Cerebrospinal fluid sodium

Weisinger RS. Considine P. Denton DA. McKinley MJ. Rapid effect of change in cerebrospinal fluid sodium concentration on salt appetite. Nature 1979 280 490-491. 

Weisinger RS, Denton DA, McKinley MJ, Muller AE, Taijan E. Cerebrospinal fluid sodium concentration and salt appetite. Brain Res 1985 326 95-105. 

Hiraoka, A., et al (1998). Sodium dodecyl sulfate-capillary gel electrophoretic analysis of molecular mass microheterogeneity of beta-trace protein in cerebrospinal fluid from patients with central nervous system diseases./. Chromatogr. A 802, 143-8. 

An alternative system proved to be both simpler and more user friendly (Unger et al., 2004 Machtejevas et al., 2006). Thus far we have used this configuration to analyze human plasma, sputum, urine, cerebrospinal fluid, and rat plasma. For each particular analysis we set up an analytical system based on a simple but specific strategy (Figure 9.5). The analysis concept is based on an online sample preparation and a two-dimensional LC system preseparating the majority of the matrix components from the analytes that are retained on a RAM-SCX column followed by a solvent switch and transfer of the trapped peptides. The SCX elution used five salt steps created by mixing 20 mM phosphate buffer (pH 2.5) (eluent Al) and 20 mM phosphate buffer with 1.5 M sodium chloride (eluent Bl) in the following proportions 85/15 70/30 65/45 45/55 0/100 with at the constant 0.1 mL/min flow rate. Desorption of the... 

Neonates and children (younger than 2 years of age) - Rapid injection (10 mL/min) of hypertonic sodium bicarbonate solutions may produce hypernatremia, a decrease in cerebrospinal fluid pressure and possible intracranial hemorrhage. Do not administer more than 8 mEq/kg/day. A 4.2% solution is preferred for such slow administration. 

Mezlocillin, piperacillin, and ticarcillin are parenteral antibiotics formulated as sodium salts, so prescribers must consider the sodium content of these antibiotics when administering them to patients with congestive heart failure. During their distribution phase, antipseudomonal penicillins achieve orfly low concentrations in the cerebrospinal fluid. Consequently, antipseudomonal penicillins are not among the drugs of first choice for meningitis therapy. 

The onset of local anesthesia can be accelerated by the addition of sodium bicarbonate (1-2 mL) to the local anesthetic solution. This maximizes the amount of drug in the more lipid-soluble (unionized) form. Repeated injections of local anesthetics can result in loss of effectiveness (ie, tachyphylaxis) due to extracellular acidosis. Local anesthetics are commonly marketed as hydrochloride salts (pH 4.0-6.0) to maximize aqueous solubility. After injection, the salts are buffered in the tissue to physiologic pH, thereby providing sufficient free base concentration for diffusion through the axonal membrane. However, repeated injections of the local anesthetic can deplete the buffering capacity of the local tissues. The ensuing acidosis increases the extracellular cationic form, which diffuses poorly and results in tachyphylaxis. Tachyphylaxis to local anesthetics is common in areas with a limited buffer capacity (eg, the cerebrospinal fluid). 

Bradbury, M.W.B., et al. 1963. The distribution of potassium, sodium, chloride and urea between lumbar cerebrospinal fluid and blood serum in human subjects. Clin Sci 25 97. 

Disposition in the Body. Readily absorbed after oral administration. About 97% of a dose is excreted unchanged in the urine in 10 days with 50 to 60% in the first 24 hours. The urinary excretion of lithium appears to be slower in the elderly than the young and also appears to occur more slowly at night, resulting in a diurnal rhythm in excretion rate its excretion is also markedly influenced by sodium and, possibly, potassium status in subjects where the sodium intake is reduced, lithium is reabsorbed by the renal tubules and in subjects who have a high sodium intake the excretion of lithium is increased. Lithium is widely distributed throughout the body and concentrations in the cerebrospinal fluid may reach 50% of those in plasma. 

Even though free-solution CE is most commonly used for neuropeptides and neuroproteins, other forms of CE have also been employed. For instance, as an alternative to conventional slab-gel electrophoresis, a method using sodium dodecyl sulfate (SDS) capillary gel electrophoresis was developed. It was applied to low-molecular-mass proteins (j8-trace protein, ft-microglobulin, -trace protein, and myelin basic protein) in cerebrospinal fluid [4], Advantageous features of capillary gel electrophoresis over slab-gel electrophoresis are compatibihty with small sample volumes, shorter analysis times, and more accurate quantihcation of the analytes. 

Approximately 10-11 al of the sample or specimen to be assayed (serum or plasma, and for some chemistries urine or cerebrospinal fluid) are applied to the reagent carrier slide. The specimen will diffuse into the slide within a short time, where it reacts with a reagent that is present in a gelatine or agarose matrix. The dye that forms can be measured reflectometrically. The electrolytes (sodium, potassium, chloride and carbon dioxide) are assayed by means of single use ion-selective electrodes. 

Cefntaxime is metabolized in part to the less active desa-cctyl metabolite. Approximately 20% of the metabolite and 25% of the parent drug are excreted in the urine. The parent drug reaches the cerebrospinal fluid in sufEcient concentration tn be effective in the treatment of meningitis. Solutions nf cefotaxime sodium should be used within 24 hours. If stored, they. should be refrigerated. Refrigerated solutions maintain potency up to 10 days. 

Bromethalin is an uncoupler of oxidative phosphorylation in mitochondria in cells of the central nervous system. Uncoupling leads to a decreased cellular ATP production and failure of the Na, K + -ATPase pumps, which in turn leads to sodium retention and a loss of ability to maintain osmotic control. The outcome is a buildup of cerebrospinal fluid and vacuolization of myelin. The resulting edema and high intracranial pressures cause damage to nerve axons, inhibiting neural transmission, and leads to paralysis, convulsions, and, ultimately, death. 

Nonionic contrast media in either hypertonic or hypotonic solution, when injected in-tracerebrally or into the subarachnoid space of rats, will cause distinct depression of the central nervous system (CNS) and associated brain functions but no excitation (675). Such depressive action can obscure the excitatory action caused by ionicity or chemotoxicity of myelographic agent. When an isotonic contrast medium is injected and mixed with the normally produced cerebrospinal fluid (CSF) in the subarachnoid space of the rat, the resultant mixture is hypertonic with higher levels of sodium and chloride. This movement of sodium and chloride into CSF without accompaniment of water is unexpected. Mennini et al. (672) noted that contrast enhancement of brain parenchyma is never achieved by direct intracarotid or intravenous injection of nonionic contrast media, unless the BBB is spontaneously or experimentally broken ( 6). 

Extracellular fluid contains sodium as the predominant cation and accounts for 20-25% of body weight, or one-third of total body water. It makes up vascular, interstitial, transcellular, and dense connective tissue fluid pools. Vascular fluid is the circulating portion, is rich in protein, and does not readily cross endothelial membranes. Interstitial fluid surrounds cells and accounts for 18-20% of total body water. It exchanges with vascular fluid via the lymph system. Transcellular fluid is present in digestive juices, intraocular fluid, cerebrospinal fluid (CSF),... 

In theory, sodium bicarbonate administration provides fluid and electrolyte replacement and increases arterial pH, thereby improving cardiac function, perfusion and oxygenation of peripheral tissues, and intracellular pH, and should therefore decrease lactate production and increase clearance. However, sodium bicarbonate administration can actually have an adverse effect on intracellular pH. When bicarbonate is given by IV infusion, the carbon dioxide generated diffuses more readily than bicarbonate across cellmembranes and into cerebrospinal fluid. Therefore the intracellular pH can actually be decreased by administration of bicarbonate." ... 

CCS, Glasgow Coma Scale BP, blood pressure HR, heart rate RR, respiratory rate CSF, cerebrospinal fluid TBI, traumatic brain injury ICP, intracranial pressure CPP, cerebral perfusion pressure ABC, arterial blood gas CBC, complete blood count Na, sodium K, potassium Cl, chloride Mg, magnesium Ca, calcium P, phosphorus CT, computed tomography. 

A / iV-imidazoleacetic acid (I A A, 99), a metabolite of histidine 100, and histamine S found in brain and cerebrospinal fluid , has been synthesized by oxidizing A, Af-DL-histidine with sodium hypochlorite, subsequent acid hydrolysis of the formed A, A -imidazoleacetonitrile 101 and separation of the product 99 on an anion exchange column with 0.1 N acetic acid (equation 42). The A, A -IAA obtained served as an internal standard for GC-MS analysis of physiological fluids. 

Loscher, W. 1979. GABA in plasma and cerebrospinal fluid of different species. Effects of y-acetylenic GABA, y-vinyl GABA and sodium valproate. J. Neurochem. 32 1587-91. 

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