Saline solution intravenously. What does Sodium Chloride help with?

The universal remedy prescribed by doctors is a sodium chloride dropper. The body is very complex and requires a careful approach to treating diseases. The composition of the drug maintains the body's water balance, helping the absorption of various medications.

Knowing its effectiveness and virtually no side effects, sodium chloride solution helps provide quick relief for serious cases such as severe food poisoning. More often, sodium chloride is called saline solution. And the patient entering the hospital receives it intravenously. Wounds are also treated with saline and a number of medications are diluted, including potassium injections.

How does the drug affect the body?

Due to its range of applications, saline solution has no competitors and has been actively used in medical practice for decades.

Many diseases provoke rapid removal of moisture from the body. Therefore, in some cases it is necessary to quickly restore it. What is the sodium chloride dropper for? Thanks to its composition, it restores lost water, normalizing the water balance in cells.

Its effect is immediately noticeable, the patient’s well-being improves, normalizing the condition. One of the advantages of this type of medication is that it is quickly eliminated. The effect of sodium chloride can be compared to an ambulance, so it is often used:

• In case of severe intoxication of the body, for example, patients with dysentery. the liquid helps quickly remove accumulated toxins from the patient’s blood;
• The drug is also prescribed to patients with cholera to quickly cleanse the blood of toxins;
• If a person is poisoned. Already a couple of hours after the intravenous infusion of sodium chloride, the patient becomes significantly better;
• Another solution of sodium chloride is used as a means for rinsing the sinuses or gargling. The saline solution removes all harmful bacteria and moisturizes the nasal mucosa.

This is appropriate, especially if children have a runny nose, because taking medicinal drops or nasal sprays is contraindicated for small children.

• If the patient has purulent sinusitis, then a sodium chloride solution is placed in the nasopharynx. This approach helps to thoroughly rinse the sinuses, dissolving purulent formations and quickly removing them;
• Sore throat is also a common disease, so sodium chloride can be used as a rinse solution. It disinfects and moisturizes the throat at the same time.

Sodium chloride can be used as a cleanser for purulent wounds; it is effective, especially for burns.

The active substance included in the composition is sodium chloride. It helps to quickly remove all harmful substances, increasing kidney activity. Many people are interested in the question: is it possible to use sodium chloride during pregnancy? The composition is safe, therefore it is often prescribed to expectant mothers and babies to maintain health. But here, too, you should be careful and use saline solution only as prescribed by a doctor.

Due to the load on the kidneys during pregnancy, a single dose of sodium chloride solution should not exceed 400 ml.

For what diseases is sodium chloride prescribed?

A number of diseases where sodium chloride intake is required:

• Cholera;

• Severe diarrhea;
• Constant vomiting is usually due to poisoning;
• Dyspepsia;
• Serious burns involving large areas of skin;
• Hyponatremia, one of the consequences of which is dehydration.

Another solution of sodium chloride is used for bleeding:

• gastric;
• intestinal;
• pulmonary

The use of a dropper as a disinfectant for treating external wounds is also common.

Hypertonic sodium chloride solution is used for severe changes in blood pressure. Sodium chloride is the basis for taking additional medications for various diseases. Therefore, combining saline solution with medications prescribed by a doctor helps speed up the effect of the medication.

The release form of sodium chloride is ampoule, of various volumes - 200 ml, 400 ml. But before direct administration, it must be heated to a temperature of 38 degrees.

The composition of saline solution is close to the composition of blood in the body. Therefore, it can effectively replenish lost elements during the progression of the disease. This promotes the functioning of important organs: kidneys, brain, stomach and the entire digestive system. The drip is prescribed to replenish the deficiency of potassium ions, this helps to avoid the development of hypoglycemia and disrupt the normal functioning of the kidneys.

Who is contraindicated to take an IV?

Despite the safety of saline and its possible use by pregnant women and children, there are a number of contraindications:

• If there is an excess of sodium and chlorine and a lack of potassium;
• When the circulation of fluids in the body is impaired and the patient is predisposed to edema. Important internal organs of the patient may be at risk: lungs or brain;
• Acute heart failure is also a reason not to use sodium chloride liquid;
• If the patient has taken corticosteroid drugs in large quantities, it is also impossible to take sodium chloride;
• High cell hyperhydration.

You should carefully monitor the dosage of the drug during use; the exact amount can be prescribed by your doctor after the study.

Instructions for taking the drug

A dropper with saline restores potassium balance and also balances the water-electrolyte composition in the blood. It is often used as a prophylactic agent in patients with a predisposition to tachycardia or arrhythmia.

The exact dosage of the drug is important:

• Large doses of sodium chloride solution narrow the coronary vessels;
• Injection of chloride in small doses promotes dilation of coronary vessels.

If your doctor has prescribed you the drug as a drip, then potassium chloride must be diluted in saline solution - 0.9% or glucose - 0.5%. Due to contraindications, please read the included instructions in the drug package.

A number of actions still need to be followed:

• Before directly administering the sodium chloride solution, it should be heated to body temperature - 37-38 degrees;
• The amount of the drug dose is regulated by the doctor and depends entirely on the patient’s condition. For example, for dehydration, the daily dose is about one liter;
• In case of serious poisoning, when the patient quickly loses fluid, during severe vomiting or diarrhea, the amount of solution dose may increase to 3 liters per day;
• The speed of administration is also important; it depends on the necessary replenishment of lost fluid by the body. For example, in case of poisoning with severe fluid deficiency, the patient requires an infusion rate of 540 ml per hour;
• Dehydration in children is accompanied by a decrease in blood pressure, so the rate of administration of the solution is from 20-30 ml per kilogram of the child’s weight;
• When washing the stomach, a 4% solution of the drug is used;
• When it is necessary to eliminate constipation, an enema with a 5% sodium chloride solution is used;
• A patient with internal bleeding: gastrointestinal tract, lungs receives a 10% solution by drip;
• When a doctor prescribes gargles for colds, 1% of the composition is used.

There are combinations of drugs with sodium chloride, but before doing this you need to consult your doctor. Only after a thorough examination of the patient can the required dosage of the medicine be determined.

It is necessary to observe safety precautions when administering the drug using a dropper. You cannot inject the drug under the skin; this will lead to the death of subcutaneous tissues and the development of internal inflammatory processes, including gangrene.

The chloride solution does not contain elements that affect the ability to drive a car or other vehicles, so after the procedure the patient is allowed to engage in their normal activities.

Possible side effects

The drug sodium chloride is easily tolerated by patients. But even it has its side effects. So, if you take the medicine for a long time or increase the dose prescribed by your doctor, the following problems may arise:

• Acidosis;
• Cell hyperhydration;
• Hypokalemia;

What to do in case of drug overdose? If an overdose situation occurs, you must immediately seek medical help for symptomatic therapy.

Taking the solution by pregnant women

The use of any drugs by pregnant women is undesirable. After all, any external chemical influence can provoke a disturbance in the development of the fetus. Therefore, when prescribing medications, the doctor weighs the expected benefits for the mother’s health and the possible development of complications during the growth of the child’s fetus. The use of any potassium preparations by expectant mothers leads to stimulation of the nervous system. The potential harm and likelihood of side effects should be assessed.

Taking potassium-sparing drugs during lactation often leads to a cessation of mother's milk production. And if therapy is needed, then you should prepare to change the child’s diet.

Summing up about the IV

The use of any medicine has two sides. On the one hand, they help us recover from existing diseases, but on the other hand, the chemical elements included in any medicine have a detrimental effect on other healthy organs. These are the liver and kidneys. They are responsible for processing the chemical elements that make up the bulk of all drugs.

When taking a drip, a serious load is placed on the kidneys, as they are responsible for eliminating toxins. Therefore, after treatment therapy, it is necessary to undergo a rehabilitation course to restore the normal functioning of all organs. Take care of yourself and be mindful of what you eat.

Main active ingredient:

sodium chloride(NaCl) - white crystals with a salty taste, easily soluble in water, but poorly soluble in ethanol.

For medical purposes the following are used:1. Isotonic (physiological) 0.9% solution containing sodium chloride – 9 g, distilled water – up to 1 liter.

2. Hypertonic 10% solution containing sodium chloride - 100 g, distilled water - up to 1 liter.

Release form

• To dissolve medicinal substances for intramuscular and subcutaneous injections, a 0.9% sodium chloride solution is produced in ampoules of 5, 10, 20 ml.
• For dissolving medications, intravenous drips, enemas and external use: 0.9% sodium chloride solution in bottles of 100, 200, 400 and 1000 ml.
• For intravenous injection and external use: 10% sodium chloride solution in bottles of 200 and 400 ml.
• For oral (inside) administration: tablets 0.9 g. To use the tablet must be dissolved in 100 ml of boiled warm water.
• For treating the nasal cavity: nasal spray – 10 ml.

pharmachologic effect

Sodium chloride is responsible in the body for maintaining constant pressure in the blood plasma and extracellular fluid. Its required amount enters the body with food.

Various pathological conditions (for example, diarrhea, vomiting, extensive burns), accompanied by increased secretion of sodium chloride, provoke a deficiency of sodium and chloride ions. This leads to thickening of the blood, convulsive muscle contractions, spasms of smooth muscles, dysfunction of the nervous system and blood circulation may develop. Timely introduction of an isotonic solution into the body replenishes the lack of fluid in the body and temporarily restores the water-salt balance. However, due to the same osmotic pressure as blood plasma, the solution is not retained in the vascular bed. After 1 hour, no more than half of the administered amount of the substance remains in the vessels. This explains the insufficient effectiveness of isotonic solution in such severe conditions as blood loss. It has detoxification and plasma-substituting properties.

Hypertonic sodium chloride solution, when administered intravenously, enhances diuresis and replenishes the deficiency of sodium and chloride ions.

Indications for use Saline solution is used for:

• Restoring water balance in case of body dehydration caused by various reasons.
• Maintaining plasma volume during surgery and after.
• Detoxification of the body (food poisoning, dysentery, cholera, etc.).
• Maintaining plasma volume in case of extensive burns, diarrhea, blood loss, diabetic coma.
• Eye rinsing for inflammatory and allergic irritations of the cornea.
• Rinsing the nasal mucosa for allergic rhinitis, nasopharyngitis, prevention of sinusitis, acute respiratory infections, after removal of polyps and adenoids.
• Inhalation of the respiratory tract (using special devices - inhalers).

It is used to treat wounds, moisturize bandages and fabric dressings. The neutral environment of saline is well suited for dissolving drugs and co-infusion with other drugs.

Hypertonic solution is used for:1. Deficiency of the elements sodium and chlorine.

2. Dehydration

due to various reasons: pulmonary, gastric and intestinal

bleeding

Burns, vomiting, diarrhea.

3. Poisoning

silver nitrate.

Used as an adjuvant when increased diuresis (increased urine volume) is necessary. It is used externally for antimicrobial treatment of wounds, and rectally for enemas for constipation.

Sodium chloride - instructions for use

Isotonic (physiological) sodium chloride solution is administered intravenously and subcutaneously. More often - intravenously. Before use, it is recommended to warm the solution to 36-38

C. The volume administered depends on the patient’s condition and the amount of fluid lost by the body. The patient's age and body weight are taken into account. The average daily dose is 500 ml (it completely covers the daily need for sodium chloride), the average rate of administration is 540 ml/h. The maximum daily volume of 3000 ml is administered in cases of severe

intoxication

and dehydration. If necessary, a drip infusion of 500 ml is carried out at a fairly high speed - 70 drops/minute.

The dose of the solution for children depends on body weight and age. On average, it ranges from 20 to 100 ml per day per 1 kg of body weight.

With long-term use of large doses of sodium chloride, it is necessary to analyze the content of electrolytes in plasma and urine.

To dilute medications administered by drop method, use 50 to 250 ml of sodium chloride solution per dose of the drug. To determine the rate of administration and dose, they are guided by the recommendations for the main therapeutic drug.

A hypertonic sodium chloride solution is administered intravenously in a stream (slowly), on average 10-30 ml. A 2-5% solution is used for gastric lavage in case of poisoning with silver nitrate, which turns into non-toxic silver chloride. In cases requiring immediate replenishment of sodium and chlorine ions in the body (food poisoning, vomiting), 100 ml of solution is administered dropwise.

For rectal enemas to induce defecation, 100 ml of a 5% solution or 3000 ml/day of an isotonic solution is sufficient. Hypertensive enema is also used for cardiac and renal edema, hypertension and intracranial pressure. Contraindications to it are inflammation and erosion of the lower colon.

Treatment of purulent wounds is carried out in accordance with the treatment regimen. A compress moistened with the solution is applied to the festering wound, abscesses, boils and phlegmons. This causes the death of microorganisms and the separation of pus from the problem area.

To treat the nasal mucosa, you can use a nasal spray, a ready-made isotonic solution, or a solution obtained by dissolving a tablet.

The solution is instilled after clearing the nasal cavity of mucus. When instilling into the left nostril, the head should be tilted to the right and slightly tilted back. In the case of the right nostril, it’s the opposite. Adult dose - 2 drops in the right and left nostril, children from one year - 1-2 drops, up to one year - 1 drop 3-4 times a day, for therapeutic or prophylactic purposes. The average course of therapy is 21 days.

Rinsing the nasal cavity is carried out in a lying position. Adults can use a syringe for this procedure. After the procedure, you need to stand up to clear your nose of thin mucus and restore breathing.

To effectively inject the spray, you need to take a shallow breath through your nose, and then lie down for a few minutes with your head thrown back. Adults are prescribed 2 doses, children over 2 years old - 1-2 doses 3-4 times a day.

Sodium chloride inhalations are used to treat colds. To do this, mix equal amounts of an isotonic solution with bronchodilators (Lazolvan, Ambroxol, Tussamag, Gedelix). The duration of the procedure for adults is 10 minutes, for children – 5-7 minutes 3 times a day.

To relieve attacks of allergic cough and bronchial asthma, an isotonic solution is added to drugs that dilate the bronchi (Berodual, Berotek, Ventolin).

Sodium chloride 10 - instructions for use

Hypertonic sodium chloride solution is a clear, colorless, odorless liquid with a very salty taste. The solution for intravenous administration must be sterile, securely packaged, free from foreign impurities, sediment, crystals and turbidity.

To prepare the solution yourself, dissolve 4 level tablespoons of salt in 1 liter of boiled warm water. The solution is used for enemas.

Sodium chloride 9 - instructions for use

Isotonic sodium chloride solution is a clear, colorless, odorless liquid with a slightly salty taste. Ampoules and bottles must be free of cracks and breaks. The solution is sterile, without foreign impurities, sediment, crystals and turbidity.

Instructions for preparing saline solution at home: A teaspoon (heaped) of ordinary table salt is stirred in 1 liter of boiled warm water. Since the prepared solution is not sterilized, its shelf life is one day. This solution is suitable for inhalation, enemas, rinsing and topical use. Strictly contraindicated for intravenous or intramuscular administration, treatment of eyes and open wounds. Before each use, the required amount of solution is warmed to room temperature. Home preparation of saline solution is justified only in extreme cases, when it is impossible to visit the pharmacy.

Contraindications Isotonic (physiological) sodium chloride solution is contraindicated in the following cases:

• increased content of sodium ions in the body;
• increased content of chlorine ions in the body;
• lack of potassium;
• circulatory fluid disorders, with the possibility of cerebral and pulmonary edema;
• cerebral edema, pulmonary edema;
• intracellular dehydration;
• extracellular excess fluid;
• treatment with significant doses of corticosteroids.

Used with great caution in patients with changes in renal excretory function, as well as in children and the elderly.

Contraindications for hypertonic solution: injection under the skin or into muscles is strictly prohibited. When the solution comes into contact with tissues, fluid passes from the cells into the solution. Cells, losing water, shrink and die from dehydration. This is how necrosis (death) of tissue occurs.

Side effects

When the solution is administered intravenously, local reactions may occur: a burning sensation and

hyperemia

at the place of application.

With prolonged use of the drug, symptoms of intoxication of the body are possible:

• discomfort in the digestive system: nausea, vomiting, stomach cramps, diarrhea;
• disorders of the nervous system: lacrimation, constant thirst, anxiety, sweating, dizziness, headache, weakness;
• arterial hypertension, rapid heartbeat and pulse;
• dermatitis;
• menstrual irregularities;
• anemia;
• excess fluid content in the body or its parts (edema), which indicates a pathological shift in water-salt metabolism;
• acidosis – a shift in the body’s acid-base balance towards increased acidity;
• hypokalemia – a decrease in potassium content in the body’s blood.

If side effects occur, the drug should be stopped. It is necessary to assess the patient’s well-being, provide adequate assistance and save the bottle with the remaining solution for analysis.
Sodium chloride during pregnancy

It is believed that the body's daily sodium requirement is about 4-5 grams. However, during

pregnancy

this value must be reduced to a minimum. Excess sodium in the food consumed leads to fluid retention in the body, resulting in increased blood density and

). Constantly monitoring the sodium chloride content in food will help avoid edema.

It is impossible to do without this important microelement, since it is necessary for the normal functioning of all intracellular and intercellular processes, maintaining a constant salt balance and osmotic pressure not only for the mother, but also for the child.

The main source of sodium chloride for a pregnant woman is ordinary table salt, which consists of 99.85 of this important element. To reduce your sodium chloride intake, you can use low-sodium salt. This salt additionally contains potassium and magnesium salts.

Consumption of iodized salt will provide the required dose of iodine, a microelement that affects the stability of pregnancy.

Physiological sodium chloride solution is used intravenously in pregnant women under the following conditions:1. Preeclampsia (increased concentration of sodium in the blood plasma) with severe swelling.

2. Medium and severe stages

toxicosis

Interaction with other drugs

Sodium chloride is compatible with almost all medications. This determines its use for dissolving and diluting drugs. During the process, visual control of their compatibility is necessary (absence of sediment, flakes, crystal formation and color change).

The drug norepinephrine, which is stable in an acidic environment, is poorly compatible with the neutral environment of sodium chloride.

Simultaneous administration with corticosteroids requires constant monitoring of the level of electrolytes in the blood.

The hypotensive effect of the drugs Enalapril and Spirapril is reduced when taking sodium chloride drugs.

The leukopoiesis stimulator Filgrastim and sodium chloride are incompatible.

Polypeptide antibiotic Polymyxin B and sodium chloride are incompatible.

It is known that an isotonic solution can increase the bioavailability of drugs. Powdered antibiotics diluted in sodium chloride solution are completely absorbed by the body. Antibiotics dissolved in novocaine are absorbed 10-20% worse.

Synonymous drugs for sodium chloride

Different manufacturers produce isotonic sodium chloride solution under their own trade name. Such preparations are completely identical to the standard isotonic solution.

List of synonyms:

• Sodium chloride 0.9% for intravenous infusion - sterile solution in bottles.
• Sodium chloride 1.6% for intravenous infusion.
• Sodium chloride 12% for intravenous infusion.
• Sodium chloride Brown (Germany) - powder for the preparation of solution for injection, solution for infusion, solution for injection, solvent for the preparation of dosage forms for injection, nasal spray.
• Sodium chloride bufus – powder for the preparation of solution for injection, solution for infusion, solution for injection, solvent for the preparation of dosage forms for injection, nasal spray.
• Sodium chloride-Cinco – isotonic solution for infusion, hypertonic solution, eye drops and eye ointment.
• Sodium chloride – 0.9% solution for infusion (Bulgaria).
• Salorid – 0.9% solution for infusion (Bangladesh).
• Rizosin – 0.65% nasal spray with and without menthol.
• Salin – 0.65% nasal spray (India).
• No-salt – 0.65% nasal spray.
• Physiodose – 0.9% solution for topical use.

Additional information Any introduction of sodium chloride into the body requires monitoring the patient's condition and biological indicators. This is especially true for children. Immature renal function may slow sodium excretion, so each subsequent infusion is carried out only after appropriate tests.

Use only a clear solution from an undamaged package. First, it is connected to the infusion system according to all the rules of asepsis. Connecting plastic containers one after another is excluded, as this can lead to an air embolism - air entering the blood vessels. To prevent air bubbles from penetrating into the infusion system, it must be filled with a solution, releasing any residual air from the container. Other drugs can be added to the isotonic solution by injection into the container, before or during the infusion.

An important condition is the preliminary determination of the compatibility of drugs with sodium chloride. Compatibility is determined by mixing the ingredients and observing possible changes in color, sediment, flakes or crystals.

The prepared complex solution of two drugs should be used immediately and not stored.

Violation of the technique of mixing medications and the rules of asepsis can cause pyrogens - substances that provoke an increase in temperature - to enter the solution. If any adverse reactions occur, such as fever, the administration of the drug should be stopped immediately.

Brief instructions for using soft containers with isotonic solution:1. Remove container from outer packaging immediately before use. It protects and maintains the sterility of the drug.

2. Squeeze the container tightly and check for integrity. If damage is found, discard the container, as the solution in it is dangerous.

3. Check the solution visually: for transparency, absence of impurities and inclusions. If present, discard the container.

4. Hang the container on a tripod, remove the plastic fuse and unscrew the lid.

5. Add medications to the solution using aseptic technique. Move the clamp that regulates the movement of the solution to the “closed” position. Disinfect the area of ​​the injection container, make a puncture in it with a syringe and inject the drug. Mix well. Move the clamp to the “open” position.

All unused doses should be discarded. The combination of several partially used containers with solutions is strictly prohibited.

Storage conditions and expiration dates

Sodium chloride in the form of powder, tablets and solutions is stored in carefully closed containers, in a dry, clean place, at a temperature not exceeding 25

C. Storage areas must be out of reach of children. Freezing the drug while maintaining the seal of the package does not affect the pharmacological properties. For further use, the containers must be kept in normal climatic conditions for at least 24 hours.

Expiration dates:

• powder and tablets - without restrictions;
• 0.9% solution in ampoules – 5 years;
• 0.9% solution in bottles – 12 months;
• 10% solution in bottles – 2 years.

Do not use after expiration date. Before using any drug containing sodium chloride, you should consult your doctor.

ATTENTION! The information posted on our website is for reference or popular information and is provided to a wide range of readers for discussion. Prescription of medications should be carried out only by a qualified specialist, based on the medical history and diagnostic results.

Sodium chloride is a plasma replacement drug.

Pharmacological action of Sodium chloride

The drug is aimed at restoring water balance and has a detoxifying effect. Due to the fact that the drug replenishes sodium deficiency, it is effective in various pathological conditions.

Sodium chloride 0.9% has the same osmotic pressure as human blood. For this reason, the drug is quickly eliminated from the body and increases the volume of circulating blood for a short period of time.

When applied externally, saline solution of sodium chloride can remove pus from the wound or restore the microflora.

If an intravenous infusion of sodium chloride solution is performed, the patient will increase urination and also replenish the lack of sodium and chlorine.

Release form

The drug is available in the form of a powder, a solvent for certain medications, a solution or a nasal spray.

Indications for use

Experts recommend prescribing sodium chloride 0.9% for large losses of extracellular fluid or in cases where its supply decreases. This can be dyspepsia (which is caused by poisoning), cholera, diarrhea, vomiting, and also large burns. This solution is effective for hyponatremia and hypochloremia, which is accompanied by dehydration.

Externally, sodium chloride saline solution should be used to wash the nose, wounds, and to moisten bandages.

In addition, the solution is used for bleeding of various types (gastric, intestinal, pulmonary), for poisoning, constipation, or for forced diuresis.

Contraindications

Experts do not recommend using the drug for: extracellular hyperhydration, blood circulation disorders (pulmonary or cerebral edema may develop), high sodium levels, acute left ventricular failure, hypokalemia, renal failure and decompensated cardiac failure.

The drug Sodium chloride should not be mixed with large doses of glucocorticosteroids. If the solution is prescribed in large dosages, the level of electrolytes in the urine or plasma should be monitored.

Directions for use and dosage

Before administration begins, the sodium chloride solution must be heated to 36-38 degrees. In case of dehydration, the dosage is determined individually. The average dose is 1 liter per day.

If the patient is severely poisoned or there is a large loss of fluid, it is recommended to administer the solution up to 3 liters per day. In this case, a sodium chloride dropper is used. The product should be administered at a speed of 540 milliliters per hour.

Children who are found to be dehydrated, accompanied by a decrease in blood pressure, must be administered a solution in the amount of 20-30 milliliters per 1 kilogram of weight.

To perform gastric lavage, use a 2-5 percent solution; to eliminate constipation, use enemas with a 5 percent solution (administer 75 milliliters rectally).

A dropper of sodium chloride 10 percent is prescribed for pulmonary bleeding, intestinal bleeding, and to increase diuresis. In these situations, the drug must be administered slowly (10-20 milliliters of solution).

In the case of complex therapy for diseases of the upper respiratory tract, experts recommend rinsing, rubbing and bathing (1-2 percent solution).

When treating colds, sodium chloride is used for inhalation (used as an adjuvant). Adults are allowed to inhale for 10 minutes, and children - 3 times a day for 5-7 minutes (in this case, the solution is mixed with Lazolvan in a ratio of 1 to 1 ml).

For inhalation it is also allowed to be combined with Berodual.

special instructions

Large volumes of the drug should be used with caution in patients who have impaired renal excretory function.

You can freeze the medicine as long as the container remains sealed. If the solution is mixed with other drugs, it is recommended to visually check the compatibility (invisible as well as therapeutic incompatibility is possible).

In case of prolonged use of the solution, as well as its use in increased dosages, hypokalemia and acidosis may occur.

Sodium chloride is a well-known saline solution, which is most often used for injection into a vein by drip. It is a universal solvent, so it can be used in conjunction with most injectable drugs.

Sodium chloride - description and action

Sodium chloride- a colorless, odorless drug, presented in the form of a solution for intravenous, intramuscular, and external use. It is also used for diluting various drugs, washing the nose and eyes, and performing inhalations. Usually, an isotonic solution (0.9 percent) is taken for these purposes, but in some cases the use of a hypertonic solution (stronger) is indicated.

The medicine is available in ampoules, as well as in bottles of 50-500 ml, the price for 250 ml of solution is about 60 rubles.

The drug has a rehydrating, detoxifying effect. He replenishes sodium deficiency, which occurs in various conditions associated with dehydration, poisoning, etc.

Saline solution is often dripped together with calcium and potassium preparations if it is necessary to eliminate the lack of essential minerals.

Sodium is important for:

• transmission of nerve impulses;
• performing electrophysiological reactions in the heart;
• implementation of metabolic processes in the kidneys;
• maintaining the required volume of blood and cellular fluid.

Hypertonic solution sodium chloride is required by the body less frequently, but is also often used in medicine. It helps to adjust the pressure of plasma and intercellular fluid in various pathological conditions.

Indications for use

Sodium chloride droppers are prescribed for the treatment of acute conditions, or for diluting various drugs for acute and chronic diseases.

Examples of using the medicine in conjunction with other drugs are as follows:

• with Diphenhydramine(Diphenhydramine) - for urticaria, anaphylactic shock, and other allergic reactions;
• with Drotaverine- for renal colic;
• with Pyridoxine- for muscle pain, diseases of the nervous system;
• with Lincomycin- for pneumonia, abscesses, sepsis.

An isotonic solution is prescribed to adults and children with a lack of sodium in the body. This occurs more often with acute or chronic dehydration (for example, with intestinal infections, poisoning with diarrhea and vomiting).

Also, the indications for use of the solution are as follows:

• acidosis;
• overdose of hormonal agents, antibiotics and other drugs;
• acute heart failure;
• hypokalemia;
• maintaining the required volume of fluid during operations and after bleeding;
• burn disease.

During pregnancy, the drug is administered for severe toxicosis, for severe edema, as a detoxification method, for a sharp drop in blood pressure during childbirth, after a cesarean section.

Also, saline solution is often dripped in case of alcohol, drug intoxication, or in case of overdose of drugs for potency and weight loss (for example, Yohimbine).

A hypertonic solution (2-3%) copes well with pulmonary edema, cerebral edema, and is recommended for severe electrolyte imbalances and to stop increased urination. Wounds are washed with a stronger solution (10%) and enemas are given to cleanse the intestines.

Instructions for use

The dosage of the drug and the drugs that are diluted with it is determined only by the doctor. This is done based on age, weight, and existing disease. The drip is performed in a medical facility, or, if indicated, at home (only under the supervision of a healthcare professional). If you need to administer saline in courses, you need regular monitoring of electrolyte levels.

Typically the dosage per day is as follows:

• children - 20-100 ml/kg body weight;
• adults - 1500 ml for three procedures;
• in severe cases - up to 3 liters for 3-5 procedures;
• in case of acute lack of electrolytes - 100 ml once, then according to indications.

To dilute the drug, 50-200 ml of saline solution is usually used. The rate of intravenous drip administration is determined by the instructions for the drug. Sodium chloride is heated before use. up to 37-38 degrees. The course of therapy is determined by the underlying disease.

In case of alcohol dependence, detoxication with the help of droppers is carried out within 3-4 days.

In folk medicine, the drug is used for facial peeling with calcium chloride (calcium hydrochloride). The tablets should be diluted with saline solution (1:2) and applied to a cleansed face. After drying, massage your face and rinse off the pellets with water. If your skin is problematic, you can additionally add one capsule of Doxycycline to the peeling.

Contraindications and side effects

The drug should not be used for high-grade hypertension, peripheral edema of unknown origin, or chronic heart failure. Therapy is carried out with great caution in the presence of severe kidney diseases, especially in cases of impaired filtration function.

Side effects that more often occur with an overdose may include:

• nausea, vomiting;
• spasms of the intestines, stomach;
• hyperhidrosis;
• hypertension;
• tachycardia;
• swelling;
• dyspnea;
• increased muscle tone.

If the therapeutic dose of saline solution is greatly exceeded, fever, thirst, weakness, and severe abdominal pain may occur. Treatment is symptomatic, aimed at stopping the manifestations.

Analogues and other information

Analogues include sodium chloride from different manufacturers, as well as combined formulations, for example, saline solution and sodium acetate.

Before administering the drug by drip, it is important to make sure that there are no foreign inclusions in the solution and that the packaging is not damaged.

The medicine should be administered with strict adherence to antiseptic rules. Drugs that are insoluble in it - those that form crystals and precipitate complexes - should not be used together with the medicine.

The active ingredient of this product is sodium chloride. The formula for sodium chloride is NaCl, these are white crystals that quickly dissolve in water. Molar mass 58.44 g/mol. OKPD code - 14.40.1.

Saline solution (isotonic) is a 0.9% solution, it contains 9 g of sodium chloride, up to 1 liter of distilled water.

Hypertonic sodium chloride solution is a 10% solution, it contains 100 g of sodium chloride, up to 1 liter of distilled water.

Release form

A 0.9% sodium chloride solution is produced, which can be contained in ampoules of 5 ml, 10 ml, 20 ml. Ampoules are used to dissolve medications for injection.

A solution of sodium chloride 0.9% is also produced in bottles of 100, 200, 400 and 1000 ml. Their use in medicine is practiced for external use, intravenous drips, and enemas.

Sodium chloride solution 10% is contained in bottles of 200 and 400 ml.

For oral use, tablets of 0.9 g are available.

A nasal spray is also produced in 10 ml bottles.

pharmachologic effect

Sodium chloride is a drug that acts as a rehydrating and detoxifying agent. The medicine is able to compensate for the lack of sodium in the body, subject to the development of various pathologies. Sodium chloride also increases the amount of fluid that circulates in the vessels.

Such properties of the solution are manifested due to the presence in it chloride ions And sodium ions. They are able to penetrate the cell membrane using various transport mechanisms, in particular the sodium-potassium pump. Sodium plays an important role in the process of signal transmission in neurons; it is also involved in the metabolic process in the kidneys and in the electrophysiological processes of the human heart.

Pharmacopoeia indicates that sodium chloride maintains constant pressure in the extracellular fluid and blood plasma. In the normal state of the body, a sufficient amount of this compound enters the body with food. But in pathological conditions, in particular, with vomiting, diarrhea, serious burns There is an increased release of these elements from the body. As a result, the body experiences a deficiency of chlorine and sodium ions, as a result of which the blood becomes thicker, the functions of the nervous system, blood flow, convulsions, and spasms of smooth muscles are disrupted.

If an isotonic sodium chloride solution is introduced into the blood in a timely manner, its use promotes recovery water-salt balance. But since the osmotic pressure of the solution is similar to the pressure of blood plasma, it does not stay in the vascular bed for a long time. After administration, it is quickly eliminated from the body. As a result, after 1 hour, no more than half of the injected amount of solution is retained in the vessels. Therefore, in case of blood loss, the solution is not effective enough.

The product also has plasma-substituting and detoxifying properties.

When a hypertonic solution is administered intravenously, an increase in diuresis, replenishing the deficiency of chlorine and sodium in the body.

Pharmacokinetics and pharmacodynamics

Excretion from the body occurs mainly through the kidneys. Some sodium is excreted in sweat and feces.

Indications for use

Sodium chloride is a saline solution that is used when the body loses extracellular fluid. Indicated for conditions that lead to limited fluid intake:

• dyspepsia in case of poisoning;
• vomit, diarrhea;
• cholera;
• extensive burns;
• hyponatremia or hypochloremia, in which dehydration of the body is noted.

Considering what sodium chloride is, it is used externally to wash wounds, eyes, and nose. The drug is used to moisturize dressings, for inhalation, and for the face.

The use of NaCl for forced diuresis during constipation, poisoning, with internal bleeding(pulmonary, intestinal, gastric).

It is also indicated in the indications for use of sodium chloride that this is a drug that is used for diluting and dissolving drugs that are administered parenterally.

Contraindications

The use of the solution is contraindicated for the following diseases and conditions:

• hypokalemia, hyperchloremia, hypernatremia;
• extracellular overhydration, acidosis;
• pulmonary edema, cerebral edema;
• acute left ventricular failure;
• development of circulatory disorders, in which there is a threat of cerebral and pulmonary edema;
• prescription of large doses of GCS.

The solution should be prescribed with caution to people who are sick. arterial hypertension, peripheral edema, decompensated chronic heart failure, chronic renal failure, preeclampsia, as well as those diagnosed with other conditions that cause sodium retention in the body.

If the solution is used as a diluent for other medications, existing contraindications should be taken into account.

Side effects

The following conditions may develop when using sodium chloride:

• overhydration;
• hypokalemia;
• acidosis.

If the drug is used correctly, the development of side effects is unlikely.

If a 0.9% NaCl solution is used as a base solvent, then side effects are determined by the properties of the drugs that are diluted with the solution.

If any negative effects occur, you should immediately report it to a specialist.

Instructions for use of Sodium Chloride (Method and dosage)

The instructions for saline solution (isotonic solution) provide for its administration intravenously and subcutaneously.

In most cases, intravenous drip administration is practiced, for which the Sodium Chloride dropper is heated to a temperature of 36-38 degrees. The volume that is administered to the patient depends on the condition of the patient, as well as the amount of fluid that has been lost by the body. It is important to take into account the person’s age and weight.

The average daily dose of the drug is 500 ml, the solution is administered at an average speed of 540 ml/h. If there is a severe degree of intoxication, then the maximum volume of medication per day can be 3000 ml. If there is such a need, a volume of 500 ml can be administered at a speed of 70 drops per minute.

Children are given a dose of 20 to 100 ml per day per 1 kg of weight. The dosage depends on body weight and the age of the child. It should be borne in mind that with prolonged use of this medicine it is necessary to monitor the level of electrolytes in plasma and urine.

To dilute drugs that need to be administered by drip, use 50 to 250 ml of sodium chloride per dose of the drug. The characteristics of administration are determined based on the main drug.

The hypertonic solution is administered intravenously.

If the solution is used to immediately compensate for the deficiency of sodium and chlorine ions, 100 ml of the solution is injected dropwise.

To perform a rectal enema to induce defecation, 100 ml of a 5% solution is administered; 3000 ml of an isotonic solution can also be administered throughout the day.

The use of a hypertensive enema is slowly indicated for renal and cardiac edema, increased intracranial pressure and for hypertension, it is carried out slowly, 10-30 ml is administered. Such an enema cannot be performed in case of colon erosion and inflammatory processes.

Purulent wounds are treated with a solution according to the regimen prescribed by the doctor. Compresses with NaCl are applied directly to a wound or other lesion on the skin. Such a compress promotes the separation of pus and the death of pathogenic microorganisms.

The nasal spray is instilled into the nasal cavity after it has been cleansed. For adult patients, two drops are instilled into each nostril, for children - 1 drop. It is used for both treatment and prevention, for which the solution is dripped for about 20 days.

Sodium chloride for inhalation is used for colds. To do this, the solution is mixed with bronchodilators. Inhalation is carried out for ten minutes three times a day.

If absolutely necessary, saline solution can be prepared at home. To do this, mix a full teaspoon of table salt in one liter of boiled water. If it is necessary to prepare a certain amount of solution, for example, with salt weighing 50 g, appropriate measurements should be taken. This solution can be applied topically, used for enemas, rinses, and inhalations. However, under no circumstances should such a solution be administered intravenously or used to treat open wounds or eyes.

Overdose

In case of overdose, the patient may feel nausea, suffer from vomiting and diarrhea, he may develop abdominal pain, fever, and rapid heartbeat. Also, with an overdose, indicators may increase blood pressure, develop pulmonary edema and peripheral edema, renal failure, muscle cramps, weakness, dizziness, generalized seizures, coma. If the solution is administered excessively, it may develop hypernatremia.

If ingested excessively, it may develop hyperchlorimic acidosis.

If sodium chloride is used to dissolve drugs, then the overdose is mainly associated with the properties of those drugs that are diluted.

If NaCl is inadvertently overadministered, it is important to stop this process and assess whether the patient has any more negative symptoms. Symptomatic treatment is practiced.

Interaction

NaCl is compatible with most medications. It is this property that determines the use of the solution for diluting and dissolving a number of drugs.

When diluting and dissolving, it is necessary to monitor the compatibility of drugs visually, determining whether a precipitate appears during the process, whether the color changes, etc.

Doesn't fit well with norepinephrine.

When prescribing the drug simultaneously with corticosteroids It is important to constantly monitor the levels of electrolytes in the blood.

When taken in parallel, the hypotensive effect decreases Enalapril And Spirapril.

Sodium Chloride is incompatible with a leukopoiesis stimulator Filgrastim, as well as with a polypeptide antibiotic Polymyxin B.

There is evidence that isotonic solution increases the bioavailability of drugs.

When diluted with a solution of powdered antibiotics, they are completely absorbed by the body.

Terms of sale

Sold in pharmacies by prescription. If necessary, use the drug to dilute other medications, etc. write out a prescription in Latin.

Storage conditions

The powder, tablets and solution should be stored in a dry place, in a well-closed container, and the temperature should not exceed 25 degrees Celsius. It is important to keep the drug away from children. If the packaging is sealed, freezing does not affect the properties of the drug.

Best before date

There are no restrictions on storing powder and tablets. The solution in 0.9% ampoules can be stored for 5 years; solution in bottles 0.9% - one year, solution in bottles 10% - 2 years. Cannot be used after the shelf life has expired.

special instructions

If an infusion is given, the patient's condition should be carefully monitored, in particular plasma electrolytes. It should be taken into account that in children, due to the immaturity of kidney function, a slowdown in sodium excretion. It is important to determine its plasma concentration before repeated infusions.

It is important to monitor the condition of the solution before administering it. The solution must be transparent and the packaging undamaged. Only a qualified specialist can use the solution for intravenous administration.

Any preparations with Sodium Chloride should only be dissolved by a specialist who can qualifiedly assess whether the resulting solution is suitable for administration. It is important to strictly adhere to all antiseptic rules. Any solution should be administered immediately after its preparation.

The result of a series of chemical reactions involving sodium chloride is the formation of chlorine. Electrolysis of molten Sodium Chloride in industry is a method of producing chlorine. If you carry out electrolysis of a solution of Sodium Chloride, you also end up with chlorine. If crystalline Sodium Chloride is treated with concentrated sulfuric acid, the result is hydrogen chloride. Sodium sulfate and sodium hydroxide can be produced through a chain of chemical reactions. Qualitative reaction to chloride ion - reaction with silver nitrate.

Analogs Level 4 ATX code matches:

Different drug manufacturers may produce the solution under a separate name. These are drugs Sodium Chloride Brown, Sodium chloride Bufus, Rizosin, Salin Sodium Chloride Cinco and etc.

Preparations containing sodium chloride are also produced. These are combined saline solutions sodium acetate+ sodium chloride, etc.

It is used in accordance with the instructions and under the careful supervision of specialists. The immaturity of renal function in children should be taken into account, so repeated administration is carried out only after an accurate determination of plasma sodium levels.

During pregnancy and lactation

During pregnancy, a sodium chloride dropper can only be used in pathological conditions. This is toxicosis in the moderate or severe stage, as well as gestosis. Healthy women receive sodium chloride from food, and its excess can lead to the development of edema.

Sodium chloride, another name for sodium chloride or table salt (nacl), is a chemical element necessary for humans. It is found in large quantities in natural deposits of rock salt (the mineral halite), salt lakes and sea water. It is a mineral element - sodium and chlorine ions in the liquid tissue of human blood, with proteins, amino acids, glucose and other enzymes included in the plasma. It maintains a constant balance of fluid pressure in the blood plasma and the extracellular fluid medium in the body, and is involved in the production of digestive juices in the stomach and hydrochloric acid.

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Aqueous solutions (saline solutions) containing it are widely used in medicine. They are used as a disinfectant in ophthalmology and surgery. Other medications are diluted with saline to achieve the desired concentration. For colds, it is used as an antimicrobial agent. IVs with saline solution, replacing blood plasma and replenishing the water-salt balance of the body, its most common use is in medical institutions.

Solutions and preparations of sodium chloride, composition

Chemical formula NaCI, sodium salt of hydrochloric acid, water-soluble white crystals.

A sterilized solution that contains 9 grams of sodium powder per liter of distilled water is called isotonic or physiological solution of 0.9% sodium chloride. Ampoules containing 5, 10, 20 ml of saline solution, which is used to dissolve the medicine. For the treatment of external areas of the body, glass bottles of 0.9% saline solution with a volume of 100, 200, 400 ml and one liter have been launched.

Sterile hypertonic or 10% solution, contains 10 g of sodium chloride per liter of distilled water, bottles of 200 and 400 ml.

Sodium chloride is available in tablets weighing 0.9 grams.

This drug is also presented in the form of a nasal drip spray, the contents of the can are 10 ml.

The condition of the body in various diseases and pathologies, accompanied by a sharp loss of fluid in the body or limited supply.

• Toxic poisoning of the body.
• Intestinal infections (dysentery, viral enteritis).
• Food poisoning, dyspepsia.
• Thermal, chemical, extensive burns.
• Gastroenteritis, cholera leading to dehydration.
• Profuse vomiting, prolonged diarrhea in various diseases.

Saline solution of sodium chloride 0.9 has antidote properties, participates in the detoxification process, restores and maintains the volume of fluid and plasma in the body.

Instructions for using saline solution 0.9 according to instructions

To quickly replenish the required level of sodium in the body, in order to normalize the patient’s condition, use saline solution 0.9 for infusion, ensuring a slow continuous flow of the solution into the circulatory system of the body.

The procedure is carried out with an isotonic solution of 0.9% using a dropper, the needle is inserted into the vein with a catheter. The temperature of the solution should be 36–38 degrees. When prescribing the required amount of solution to a patient, his weight, age, general condition and the amount of fluid lost are taken into account. The average daily intake is 500 ml, with an injection rate of 540 ml/h. In case of severe forms of poisoning of the body, the volume of the injected solution is increased to 3000 ml per day; in rare cases, the infusion is carried out at a rate of 70 drops per minute from a 500 ml bottle.

The dosage of sodium chloride 0.9 solution for a child’s IV is calculated depending on age and weight. The average calculation is 20–100 ml per kilogram of weight.

Use of saline solution 0.9 as a solvent: one dose of the main medicine is diluted with a solution of 50 to 250 ml.

Sodium chloride solution 10% or hypertonic has a decongestant and antidiuretic effect; in case of bleeding, it is used to raise blood pressure. Administer intravenously in a slow stream. For edema caused by diseases of the kidneys, heart, hypertension, enemas are given with a 10% solution, 10-30 ml are slowly injected into the rectum.

A saline solution of 0.9% is used for external treatment of the skin from purulent wounds, compresses are made on the affected areas of the skin, it is used in surgery for dressings, and the corneas of the eyes are washed.

A 0.9% solution is used as an antimicrobial agent for the treatment of inflammation of the nasopharynx. To gargle and rinse the nose, a 10 mg tablet should be crushed and diluted with 100 ml of warm water. Having previously cleared the nose of accumulated mucus, instill the solution: adults - 2 drops into each nostril; for children over one year of age, 1–2 drops; for infants up to one year, one drop. Instillation is carried out 3-4 times a day, for three weeks.

Use of sodium chloride nasal spray: take a shallow breath through your nose, spray, after which you should lie down for a while with your head thrown back.

With such high efficiency in the treatment of serious pathological diseases, their price is affordable for any patient.

Carrying out inhalations with saline solution

For acute respiratory diseases accompanied by cough, difficulty breathing through the nose, runny nose, redness of the throat, it is good to treat with inhalations.

For preparing the inhalation mixture use physical sodium chloride solution for inhalation. The isotonic solution is mixed with any medicine (antitussive, bronchial, anti-inflammatory, etc.) in equal proportions. It is better to use the solution in ampoules.

Any type of inhaler can be used for the procedures. Do 2-3 inhalations a day. Duration for children - 5–7 minutes, adults - 10.

The instructions do not contain information about contraindications and side effects. It is allowed to use sodium chloride saline solution for inhalation during pregnancy.

Use of sodium chloride during pregnancy

Sodium chloride instructions for use allow the use of an isotonic solution by pregnant women for therapeutic treatment. A saline solution whose composition is close to natural human blood guarantees safety when used. normal fetal development and does not harm the mother's health. Droppers of sodium chloride 0.9 solution for infusion are given to pregnant women for severe and prolonged toxicosis, to quickly replenish missing vitamins and microelements and for severe swelling of the body. The procedures are carried out in medical institutions under the supervision of medical staff.

Side effects

Correct use of sodium chloride practically does not cause side effects; local irritations may occur: itching, burning and redness of the injection site.

Long-term use may cause stomach cramps, dizziness, weakness, increased sweating, constant feeling of thirst, some skin manifestations, swelling in different parts of the body.

Contraindications

1. Sodium chloride 0.9% solution is contraindicated for use in the following conditions:

• the content of sodium and chlorine ions in the blood plasma is higher than normal;
• excess water content in the body associated with impaired water-salt metabolism;
• acidosis or acid-base imbalance, with a sharp increase in acidity;
• low potassium content in the body;
• severe forms of renal failure;
• chronic diseases in which there is a risk of edema of the brain and lungs;
• Use with caution in children, the elderly and people with persistent blood pressure, diabetes mellitus and cerebrovascular accidents, and acute heart failure.

2. Hypertonic solution 10% is prohibited from being administered intramuscularly or subcutaneously, sodium chloride in this case dehydrates tissue cells, which leads to their death.

Additional application information

Drip infusions are carried out only as prescribed by a therapist, by trained personnel in medical institutions. Special observation and monitoring of well-being is required for children and the elderly. Trying to administer the infusion yourself lead to negative consequences.

In cases of using sodium chloride 0.9% as a solvent, side effects and contraindications of the main dissolved drug should be studied.

Droppers with an isotonic solution for infusion are recommended for acute alcohol poisoning.

Sodium chloride solution reacts well with most medications, with the exception of drugs with special specifics (antitumor, hormonal, etc.).

The resulting combined preparations must be transparent, without the presence of undissolved crystals and sediment.

The instructions do not contain information about prohibiting the use of sodium chloride for drivers of vehicles.

The packaging with the solution must not be damaged; unused solution cannot be reused.

Sodium chloride preparations have a long shelf life, are available to buyers, the price is low, given the effectiveness of their use.

High intake of unrefined fats

Dietary features (low animal protein,

fresh herbs, vitamin C, microelements,

milk and dairy products, predominance

plant products with excess starch,

eating hot food, irregular

Smoking, especially in combination with alcohol

reverse – zinc, manganese

One of the most reliable causes of cancer development

stomach are N-nitrosoamines, often

endogenous. The starting point of pathogenesis

is a decrease in gastric acidity

juice, for chronic gastritis,

promoting the development of pathogenic flora,

with an increase in the synthesis of nitro compounds.

The significance of hereditary factors in

development

genetic

predisposition

increases the risk of development by 2 times. A typical example

high risk hereditary transmission is family

Napoleon Bonaparte, where RJ was detected in all generations.

A marker of high risk of developing GC is blood type,

because there is a 15-20% increase in the frequency of gastric cancer in people with II(A)

blood group, which may be due to linked blood

genetic factors.

In cases of familial cancer, a mutant E-cadherin gene has been identified

(CDH-1). GC is often associated with mutations in the Ecadherin, β-catenin, or colon polyposis genes. Ecadherin is a member of the transmembrane family

glycoproteins that carry out adhesive intercellular

contacts of the “adhesion zone” type, it also affects the regulation

p53 gene. E-cadherin mutations and intercellular disconnection

contacts causes a decrease in expression and functional

p53 activity.

Possible connection of Helicobacter pylori with the development of gastric cancer.

This correlation is especially strong when

long-term

infection

increased risk, in the older age group and

decreases as infection rates decrease.

The mechanism of carcinogenesis is associated with the ability of HP

cause severe infiltrative gastritis with

proliferation of interstitial cells. Long

the period of inflammation leads to the processes of atrophy and

intestinal metaplasia are already precancerous changes

for intestinal type gastric cancer. HP infection with diffuse

carcinomas are found in 100%, although diffuse

GC is not combined with intestinal metaplasia, this is also

should be considered as a superinfection when there is a decrease

protective forces of the mucous membrane.

Factor

defining

relationship

carcinogenesis is the presence in 60% of strains

microorganism

cagA oncogene.

cagA-oncogene,

are characterized

expressed

gastritis

availability

lymphoid

infiltration and more frequent malignancy.

Long latent period between

infection with HP and development of gastric cancer, includes

a large number of cumulative factors playing a role

in carcinogenesis.

The Epstein-Barr virus may be associated with the development of cancer. Tumors arising from infection

virus – poorly differentiated with pronounced

lymphoid

infiltration

are described

lymphoepithelioma-like cancer. Detected in 80% of cases

tumors

lymphoid

poorly differentiated

adenocarcinoma

lymphoid infiltration.

Background diseases or risk groups

stomach cancer

Chronic atrophic hyperplastic

gastritis (CAG)

For a long time, CAH and gastric cancer have been associated with a high frequency of reliability.

It turned out that the presence of CAH does not mean that the patient necessarily has

RJ will develop. 80-85% of older people develop some form of CAH

degrees, and only a few have RJ. At the same time, the presence of CAH with pronounced

changes in the gastric mucosa is the background against which there will be

neoplastic processes occur. In Europe, CAH is detected in 22-37%

GC patients. In Japan, CAH is diagnosed in 94.8% of early GC, and

the incidence of advanced gastric cancer in patients with CAH is –

With CAH, proliferation with structural changes is noted in the mucosa

cells and p53 gene mutation and aneuploidy.

In rare cases, CAH develops against the background of autoimmune fundusgastritis, combined with pernicious anemia.

Atrophic Hp-associated

gastritis is the most common precancerous

disease

Cascade of precancerous changes in atrophic

gastritis

Normal mucosa

Chronic active gastritis

Atrophic gastritis

Intestinal metaplasia (types I/II/III)

Dysplasia

Stomach cancer

Correa P. et al., 1975

Epithelial polyps

According to their course, ES are divided into 1) non-neoplastic and 2)

neoplastic. Neoplastic – adenomas of the gastric mucosa. They

They are divided according to the macroscopic form of growth into: flat and papillary.

They occur against the background of existing metaplasia of the gastric mucosa.

The incidence of cancer associated with neoplastic adenomas ranges from

within wide limits. Malignancy of flat adenomas occurs in 621%, papillary adenomas - much more often (20-76%).

Gastric resection

Cancer develops in the remaining part. Reasons for delayed changes

in time are not entirely clear. However, the most likely factor

is

deletion

basic

parietal

responsible for the production of hydrochloric acid. Against the background of increasing pH

gastric juice, metaplasia processes begin to develop in

mucous membrane of the remaining part of the stomach, which can be considered as

precancerous changes. Time to cancer development after gastrectomy

ranges from 15 to 40 years.

Ménétrier's disease

It is a rare disease and is characterized by the presence of hypertrophic

mucous membrane,

reminiscent

convolutions

decrease

acid-producing function, protein-losing enteropathy. Disease

is rare, with unknown etiology and is treated symptomatically.

Pernicious anemia

With a combination of pernicious anemia and atrophic gastritis, the risk of developing gastric cancer

increases to 10%. The pathogenesis of pernicious anemia lies in the production

antibodies against proton pump cells, pepsinogen-producing cells and

Castle's internal factor.

Chronic stomach ulcer?

The question is debatable. It was recognized that cancer occurs in inflammatory

changed tissues of the edge of the ulcer (50s). However, further research

allowed us to note that only 10% of gastric cancer was combined with a chronic ulcer; in 75% it was primary gastric cancer that occurred with ulceration. That. stomach ulcer connection

and the RJ is not considered reliable.

Excessive consumption of genotoxic foods,

causing mutation of the p53 gene: smoked meats containing

polycyclic hydrocarbons, marinades, pickles containing

Insufficient intake of vitamin C, β-carotene, α-tocopherol,

which are RJ protectors

Environment: an increased risk of developing gastric cancer is observed in

persons in contact with asbestos, nickel, workers at

rubber production.

Helicobacter pylori infection

Having blood type A

Peptic ulcer disease. Malignancy often occurs over a long period of time

existing callous ulcers

Polyps and polyposis of the stomach

The risk of developing stomach cancer is 2.5 times higher in people who have had

previous resection for peptic ulcer disease. Cancer develops in

within 15-40 years after resection.

Stage 0 means carcinoma in situ (CIS).

1a - the cancerous tumor does not extend beyond the

stomach walls; there are no signs of cancer in the lymph nodes (T1, N0,

1b - the cancerous tumor is still within the

limits of the stomach wall, however located

OR there are no cancer cells in the lymph nodes, but a tumor

has grown into the muscle layer of the stomach wall (T2,

Stage 2

2a - The cancerous tumor is within

stomach wall, but cancer cells

found in 3-6 lymph nodes (T1, N2, M0) OR

The cancerous tumor has grown into the muscle layer

stomach wall, and is also found in 12 adjacent LNs (T2, N1, M0)

OR The tumor has grown through the wall

stomach, but there are no cancer cells in the lymph nodes (T3,

2b - The cancerous tumor is within

found in 7 or more lymph nodes (T1, N3, M0)

OR The cancerous tumor has grown into the muscle

layer of the stomach wall, in addition to cancerous

cells are found in 3-6 LNs (T2, N2, M0)

OR A cancerous tumor has grown through the wall

stomach, and is also found in 1-2 nearby

located LUs (T3, N1, M0) OR

There are no cancer cells in the lymph nodes, but the tumor has grown

through the stomach wall (T4a, N0, M0)

In the muscle layer of the stomach wall; Besides

cancer cells are found in 7 or more

LU (T2, N3, M0)

Through the wall of the stomach; cancer cells

also found in 3-6 lymph nodes (T3, N2, M0)

are also found in 1-2 nearby lymph nodes

In the connective tissue that surrounds

stomach outside; besides cancer cells

found in 7 or more lymph nodes (T3, N3, M0)

Directly through the stomach wall;

cancer cells are also found in 3-6

LU(T4a, N2, M0)

Directly through the stomach wall and nearby

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located organs; LNs contain cancerous

cells (T4b, N0 or 1, M0)

cancer cells are also found in 7 and

more than LU (T4a, N3, M0)

Directly through the stomach wall and

nearby tissues and organs; LU

Stage 4 indicates advanced cancer.

which metastasized to distant organs and

tissues through the lymphatic system (any T,

any N, M1).

Stage 0

Stage IA

Stage IB

Stage IIIA T2 a/b

Stage IIIB T3

Stage IV T4

Stages of gastric cancer

16. Pathomorphological characteristics

ON YARZH (1998)

Differentiated adenocarcinomas –

papillary (pap) –

well-differentiated (tub1) moderately differentiated adenocarcinoma (tub2).

solid type (porl);

undignified type (horn2);

signet ring cell carcinoma (sig);

mucinous adenocarcinoma (muc).

squamous cell carcinoma;

glandular-squamous (dimorphic) cancer;

carcinoid tumors;

other types (mesenchymal tumors, lymphosarcoma, etc.).

IN EUROPE (after Laurence, 1953)

Intestinal type of adenocarcinoma

Solid type

Mixed

17. Clinic and diagnostics

Clinical signs characteristic

for the initial form of stomach cancer, not

exists. It may leak

asymptomatic or manifest

signs of disease, against the background

which it develops.

Early diagnosis of cancer is possible with

mass endoscopic

population survey. Gastroscopy

allows you to detect changes in

diameter of gastric mucosa

less than 0.5 cm and take a biopsy for

verification of diagnosis.

Stomach cancer is more likely

in a group of people with increased

cancer risk. To factors

increased cancer risk

precancerous diseases of the stomach

(chronic gastritis, chronic ulcer

stomach, stomach polyps);

chronic gastritis of the gastric stump

operated on for non-cancer

stomach diseases after 5 years or more

after gastrectomy;

effects of occupational hazards

(chemical production).

Clinical manifestations of cancer

stomachs are diverse, they depend on

pathological background, against which

a tumor develops, i.e. from

precancerous diseases, localization

tumors, forms of its growth,

histological structure, stage

dissemination and development

complications.

A. Endoscopic examination

(fibrogastroduodenoscopy)

Thanks to endoscopic methods

examinations can visually identify a tumor.

At the same time, you can estimate its size, growth pattern,

presence of bleeding, ulceration, rigidity

gastric mucosa. It is also important that

during fibrogastroscopy, you can take a section

tumors for morphological examination

(biopsy). But, unfortunately, information content

single biopsy most often does not exceed 50%

and to establish the exact morphological

diagnosis requires several

Changes in blood tests appear later

stages of stomach cancer. The most common manifestation of cancer

stomach in laboratory tests is anemia. Anemia

develops mainly due to bleeding from tissues

tumors, but also a certain effect on the development

anemia is caused by impaired absorption of substances.

As anemia progresses, it will increase and

A leukimoid reaction may develop. Wherein

the number of leukocytes in the blood will exceed 30,000,

myelocytes and myeloblasts will appear.

One of the most common manifestations in blood tests for cancer

stomach and other forms of cancer is hypoproteinemia and

dysproteinemia.

1. Questioning the patient (according to the scheme)

2. Inspection and objective examination data

3. Laboratory data

X-ray: filling defect,

deformation of the stomach contour, pathological changes

CO relief, lack of peristalsis in the zone

tumor lesion

Endoscopic histology

Ultrasonic

laparoscopy

polypoid (3-18%)

saucer-shaped (non-infiltrative

cancerous ulcer) (50%)

diffuse infiltrative cancer (10-30%)

infiltrative-ulcerative form of cancer (4560% - most common)

POLYPOID GC

DIF.INFILTRATE. RJ

SAUCER ULCER

INFILTER-ULCER. RJ

prevalence

tumor process, especially in patients

For diagnostics

III-IV stages of GC, the definition used is

1. Tumor markers (carcinoembryonic Ag and CA-19-9)

2. Acute phase proteins (orosomucoid,

haptoglobin, α1-antitrypsin)

An increase in their level indicates

increase in “tumor cell mass”,

characteristic of generalized forms of gastric cancer and

unfavorable prognosis

Benign

Malignant

Round or oval

Irregular, polygonal

Rounded "pronounced"

Irregularly wavy or

broken

At the level of surrounding tissues or Always raised by a darker

raised

Yellow fibrin or dried necrotic

blood on the bottom, smooth

lumpy

Bleeding

Rarely, from the bottom

Often, from the edges

Petechiae in surrounding tissues

Ulceration in the circumference

Radial folds

mucous shaft,

crossing the big one

curvature

17. Clinic and diagnostics

complications.

1) cancer developing in a healthy stomach;

2) cancer developing against the background of peptic ulcer;

3) cancer developing against the background of atrophic gastritis and

polyposis.

V.I. Chissov et al., 1985

In patients with early cancer - ulcerative

symptom complex (36 months) and dyspepsia,

hemorrhagic complications are possible.

With “late” cancer - dyspepsia and loss

body weight, ulcerative symptom complex - 6

P. H. R. Green et al., 1982

18. Localization of the tumor in the stomach

Antral and pyloric cancer

channel – more than 40%.

Cancer of the body of the stomach or antrum with

spread to the body - about 30%.

Cardioesophageal cancer or carcinoma

proximal part – does not exceed 20%.

More often occurs along the lesser curvature (20-25%), on

large is much less common (3%).

Relatively common (2%) in the stomach

multicentric tumor growth is observed,

which indirectly confirms the theory

tumor field.

19. Regional visceral lymph nodes of the stomach (YARZh, 1998)

subpyloric.

mesenteric root

metastases

N – regional lymph nodes.

N0 – metastases to regional lymphatics

nodes are not detected.

Na – only perigastric areas are affected

The lymph nodes.

Nb – lymph nodes along the course are affected

left gastric, celiac, general hepatic,

splenic arteries, along the hepatoduodenal ligament.

NXc – lymph nodes along the course are affected

aorta, mesenteric and iliac arteries.

2. Epidemiology of stomach cancer

Every year there are registered

800 thousand new cases and 628

thousand deaths.

Countries that are “leaders” in

Japan, Korea, Chile, Russia,

China. They account for 40%

all cases.

Japan - 78 per 100 thousand.

Chile – 70 per 100 thousand.

21. Clinical forms of stomach cancer

There are three main clinical forms of gastric cancer, which

Cancer of the gastric outlet (pyloroantrum)

Cancer of the greater curvature of the stomach.

Cardiac stomach cancer.

Gastric cancer of this localization is characterized by rapid growth

symptoms of stenosis. Persistent vomiting appears, the stomach expands, you can

listen to the sound of splashing. Due to uncontrollable vomiting occurs

dehydration of the body, hypochloremic azotemia and uremia are observed.

Cancer of the greater curvature of the stomach is distinguished by long-term asymptomatic

flow. Often the appetite remains. Due to chronic blood loss

anemia occurs. Identification of significant clinical signs of gastric cancer

with this localization, it often indicates that the process is neglected.

Cardiac cancer of the stomach is characterized by the presence of such

symptoms such as dysphagia, drooling, chest pain. Fast enough

Compared to other localizations of gastric cancer, cachexia develops.

1. Anemic

In this form of stomach cancer, bleeding comes to the fore. At the same time, the source

bleeding is a tumor with a bleeding vessel. Patients will be anemic according to clinical

blood test. Possible black stools (melena), weakness, pale skin, cold clammy

2. Feverish

With this form of stomach cancer there will be high hyperthermia (temperature may

rise to 40 degrees).

3. Cachectic

Characterized by severe exhaustion due to metabolic disorders. Often, despite

Although patients appear exhausted, they may have a good appetite. The most common form of stomach cancer is

occurs in older people.

Ulcerative form.

It is characterized by severe pain syndrome, which is of predominant importance from the very

onset of the disease.

5. Latent

This form of stomach cancer is characterized by the absence of any symptoms until

terminal stage.

6. Edema

7. Jaundice

Due to hypoproteinemia, swelling of the face, limbs, and ascites are possible.

This form of stomach cancer occurs when there are metastases that compress the bile ducts. Besides,

blood hemolysis and toxic effects on the liver are possible.

Fungiform or polypoid type - has exophytic growth in

gastric lumen

Exophytic-ulcerated type - ulceration with raised

calloused edges that have a clear boundary with the surrounding

mucous membrane (saucer-shaped cancer)

Ulcerative-infiltrative type - ulceration without clear boundaries and

intramural infiltration of the gastric mucosa

Diffuse-infiltrative type (linitis plastica) – diffuse

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damage to the stomach wall, with minimal changes to

mucosal level and diffuse damage to other layers

the walls of the stomach according to the type of plastic linitis of the organ.

In the JARJ classification, an unclassified type is added,

combining elements of different types of growth

Dyspeptic

Feverish

Cachectic

Jaundice

Tetanic

Disorders of carbohydrate metabolism

Latent

23. Syndrome of “small” signs

Painful

Gastric discomfort

Anemic

Dysphagic

Violations of evacuation from

weakness, fatigue in

over weeks and months

persistent decline and loss

appetite

stomach discomfort

progressive weight loss

persistent anemia

depression, apathy

1) distal subtotal resection

stomach (performed transabdominally),

2) gastrectomy (performed

transperitoneal and transpleural

access),

3) proximal subtotal resection

stomach (performed transperitoneally and

through pleural access).

24. Classification by TNM

Polypoid cancer (exophytic) - in the form of a polyp

Saucer-shaped cancer (exophytic) - since the tumor

collapses in the center, then a saucer shape is formed, undermined, large edges with a crater in the center.

Ulcerative-infiltrative

Diffuse-infiltrative (linitis plastica,

plastic linite). With this form of the disease

widespread tumor is observed

infiltration of the mucous and submucosal membranes.

1. Adenocarcinoma - the most common form (95%)

Papillary (highly differentiated

exophytic)

Tubular (poorly differentiated)

Mucinous (extracellular accumulations of mucin)

Signet ring cell carcinoma. (tumor cells

infiltrative)

2. Non-Hodgkin lymphomas, leiomyosarcoma,

undifferentiated sarcoma - less than 1%.

T - Primary tumor

preinvasive carcinoma: intraepithelial tumor

without invasion of the own mucous membrane (carcinoma in

the tumor infiltrates the gastric wall to the submucosal layer

the tumor infiltrates the gastric wall to the subserous

shells.

the tumor grows into the serous membrane (visceral

peritoneum) without invasion into adjacent structures.

the tumor spreads to neighboring structures.

Intramural extension to the duodenum or

the esophagus is classified according to the greatest depth of invasion

in all locations, including the stomach.

N - Regional lymph nodes

insufficient data to assess regional

no signs of metastasis

regional l/nodes

N1 there are metastases in 1-5 nodes

N2 there are metastases in 6-15 nodes

N3 there are metastases in more than 16 l/nodes

M - Distant metastases

insufficient data to determine

distant metastases

M0 no evidence of distant metastases

there are distant metastases (Virchow,

Krukenberg,

Schnitzler,

M. Joseph,

carcinomatosis of the peritoneum, to the liver)

T – tumor

TIS – intraepithelial cancer.

T1 – the tumor affects only the mucous membrane and

submucosal layer.

T2 – the tumor penetrates deeply, takes no more than

half of one anatomical region.

T3 – a tumor with deep invasion involves more than

half of one anatomical section, but not

affects neighboring anatomical sections.

T4 – the tumor affects more than one anatomical site

department and spreads to neighboring organs

The assumption of gastric cancer should arise when

1. Any gastric symptoms, gradually

progressing or remaining stable

over several weeks or months

2. Changes in the nature of complaints in patients with chronic disease.

stomach diseases

3. Symptoms caused by phenomena

destruction, obstruction or intoxication

4. Unrelated gastric complaints

directly with a dietary disorder

3. Morbidity and mortality

In Russia, RJ takes 2nd place - men, 3rd

women by incidence rate

In recent years, Russia has celebrated

a pronounced decrease in the incidence of gastric cancer

(1999 - 33.5; 2007 - 29.5)

In the Krasnodar Territory 24.4 per 100 thousand (2008).

In terms of mortality: 2nd place in men and 3rd place in

women, one-year mortality – 56%

There is also a decrease in mortality (Russia

– 30.9 in 1999, 26.4 in 2007. In Krasnodar

region 23.0 – 1999, 21.0 – 2008)

10-year survival rate after radical

treatment - 12.8%

Epidemiology of stomach cancer

World statistics of crayfish of various localizations

for both sexes in 2000

Morbidity

Prevalence

Mortality

Colorectum

Cervix

Prostate

GLOBOCAN - 2000 Database Cancer Incidence, Mortality and

Prevalence Worldwide IARC, WHO

Lion, IARCpress, 2001

Less developed

More developed

Incidence of ASR (number of cases/100,000)

Less developed

More developed

ASR Mortality (number of cases/100,000)

1. Right gastric artery (from the common

hepatic or gastroduodenal arteries)

Left gastric artery (in 75% of the celiac

Left gastroepiploic (from

splenic artery)

Right gastroepiploic artery (from

gastroduodenal artery)

Short arteries of the stomach (from the splenic

arteries, 1-6 branches)

Operational

Combined

Complex

Possibility of complete tumor removal

Absence of distant metastases: in

liver (H1-H3), Virchow, Krukenberg,

Schnitzler, S.M. Joseph, carcinomatosis

peritoneum (P1-P3),

Functional portability

interventions

Indications for performing subtotal distal resection

Exophytic

X-ray

endoscopic

signs

infiltrative growth.

No transition to the angle of the stomach (lower third

there are no multicentric growth foci.

no metastases to paracardial lymph nodes

zones, retroperitoneal, splenic, celiac area

trunk, at the gate of the spleen.

Absence of massive exit of the process to the serous

stomach lining

Proximal subtotal gastrectomy

can be performed depending on the size of the tumor

up to 4 cm, with localization in the proximal

department without spreading to the upper

third. Moreover, it is mandatory

resection unchanged visually and

palpation of the stomach wall to 2 cm

distal to the defined tumor border

with a superficial character

growth, by 3 cm with exophytic and by 5 cm with

endophytic and mixed types of growth.

The surgical method remains the gold standard in

radical treatment of GC, allowing hope for

complete recovery.

Radical operations for gastric cancer include mandatory

monoblock removal of regional lymphatics

Preventive monobloc zone removal concept

regional metastasis together with primary

lesion of GC is associated with the name of the Japanese surgeon Jinnai

(1962), who, based on his results

considered such a volume of intervention as

radical. From this moment on, the expanded radical

lymph node dissection as a mandatory integrated stage

Sodium chloride is a drug intended for detoxification (removal of intoxication), and also used for rehydration (replenishment of fluid) of the body.

Sodium chloride 0.9 - instructions for use

Composition Sodium chloride and release form

The drug is produced in a colorless 0.9% solution for infusion, where the active ingredient is sodium chloride. The auxiliary components of this medication are represented only by water for injection.

A solution of sodium chloride 0.9 is placed in special Viaflo containers, the volume of the medicine can be 50 milliliters, 100, 500, or 250, in addition, a liter container with this drug is available. The solution is packaged in cardboard boxes with the date of release of the medicine indicated on them. The medicine is available by prescription.

The shelf life of Sodium chloride 50 ml is 18 months; quantity of the drug 100 ml - 2 years; and containers of 250, 500, 1000 milliliters can be stored for three years, after which the use of the solution is contraindicated.

Pharmacological action Sodium chloride

Sodium chloride solution relieves intoxication of the body, that is, it causes a so-called detoxification effect, and also replenishes fluid volume - a rehydration effect. Sodium ions penetrate the cell membrane using various transport mechanisms, among which the leading role is played by the so-called sodium-potassium pump.

Sodium is involved in signal transmission in neurons, participates in the so-called electrophysiological processes of the heart, and in addition, in some metabolic processes. Sodium is excreted by the kidneys, with a large amount of it being reabsorbed, in addition, a small amount of this component is excreted in sweat and through the intestines.

Indications for use: Sodium chloride

I will list when Sodium chloride solution is indicated for use:

Isotonic so-called extracellular dehydration;
A solution is prescribed for hyponatremia.

In addition, Sodium chloride is used as a solvent for some medications as a so-called base solution.

Contraindications for use: Sodium chloride

Among the contraindications to the use of Sodium Chloride are:

Hypernatremia;
Brain swelling;
In case of acidosis, the drug is not used;
With pulmonary edema;
The drug is contraindicated for hyperchloremia;
Left ventricular failure in acute form;
The solution is not prescribed for hypokalemia;
Extracellular hyperhydration is a contraindication.

Sodium chloride is used with caution in the following situations: arterial hypertension, decompensated chronic heart failure, peripheral edema, in addition, aldosteronism, preeclampsia, and anuria.

Application of Sodium chloride, dosage

The dose of the drug Sodium chloride is determined by the patient's condition, as well as fluid loss, age and body weight of the patient, and it is important to monitor plasma electrolyte concentrations. Typically, the dose of solution per day varies from 500 milliliters to three liters.

The Viaflo container is used as follows. It is necessary to open the packaging; to do this, remove the container from the outer package and check it for integrity. If mechanical damage is detected, the container must be disposed of.

Then the container is suspended by a special loop from the tripod, and the plastic fuse is removed from the so-called output port. Install the infusion system, following the recommendations specified in the instructions for the medication.

Sodium chloride - drug overdose

Symptoms of an overdose of Sodium chloride: nausea, vomiting, diarrhea, there may be cramping pain in the abdomen, thirst is characteristic, salivation decreases, sweating decreases, dryness of the mucous membrane of the eye occurs, possible fever, tachycardia, peripheral edema, increased blood pressure, renal failure is possible , pulmonary edema, in addition, respiratory arrest.

Other symptoms characteristic of an overdose of Sodium chloride: headache, possible anxiety, irritability, hypernatremia, dizziness, possible weakness, muscle cramps, hyperchlorimic acidosis, and coma and death are not excluded. The patient is given the necessary symptomatic treatment.

Side effects of Sodium chloride

When using Sodium chloride, overhydration and hypokalemia may develop. In such a situation, the patient undergoes correction of the condition.

special instructions

When carrying out an infusion, it is important to monitor the patient’s condition, the main indicators, especially plasma electrolytes. It is recommended to use the solution only in a transparent form, without any visible inclusions, and it is also important to pay attention to the packaging, it should not be damaged. The medicine is administered in compliance with the basic rules of asepsis and antisepsis.

Medicines that are incompatible with it should not be used with Sodium Chloride. The doctor should determine the compatibility of the added medications, and it is important to pay attention so that crystals and so-called insoluble complexes do not form; in such a situation, the drug cannot be administered.

Analogues of Sodium chloride

Sodium chloride-Senderesis, Sodium chloride-Vial.

Conclusion

It is important to use the drug Sodium chloride on the recommendation of a specialist.