Tpn Electrolytes
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Questions & Answers
Side Effects & Adverse Reactions
CONCENTRATED, HYPERTONIC, ADDITIVE SOLUTION. Must be diluted in TPN solution prior to administration.
CONTAINS NO PHOSPHATE. Patients receiving TPN solutions containing concentrated dextrose require additive phosphate, in addition to TPN Electrolytes. Between 10 and 15 mM (310 to 465 mg) phosphorus are physically compatible with as much as 10 to 12 mEq calcium in the same admixture. The phosphate supplement should first be added to the amino acid or dextrose bottle and diluted well to avoid precipitation with calcium.
CONTAINS 20 mEq of POTASSIUM. The potassium content of other additives, such as potassium phosphate or potassium-containing antibiotics, must be considered in the context of total potassium delivered. TPN patients usually require 30 to 50 mEq of potassium per liter of TPN solution containing concentrated (20—25%) dextrose.
NOT INTENDED FOR PEDIATRIC USE.
Solutions containing sodium ions should be used with great care, if at all, in patients with congestive heart failure, severe renal insufficiency and in clinical states in which there exists edema with sodium retention.
Solutions which contain potassium ions should be used with great care, if at all, in patients with hyperkalemia, severe renal failure and in conditions in which potassium retention is present.
In patients with diminished renal function, administration of solutions containing sodium or potassium ions may result in sodium or potassium retention.
Solutions containing acetate ions should be used with great care in patients with metabolic or respiratory alkalosis. Acetate should be administered with great care in those conditions in which there is an increased level or an impaired utilization of this ion, such as severe hepatic insufficiency.
Warning: This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.
Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.
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Manufacturer Warnings
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FDA Labeling Changes
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Uses
TPN Electrolytes (multiple electrolyte additive) is indicated for use as a supplement to nutritional solutions containing concentrated dextrose and amino acids delivered by central venous infusion, to help maintain electrolyte homeostasis in adult patients.
History
There is currently no drug history available for this drug.
Other Information
TPN Electrolytes (multiple electrolyte additive) is a sterile, nonpyrogenic, concentrated solution of intra- and extracellular ions for intravenous infusion after dilution as a maintenance electrolyte replenisher only. It contains no phosphate and no bacteriostat, antimicrobial agent or added buffer. The pH is 6.6 (6.0 to 7.5). May contain hydrochloric acid for pH adjustment. The osmolar concentration is 6.2 mOsmol/mL (calc.).
__________________________
*Total Parenteral Nutrition
Ingredients and ion constituents of the solution are as follows:
| Ingredient or Ion |
mg/20 mL |
mEq/20 mL |
| Sodium Chloride |
321 |
|
| Calcium Chloride (dihydrate) |
331 |
|
| Potassium Chloride |
1491 |
|
| Magnesium Chloride (hexahydrate) |
508 |
|
| Sodium Acetate (anhydrous) |
2420 |
|
| Sodium (Na+) |
35 |
|
| Potassium (K+) |
20 |
|
| Calcium (Ca++) |
4.5 |
|
| Magnesium (Mg++) |
5 |
|
| Chloride (Cl−) |
35 |
|
| Acetate (CH3COO−) |
29.5 |
Sodium Chloride, USP is chemically designated NaCl, a white crystalline compound freely soluble in water.
Calcium Chloride, USP dihydrate is chemically designated CaCl2 • 2H2O, white, odorless fragments or granules, freely soluble in water.
Potassium Chloride, USP is chemically designated KCl, a white granular powder freely soluble in water.
Magnesium Chloride, USP hexahydrate is chemically designated MgCl2 • 6H2O, deliquescent crystals very soluble in water.
Sodium Acetate, USP anhydrous is chemically designated C2H3NaO2, a hygroscopic powder very soluble in water.
Water for Injection, USP is chemically designated H2O.
The semi-rigid container is fabricated from a specially formulated polyolefin. It is a copolymer of ethylene and propylene. The safety of the plastic has been confirmed by tests in animals according to USP biological standards for plastic containers. The container requires no vapor barrier to maintain the proper drug concentration.
Sources
Tpn Electrolytes Manufacturers
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Hospira, Inc.
![Tpn Electrolytes (Sodium Chloride, Calcium Chloride, Potassium Chloride, Magnesium Chloride, And Sodium Acetate Anhydrous) Injection, Solution, Concentrate [Hospira, Inc.]](/wp-content/themes/bootstrap/assets/img/loading2.gif)
Tpn Electrolytes | Hospira, Inc.
One 20 mL volume of TPN Electrolytes (multiple electrolyte additive) is added to each liter of amino acid/dextrose solution. Alternatively, the TPN Electrolytes can be added to the bottle of amino acids or concentrated dextrose, to permit addition of the necessary phosphate additive to the remaining bottle. This latter technique helps avoid physical incompatibilities between calcium and phosphorus. A potassium phosphate additive is recommended for addition to nutritional solutions containing TPN Electrolytes. Between 10 and 30 mEq of potassium (as phosphate) should be added per liter of TPN solution, to augment the 20 mEq of potassium provided by TPN Electrolytes.
Between two and three liters of TPN solution with added TPN Electrolytes are usually administered daily to adults. Solutions are given continuously over the entire 24-hour period at a constant rate, ranging from 83 to 125 mL/hour. TPN solutions containing TPN Electrolytes and concentrated dextrose are administered intravenously, through a central venous catheter.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. See PRECAUTIONS.
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