respiratory fluid losses but many patients are vulnerable to fluid overload.
disease
Neurology Hypothalamic or pituitary disease can severely damage fluid regulatory mechanisms. High concentration IV saline is sometime administered to try to
reduce intracranial pressure.
Dermatology Burns and other extensive skin inflammatory problems can lead to very high fluid/plasma loss.
Endocrine Problems including diabetes mellitus can markedly alter fluid and electrolyte handling. The Power of PowerPoint | thepopp.com 6
The principles of The physiology of fluid balance in health;
Pathophysiological effects on fluid balance;
fluid prescribing Clinical approaches to assessing IV fluid needs;

The properties of available IV fluids.

The knowledge needed to underpin
safe and effective IV fluid and
electrolyte prescribing lies in four
areas:

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 Tonicity is the term used to compare the osmotic pressure of
different solutions
A hypotonic solution is one that has an osmotic pressure lower than plasma.

A isotonic solution is one that has an osmotic pressure the same as plasma.

A hypertonic solution is one that has an osmotic pressure higher than plasma.

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 Example of Fluids
ISOTONIC FLUIDS HYPOTONIC FLUID HYPERTONIC FLUID

0.45% sodium chloride (0.45% 1- 3% sodium chloride (3% NaCl):•

0.9% sodium chloride (0.9% NaCl)
NaCl),
lactated Ringers solution
0.33% sodium chloride, 0.2%
5% dextrose in water (D5W)
sodium chloride, and 2.5% dextrose in
Ringers solution water•

COLLOID SOLUTION

How to calculate IV flow rates ?

1- 5% albumin (Human albumin solution
The formula for working out flow rates is: volume (ml) X drop factor (gtts / ml) = gtts / min --------------------
------------------------- (flow rate) time (min)

Example:1500 ml IV Saline is ordered over 12 hours. Using a drop factor of 15 drops /ml, how many
drops per minute need to be delivered? 1500 (ml) X 15 (drop / ml) --------------------------------------------------- =
31 drop/ minute 12 x 60 (gives us total minutes

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 Terminology
Fluid bolus: a rapid infusion to correct hypotensive shock. It typically includes the infusion of at least 500
ml over a maximum of 15 min

Fluid challenge: 100–200 ml over 5–10 min with reassessment to optimize tissue perfusion

Fluid infusion: continuous delivery of i.v. fluids to maintain homeostasis, replace losses, or prevent organ
injury (e.g. prehydration before operation or for contrast nephropathy)

Maintenance: fluid administration for the provision of fluids for patients who cannot meet their needs by
oral route. This should be titrated to patient need and context and should include replacement of ongoing
losses. In a patient without ongoing losses, this should probably be no more than 1–2 ml kg−1 h

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5 Major fluid

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 1. 9% Normal Saline ( also known as NS, 0.9NaCl, or
NSS)
This is one of the most common IV fluids because it works for most
hydration needs due to vomiting, diarrhea, hemorrhage, or even shock.

Most
It is an isotonic crystalloid that contains 0.9% sodium chloride (salt) that is
dissolved in sterile water.

common fluid 2.Lactated Ringers (also known as LR, Ringers

Lactate, or RL)
This solution is an isotonic crystalloid that contains sodium chloride,
potassium chloride, calcium chloride, and sodium lactate in sterile

in veterinary water.

It is the most similar to the body’s plasma and serum concentration, and is
especially great for burn victims or those with hypovolemia due to fluid shifts.

practice 3.5% Dextrose in Water (also known as D5 or D5W)

It is an isotonic carbohydrate (sugar) solution that contains glucose
(sugar) as the solute. When this is absorbed, the glucose is usually
quickly grabbed up by cells and utilized for energy, leaving only water
which is then a hypotonic solution.

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 Fluid Rate Calculations
When calculating the fluid requirements of a patient, there are 3 elements to consider -
1.Replacement
2.Maintainance
3.Ongoing Losses

1.Replacement 3.Ongoing replacement

Replacements are calculated based on the level of Ongoing losses are calculated based on a predicted
dehydration. Dehydration is based upon clinical Replacement = % Dehydration x Bodyweight (kg) x 10 fluid amount lost by a patient within a 24 hour period.
assessment of each individual patient. Most commonly, Common losses include vomitting and diarrhoea. To
skin tent is used for assessment. To calculate the calculate the fluid requirement, the following calculation
amount required for replacement within a 24 hour 2.Maintainance is the basic rate which is used.
period, the percentage dehydration is used in the a patient requires during a 24 hour period. It is
following calculation. commonly calculated as 50ml/kg/24hr, or
2ml/kg/hr
Calculated fluid requirement
Requirement per hour (ml/hr) = Requirement per day (ml/24hr) ÷ 24 Ongoing losses = Amount per loss (ml/kg) x Bodyweight (kg) x No. of losses
Requirement per minute (ml/min) = Requirement per hour (ml/hr) ÷ 60

Requirement per second (ml/s)= Requirement per minute(ml/min) ÷ 60

Drops per second = Requirement per second (ml/s)x Giving Set Factor
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 SECTION 2
Ecbolic
Definition
Ecbolic

A drug (as an ergot alkaloid) that tends to

increase uterine contractions and that is used
especially to facilitate delivery and expulsion of
placenta (foetal membrane).

A uterotonic, also known as ecbolic, is an agent

used to induce contraction or greater tonicity of
the uterus.

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Ecbolic drugs
INDICATION
◘For expulsion of retained placenta
◘Regulation of lochial discharge
◘Delayed involution of uterus
◘As an ideal uterine cleansing agent after manual
removal of retained placenta
◘For timely expulsion of placenta after calving

DOSAGE & ADMINISTRATION:

Liquid
Cows, Buffaloes and Mares 50 ml
Ewes and Does 20 ml
Bolus:
Cows, Buffaloes and Mares 2 bolus
Ewes and Does 1 bolus
Powder:
Cow buffalo: 50 gm,Sheep,Goat:25 gm

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 Mechanism of action

Oxytocin Prostaglandin Methylergometrin

Oxytocin is normally produced in the hypothalamus and released
by the posterior pituitary. oxytocin receptor (OTR) signalling and One of the earliest recognized effects of Methylergonovine directly stimulates
its role in the myometrium during pregnancy and in labour. The
OTR belongs to the rhodopsin-type (Class 1) of the G-protein prostaglandins is the stimulation the uterine muscle to increase force and
coupled receptor superfamily and is regulated by changes in
receptor expression, receptor desensitisation and local changes in
of myometrial contractions. frequency of contractions.
oxytocin concentration.

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Ecbolic drugs available in market are

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THANK YOU!
ANY QUESTIONS?

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