Sodium Oral Concentrate

Each 5-mL ampule of oral concentrate contains 100 mg cromolyn sodium, in purified water. It is an unpreserved, 

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Cromolyn Sodium, USP. Cromolyn stxlium. dlsodium 1.3 - bis (2 -carboxychnimon - 5 - yloxy) -2-hydroxy propane (Intal). is a hygroscopic, white, hydrated crystalline powder that is soluble in water (1 10). It i.s tasteless at first but leaves a very slightly biller aftertaste. The pK of cromolyn is 2.0. It is available as a solution for a nebuliz.cr. an aerosol spray, a nasal solution, an ophthalmic solution, and an oral concentrate. 

The toxicity of sodium peroxoborate hexahydrate in solution is equivalent to those of sodium borate and hydrogen peroxide. The LD q (mouse, oral) is 1060 mg/kg (2). Local use of high concentrations in the mouth can cause chemical bums and other problems (25). No TLV has been estabhshed. 

Fluid restriction is generally unnecessary as long as sodium intake is controlled. The thirst mechanism remains intact in CKD to maintain total body water and plasma osmolality near normal levels. Fluid intake should be maintained at the rate of urine output to replace urine losses, usually fixed at approximately 2 L/day as urine concentrating ability is lost. Significant increases in free water intake orally or intravenously can precipitate volume overload and hyponatremia. Patients with stage 5 CKD require renal replacement therapy to maintain normal volume status. Fluid intake is often limited in patients receiving hemodialysis to prevent fluid overload between dialysis sessions. 

TBW depletion (often referred to as dehydration ) is typically a more gradual, chronic problem compared to ECF depletion. Because TBW depletion represents a loss of hypotonic fluid (proportionally more water is lost than sodium) from all body compartments, a primary disturbance of osmolality is usually seen. The signs and symptoms of TBW depletion include CNS disturbances (mental status changes, seizures, and coma), excessive thirst, dry mucous membranes, decreased skin turgor, elevated serum sodium, increased plasma osmolality, concentrated urine, and acute weight loss. Common causes of TBW depletion include insufficient oral intake, excessive insensible losses, diabetes insipidus, excessive osmotic diuresis, and impaired renal concentrating mechanisms. Long-term care residents are frequently admitted to the acute care hospital with TBW depletion secondary to lack of adequate oral intake, often with concurrent excessive insensible losses. 

Sodium iodide 131 is an oral liquid that concentrates in the thyroid and initially disrupts hormone synthesis by incorporating into thyroid hormones and thyroglobulin. Over a period of weeks, follicles that have taken up RAI and surrounding follicles develop evidence of cellular necrosis and fibrosis of the interstitial tissue. 

The necessary components of oral rehydration therapy (ORT) solutions include glucose, sodium, potassium, chloride, and water (Table 39-2). The American Academy of Pediatrics recommends rehydration with an electrolyte-concentrated rehydration phase followed by a maintenance phase using dilute electrolyte solutions and larger volumes. 

Distribution. Cyanide is rapidly distributed by the blood throughout the body. In a study using orally administered radioactively labelled potassium cyanide, radioactivity detected in whole blood or plasma decreased rapidly within 6 hours. Of the low levels of radioactivity detected in the red blood cells, about 94% of the radioactivity recovered was found in the hemolysate of which 70% was detected in the heme fraction, 14-25% in globin, and only 5-10% in cell membranes (Farooqui and Ahmed 1982). Yamamoto et al. (1982) determined that the pattern of distribution of cyanide did not vary with the concentration used. Ballantyne (1983b) observed higher cyanide levels in whole blood than in serum in rabbits exposed dermally to hydrogen cyanide, potassium cyanide, and sodium cyanide. See Section 2.3.2.1 for specific studies on cyanide tissue distribution. 

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