Introduction

vet05801

Company name: Animalcare Limited

Address: Common Road

Dunnington

York YO19 5RU

Telephone: 01904 487687

Fax: 01904 487611

Email: animalcare@animalcare.co.uk

Presentation

Aqupharm No. 9 is a sterile, preservative free solution for infusion, presented in a flexible pouch containing:

Sodium chloride 0.86% w/v

Potassium chloride 0.03% w/v

Calcium Chloride dihydrate 0.03% w/v.

That is 147 millimoles of sodium, 4 millimoles of potassium, 2.2 millimoles of calcium and 156 millimoles of chloride per litre.

Uses

Aqupharm No. 9 is an isotonic solution used in dogs and cats for the treatment of dehydration with salt depletion and where there has been some intracellular potassium loss. In cases of persistent vomiting there are substantial losses of both hydrogen and chloride ions, resulting in an excess of intracellullar sodium. Renal compensation leads to an increased potassium loss and consequent hypokalaemia. It is indicated for pyometra when associated with severe vomiting.

Dosage and administration

Aqupharm No. 9 should be prewarmed to 37°C to prevent hypothermia.

Remove outer bag and protective giving set inlet tab. Push cannula fully into giving set. Prime giving set. Perform venepuncture and immediately attach giving set. Adjust infusion rate as required. Delivery is from a closed circuit, it does not need an air inlet.

Giving sets should be changed at least once every 24 hours.

The quantity of fluid and electrolyte for administration will consider existing deficits, maintenance needs and continuing losses.

The existing deficit is that which has been lost prior to examination. This must be estimated by evaluating the patient's history, making a physical examination and using laboratory aids.

Maintenance therapy is to replace normal losses occurring via urine, faeces, respiratory tract and skin. As a general rule maintenance therapy requires 50mls/kg bodyweight/day. Continuing losses during a disease period should be estimated whenever possible, i.e. quantity of vomit, diarrhoea or blood loss.

The clinical response of the animal rather than formulae or equations should be used to guide fluid therapy. The intravenous route of administration is preferred. Indwelling venous catheters offer significant advantage in intravenous fluid therapy. Subcutaneous administration may be used for isotonic and non-irritating solutions.

The rate of administration should be considered with each individual patient. The aim should be to correct about half of the calculated deficit in the first 1–2 hours. As a general rule the following formula is the maximum satisfactory rate (less where cardiovascular or pulmonary disease exists).

Maximum rate=Body wt (kg)×90=mls fluid per hour.

This rate should be slowed after the first hour and considerably slowed if no urine flow is established. Signs of over rapid administration include restlessness, moist lung sounds, tachycardia, tachypnoea, nasal discharge, coughing, vomiting and diarrhoea.

Contra-indications, warnings, etc

Contra-indications

Sodium overload may occur in cases with myocardial and renal damage. It should also be appreciated that in the period following surgical interference and severe trauma there may be an inability to excrete excessive sodium.

Undesirable effects

Hypernatraemia (sodium overload) or an inability to excrete excessive sodium.

Thrombosis of a chosen vein is always a possibility with intravenous infusion. If infusion is protracted then another vein should be selected after 12-24 hours.

Precautions

For animal treatment only.

Although Aqupharm No. 9 contains potassium the quantity may be inadequate in the presence of intracellular potassium loss, where such deficiency is known to occur it may be necessary to give oral potassium supplements.

Overdose

Symptoms: Associated signs of hypernatraemia include pronounced thirst, dry mucous membranes, constipation, hyperpyrexia, CNS disturbance and ultimately convulsions. A plasma Na+ concentration of > 150mEq/l and a urine specific gravity of > 1.030 indicate a hypernatraemic state.

Treatment of overdosage: Injection of a diuretic.

User Warning

Wash hands after use.

Pharmaceutical precautions

Store below 25°C. Do not freeze.

Store out of reach of children.

Before use the bag should be inspected and rejected if the solution is not clear or if the inner container is damaged. This product does not contain an antimicrobial preservative. Single use only; any remaining solution should be discarded.

Drugs should not be mixed in infusion containers or giving sets unless the components are of known compatibility. The user should refer to the manufacturer's literature for any drug substance which he or she proposes to co-administer and also to the Appendix of Drug Incompatibilities in the current edition of the Veterinary Formulary. Aqupharm No. 9 is incompatible with Sodium bicarbonate intravenous solution and Noradrenaline acid tartrate.

Dispose of any unused product in accordance with guidance from your local waste regulation authority.