The Effect of Ringer Lactate as the Priming Solution of
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to determine the safety of ringer lactate normal saline combination if used during a renal transplant. Methods: One Hundred adults undergoing kidney
Chart 7. How to give intravenous fluids to a child in shock without
▷ Attach Ringer's lactate or normal saline; make sure the infusion is running well. ▷ Infuse 20 ml/kg as rapidly as possible. Age (weight). Volume of Ringer's
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Images
Lactated Ringer’s and 5 Dextrose Injection USP in VIAFLEX Plastic Container DESCRIPTION Lactated Ringer’s and 5 Dextrose Injection USP is a sterile nonpyrogenic solution for fluid and
Lactated Ringer’s Injection USP in VIAFLEX Plastic Container
Lactated Ringer’s Injection USP is a sterile nonpyrogenic solution for fluid and electrolyte replenishment in single dose containers for intravenous administration It contains no antimicrobial
Lactated Ringer’s Injection USP - Baxter
Lactated Ringer’s Injection USP may not produce its alkalinizing action in patients with severe hepatic insufficiency since lactate metabolism may be impaired Lactate-containing solutions should be administered with particular caution to neonates and infants less than 6 months of age Use in Patients with or at Risk for Hypercalcemia
Lactated Ringer’s Injection USP in VIAFLEX Plastic Container
Lactated Ringer’s Injection USP is a sterile nonpyrogenic solution for fluid and electrolyte replenishment in a single dose container for intravenous administration It contains no antimicrobial agents The composition osmolarity and approx pH are shown in Table 1
Does lactated ringers raise lactate?
- The short-term infusion of lactated Ringer's solution in normal adults (hemodynamically stable) does not falsely increase circulating lactate concentrations when 1 L is given over 1 hr. Therefore, clinicians should not disregard increased lactate concentrations in patients receiving a rapid infusion …
How much potassium is in Lactated Ringers?
- Ringer’s lactate, however, has 130mmol/L of sodium, 109mmol/L of chloride, 4mmol/L of potassium, 28mmol/L of lactate, and 3mmol/L of calcium. One would expect that the solution containing potassium would cause a greater increase in potassium than the one without potassium, right? Well, not so fast.
What is lactated ringers use for?
- Lactated Ringer's solution is commonly used as an IV treatment for dehydration or acid-base imbalances. It's not the same as saline, although the two serve similar purposes.
What is lactated ringers not compatible with?
- Likewise, what is lactated ringers not compatible with? Lactated Ringer's Injection is not for use for the treatment of lactic acidosis or severe metabolic acidosis. Lactated Ringer's Injection should not be administered simultaneously with citrate anticoagulated/preserved blood through the same administration set because of the likelihood of coagulation.
TBS/CDC 16(6640) P3
©TBS 2020 All rights reserved
First Edition 2020
DRAFT TANZANIA STANDARD
Sterilized compound sodium lactate intravenous infusion (Ringers-lactate solution forinjection)TANZANIA BUREAU OF STANDARDS
TBS/CDC 16(6640) P3
©TBS 2020 All rights reserved First Edition 2020
0 Foreword
This Draft Tanzania Standard is being prepared by the Pharmaceuticals Technical Committee, under the supervision of
Chemicals Divisional Standards Committee and it is in accordance with the procedures of the Bureau. This Draft Tanzania Standard has been prepared with assistance drawn from;South Africa Standard SANS 597:2014 Sterilized compound sodium lactate intravenous infusion (Ringer-lactate
solution for injection), published by South Africa Bureau of standards (SABS)For the purpose of deciding whether a particular requirement of this draft Tanzania Standard is complied with, the final value
observed or calculated, expressing the result of a test or analysis, shall be rounded off in accordance with TZS 4.
TBS/CDC 16(6640) P3
©TBS 2020 All rights reserved First Edition 2020
1 Scope
This Draft Tanzania standard covers chemical and biological requirements for a solution of sodium chloride,
potassium chloride, calcium chloride and sodium lactate in water for injections that have been
manufactured and packed into suitable containers, sealed and sterilized. It also specifies the required
marking.2 Normative references
The following referenced documents are indispensable for the application of this document. For
dated references, only the edition cited applies. For undated references, the latest edition of the
referenced document (including any amendments) applies.2.1 Standards
ISO 15747, Plastics containers for intravenous injection. TZS 59 Water for analytical laboratory use - Specification and test methods. TZS 773 Marking and labeling of pharmaceutical products-Specification2.2 Other publications
British Pharmacopoeia (BP).
United States Pharmacopoeia (USP).
3 Definitions
For the purposes of this document, the following definitions apply. 3.1 acceptableacceptable to the authority administering this standard, or to the parties concluding the purchase contract, as relevant
3.2 batchthat quantity of the product that is homogenous, filled and sealed into containers, and sterilized in the same cycle
of operation 3.3 certified reagent for which a certificate of analysis stating the percentage purity is available 3.4 productcompound sodium lactate intravenous infusion (Ringer-lactate solution for injection) that is filled, sealed and sterilized in
the final container 3.5 Clean free from dirt, marks, stains and any other contaminantsTBS/CDC 16(6640) P3
©TBS 2020 All rights reserved First Edition 2020
4 Requirements
4.1 Freedom from visible suspended matter and sediment
When examined in accordance with 5.2, the product shall be clear and colorless, without odour or taste.
4.2 Fill volume
4.2.1 The maximum nominal fill volume of a container shall not exceed 1 L.
4.2.2 When determined in accordance with 5.3, the volume of the contents of each container shall not be less than the nominal
volume and shall not exceed: a) 115 % for containers with a nominal volume of < 50 mL; and b) 110 % for containers with a nominal volume of 50 mL.4.3 pH value
When determined in accordance with 5.4, the pH value of a product that complies with the USP
requirements for "Lactated Ringer's injection" shall be between 6.0 and 7.5 and a product that
complies with the BP requirements for "Ringer-lactate solution for injection" shall be between 5.0
and 7.0 (see table 1).4.4 Identification
4.4.1 Chlorides
When tested in accordance with 5.5, the product shall give a positive reaction for chlorides.4.4.2 Potassium
When tested in accordance with 5.6.2.3.1, the product solution (see 5.6.2.2.5(a)) shall give a reading for absorbance at
the emission wavelength for potassium.4.4.3 Sodium
When tested in accordance with 5.6.2.3.2, the product solution (see 5.6.2.2.5(b)) shall give a reading for absorbance at the
emission wavelength for sodium.4.4.4 Calcium
When tested in accordance with 5.6.2.3.3, the product solution (see 5.6.2.2.5(c)) shall give a reading for absorbance at the
emission wavelength for calcium.4.4.5 Lactate
When tested in accordance with 5.6.3, the retention time of the lactate peak in the chromatogram of
the product shall correspond to that of the standard preparation.4.5 Concentration of dissolved substances
When tested in accordance with the methods given in column 6 of table 1, the concentration of the
dissolved substances shall comply with the limits given in column 2 and column 3 of table 1 for
products that comply with the USP requirements for "Lactated Ringer's injection", and column 4 and
column 5 of table 1 for products that comply with the BP requirements for "Ringer-lactate solution
for injection", as required (see annex A).TBS/CDC 16(6640) P3
©TBS 2020 All rights reserved First Edition 2020
Table 1 - Concentration of dissolved substances
1 2 3 4 5 6
USP requirements BP requirements
Dissolved substances
concentration concentration Test mg/100 mL g/100 mL method min. max. min. max. Total chlorides (CI) present 368.0 408.0 0.37 0.42 5.6.1 expressed as: potassium chloride (KCI), sodium chloride (NaCI), and calcium chloride dihydrate (CaCI2 .2H2O)Potassium chloride (KCI):
Expressed as potassium (K) 14.2 17.3 0.019 0.022 5.6.2.3.1Expressed as KCIa 27.0 33.0 0.038 0.042
Sodium chloride (NaCI) and
sodium lactate (C3H5Na03): Expressed as sodiumb (Na) 285.0 315.0 0.27 0.32 5.6.2.3.2Calcium chloride dihydrate:
Expressed as Calcium (Ca) 4.90 6.00 - - 5.6.2.3.3 Expressed as CaCl2·2H20c 18.0 22.0 0.025 0.029Sodium lactate (C3H5Na03 ):
Expressed as lactate 231.0 261.0 0.23 0.28 5.6.3 (C3H503)Expressed as C3H5Na03d 290.0 330.0 - -
a The factor to convert K to KCI is 1.9067. b The factor to convert NaCI to Na is 0.3934. c The factor to convert Ca to CaC12·2H20 is 3.6681.0 The factor to convert C3Hs03 to C3HsNa03 is 1.244.
4.6 Particulate matter (sub-visible particles)
When tested in accordance with 5.7, the number of particles with a diarneter 10 µrn and 25 µrn, respectively, shall
comply with the limits for small volume injections and large volume injections given in the USP, as relevant.
4.7 Sterility
When tested in accordance with 5.8, there shall be no signs of microbial growth.4.8 Bacterial endotoxins
When tested in accordance with 5.9, the product shall not contain more than 0.5 endotoxin units per
millilitre according to USP requirements and 0.25 endotoxin units per millilitre according to BP
requirements.TBS/CDC 16(6640) P3
©TBS 2020 All rights reserved First Edition 2020
5 Inspection and methods of test
5.1 General
Unless otherwise specified, only use water that complies with the requirements for grade 3 water as
given in TZS 59, and reagents of analytical reagent grade or of the purest grade available.NOTE See annex B for the quality verification of sterilized compound sodium lactate intravenous infusion
(Ringer-lactate solution for injection).5.2 Inspection
5.2.1 Gently invert the container and examine, without magnification, for any visible signs of
suspended matter or sediment.5.2.2 Check for compliance with 4.1.
5.3 Fill volume
5.3.1 Transfer, as completely as possible, the contents of a container into a graduated measuring
cylinder of a size able to contain at least 110 % of the nominal volume of the container.5.3.2 Record the volume of liquid in the measuring cylinder.
5.3.3 Determine the average fill volume of at least three containers.
5.3.4 Check for compliance with 4.2.
5.4 pH value
5.4.1 Determine the pH value in accordance with the relevant procedure described in the current
USP or BP.
5.4.2 Check for compliance with 4.3.
5.5 Identification of chlorides
5.5.1 Reagents
5.5.1.1 Nitric acid solution, c(HN03) = 2 mol/L
Dilute 12.6 mL of concentrated nitric acid (d at 25°C = 1.42) to 100.0 mL with water.5.5.1.2 Silver nitrate solution, 4.25 g/100mL
Dissolve 4.25 g of silver nitrate (AgN03) in water and dilute to 100.0 mL with water. Ensure that the
silver nitrate solution is clear before use and, and filter if necessary. Store protected from light.
5.5.2 Procedure
5.5.2.1 Transfer 2 mL of the product into a 50 mL centrifuge tube.
5.5.2.2 Add one drop of the nitric acid solution and 0.4 mL of the silver nitrate solution. Shake and
allow to stand. A curdled white precipitate is formed.5.5.2.3 Centrifuge the tube with the contents. Wash the precipitate three times with 1 mL of water.
Carry out this operation rapidly in subdued light, disregarding the fact that the supernatant might not
become perfectly clear.5.5.2.4 Suspend the precipitate in 2 mL of water and add 1.5 mL of concentrated ammonia. The
precipitate dissolves easily with the exception of a few large particles, which dissolve slowly.TBS/CDC 16(6640) P3
©TBS 2020 All rights reserved First Edition 2020
5.5.2.5 Check for compliance with 4.4.1.
5.6 Concentration of dissolved substances
5.6.1 Total chloride content
5.6.1.1 Reagents
5.6.1.1.1 Silver nitrate solution, c(AgNO3) = 0.1 mol/L
Dissolve 17.0 g of silver nitrate (AgNO3) in water and dilute to 1 L with water. Standardize against
certified sodium chloride and store protected from light.NOTE 1 Commercially available concentrated volumetric solution can be used provided the diluted solution is standardized before use.
NOTE 2 The methods for standardization given in the USP or in the BP can be used.5.6.1.1.2 Potassium chromate solution, 5 g/100 mL
Dissolve 5 g of potassium chromate (K2Cr04) in water and dilute to 100.0 mL with water. Potassium
chromate produces a red precipitate with silver nitrate in neutral solutions.5.6.1.2 Procedure
5.6.1.2.1 Transfer a volume of the product that contains approximately 0.1 g of sodium chloride into
a conical flask and add about 1 mL of the potassium chromate solution.5.6.1.2.2 Titrate with the standardized silver nitrate solution to a reddish-brown endpoint.
5.6.1.2.3 Calculate the total chloride content (Clc) in the product, expressed as chloride
in mg/100 mL, using the following formula:Clc = t x M x 35.453 x100
V whereClc is the total chloride content;
t is the volume of the standardized silver nitrate solution used in the titration, in millilitres;
M is the molarity of the standardized silver nitrate solution; V is the volume of product used for the test, in millilitres; and35.453 is the atomic mass of chloride ion.
5.6.1.2.4 Check for compliance with 4.5.
NOTE Alternative test methods such as potentiometry can be also used to determine the total chloride
content of the product provided these methods give equivalent results.TBS/CDC 16(6640) P3
©TBS 2020 All rights reserved First Edition 2020
5.6.2 Potassium, sodium and calcium content
5.6.2.1 Apparatus
Atomic absorption spectrophotometer, equipped with sodium, potassium and calcium hollow- cathode lamps and an air-acetylene flame.5.6.2.2 Solutions
5.6.2.2.1 Lanthanum chloride solution
Transfer 17.7 g of lanthanum chloride (LaCI3(7)H20) into a 200 mL volumetric flask. Add 100 mL of
water and carefully add 50 mL of hydrochloric acid and mix. Allow to cool and dilute to 200.0 mL
with water.5.6.2.2.2 Standard stock solutions
NOTE Commercially available standard stock solutions can be used.Prepare the following standard stock solutions:
a) Potassium standard stock solution, 1 000 µg/mL KDissolve 381.4 mg of certified potassium chloride (KCI), previously dried at 105°C for 2 h, in
50 mL of water. Transfer into a 200 mL volumetric flask and dilute to 200,0 mL with water and
mix. This solution contains 1 000 µg/mL of potassium. b) Sodium standard stock solution, 1 000 µg/mL NaDissolve 508.4 mg of certified sodium chloride (NaCI), previously dried at 105°C for 2 h, in
50 mL of water. Transfer into a 200 mL volumetric flask and dilute to 200,0 mL with water and
mix. This solution contains 1 000 µg/mL of sodium. c) Calcium standard stock solution, 1 000 µg/mL CaTransfer 499.5 mg of certified calcium carbonate (CaC03) into a 200 mL volumetric flask with
10 mL water. Carefully add 5 mL of 10 % (volume fraction) of hydrochloric acid. Swirl to dissolve
the calcium carbonate and dilute to 200,0 mL with water. This solution contains 1 000 µg/mL of
calcium.5.6.2.2.3 Standard working solutions
Prepare the following standard working solutions from the standard stock solutions: a) Potassium standard working solution, 50 µg/mL KTransfer 5.0 mL of the potassium standard stock solution into a 100 mL volumetric flask and
dilute to 100.0 mL with water and mix. This working standard solution contains 50 µg/mL of
potassium. b) Sodium standard working solution, 50 µg/mL NaTransfer 5.0 mL of the sodium standard stock solution into a 100 mL volumetric flask and dilute
to 100.0 mL with water and mix. This working standard solution contains 50 µg/mL of sodium. c) Calcium standard working solution, 100 µg/mL CaTransfer 10.0 mL of the calcium standard stock solution into a 100 mL volumetric flask and dilute
to 100.0 mL with water and mix. This working standard solution contains 100 µg/mL of calcium.TBS/CDC 16(6640) P3
©TBS 2020 All rights reserved First Edition 2020
5.6.2.2.4 Standard reference solutions
Prepare the standard reference solutions from the standard working solutions as follows: a) Add 5 mL lanthanum chloride solution to each of the five 100 mL volumetric flasks. b) Dilute the blank solution to 100.0 mL with water and mix.c) Add the volumes given in column 2, column 3 and column 4 of table 2 of the potassium, sodium,
and calcium standard working solutions, respectively, to each of the remaining four volumetric flasks. d) Dilute to 100.0 mL with water and mix. Table 2 - Preparation of standard reference solutions1 2 3 4 5 6
Volume of working standard solutions added Final concentration inquotesdbs_dbs6.pdfusesText_11[PDF] rip.ie death notices meath
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