Oral rehydration salts

United Nations Children s Fund oral rehydration salts ... 

Q32 Constituents of oral rehydration salts include all EXCEPT ... 

Magnesium hydroxide is a laxative and is not a constituent of oral rehydration salts, which tend to be recommended for use in diarrhoea, to avoid dehydration. Sodium chloride, glucose, potassium chloride and sodium citrate are required to maintain a proper electrolyte balance and are included in oral rehydration salts. 

Sympathomimetics mimic the sympathetic system, thereby increasing the force of contraction of the heart and the blood pressure. Sympathomimetics are therefore contraindicated in patients with hypertension. Oral rehydration salts consist of electrolytes including sodium and therefore should be used with care. The advantages of oral rehydration salts in diarrhoea outweigh this disadvantage. 

Q74 Patients using oral rehydration salts should be advised that after reconstitution, any unused solution should be discarded no later than 1 hour after preparation unless stored in a refrigerator. Oral rehydration solutions should be slightly hypo-osmolar. 

Oral rehydration salts should be reconstituted with water. Patients are advised to put the reconstituted solution in the fridge or else it should be used up to 1 hour after reconstitution. Oral rehydration solution should be slightly hypo-osmolar to decrease the electrolyte and water loss from the intestines. 

The effects were predominantly beneficial and no problems with resistance were reported (5 ). Recently the use of oral rehydration salts with penicillin has been described by UNICEF (21). 

Patent and proprietary oral rehydration salts other than those conforming to the specified parameters. 

Oral rehydration salts (ORS) The WHO/UNICEF recommended formulation is ... 

Modified lactated Ringer s and dextrose injection, USP Multiple electrolytes and dextrose injection type 4, USP Oral rehydration salts, BP... 

Therapeutically, sodium bicarbonate may be used as an antacid, and as a source of the bicarbonate anion in the treatment of metabolic acidosis. Sodium bicarbonate may also be used as a component of oral rehydration salts and as a source of bicarbonate in dialysis fluids. 

Oral rehydration salts are not intended to relieve symptoms but are designed to replace water and electrolytes lost through diarrhoea and vomiting. 

The Committee noted that WHO had provided documentation and assistance since the early 1980s in an effort to increase access to oral rehydration salts (ORS), and that this document had to be updated to reflect the revised formulation of the ORS. The United Nations Children s Fund (UNICEF) and several countries had already been procuring the new formulation since 2004. The revised document would be finalized shortly. As agreed at the thirty-ninth meeting of the Committee, The International Pharmacopoeia monograph was being rewritten to reflect the revised formulation. 

Aldehyde-sugars (glucose) and derived disaccharides of it (lactose) in solid form are, in contrast to the keto-sugars (fructose), incompatible with strongly alkaline compounds and primary amines (ethylenediamine). A brown discolouration (caramellisation) takes place. In the case of primary amines is this called the MaUlard reaction. In mixtures of solid (anhydrous) substances these reactions proceed very slowly and they occur only on the surface of the sugar particle. Thus they may be irrelevant in practice. However, because of this incompatibility the WHO formulation for the oral rehydration salts prescribes anhydrous glucose, which moreover is not combined with sodium bicarbonate but with sodium citrate. It is preferable not to use lactose in capsules with primary aliphatic amines. A more recently reported Maillard reaction is that between lactose and fluoxetine [30]. 

Sodium deficiency is corrected by infusions in severe cases or using oral rehydration salts to replace sodium lost by vomiting or perspiration. Extensive studies have been made on the effect of salt intake on blood pressure however, the actual effects of a reduction in the diet remain controversial. Excessive sodium levels have been linked to hypertension but this is probably only in a subpopulation of susceptible individuals. 

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