Optional: Add a pinch of baking soda. Carefully pour the salt-water solution from the pan into the jar or bottle and put the lid on. Refrigerate solution and use within 24 hours. Option 2: You can used distilled water purchased from most drug and grocery stores to make sterile and longer-lasting saline without boiling water.
Mix eight teaspoons of salt into 1 gallon 4 L of distilled water. Refrigerate solution and use within one month. If you plan on using the saline solution as a nasal saline rinse, follow this recipe: Put one cup mL of tap water into a pot and boil for 15 minutes with the lid on. Add three teaspoons of salt and one teaspoon of baking soda into the pot and stir to dissolve. Carefully pour the solution from the pan into the jar or bottle and put the lid on. More information about the treatment.
Saline solution: A few important points Bacteria can grow in saline and cause infections, so it is very important to only use a freshly made saline solution. Use a clean glass jar or bottle that has been recently washed in a full-cycle dishwasher or boil-sterilize for 10 minutes. This will help prevent bacteria from contaminating the solution.
Boiling tap water will sterilize the water by removing bacteria and chemicals. Normal saline is typically the first fluid used when dehydration is severe enough to threaten the adequacy of blood circulation and is the safest fluid to give quickly in large volumes. Physiological saline is 9g NaCl dissolved in 1 liter water. Since NaCl dissociates into two ions — sodium and chloride — 1 molar NaCl is 2 osmolar.
It has a slightly higher degree of osmolality i. Note that in chemistry , a normal concentration of sodium chloride is 5. The amount of normal saline infused depends largely on the needs of the patient e. Other concentrations of saline are frequently used for other medical purposes, such as supplying extra water to a dehydrated patient or supplying the daily water and salt needs "maintenance" needs of a patient who is unable to take them by mouth.
Because infusing a solution of low osmolality can cause problems, intravenous solutions with reduced saline concentrations typically have dextrose glucose added to maintain a safe osmolality while providing less sodium chloride. As the molecular weight MW of dextrose is greater, this has the same osmolality as normal saline despite having less sodium.
Carefully consider fluid status in hyponatremic patients with hepatic disease e. Water retention and dilutional hyponatremia are common in patients with advanced disease and should be treated with sodium and fluid restriction, as well as diuretics.
Sodium supplementation may aggravate edema. In addition, patients with advanced liver disease may be more susceptible to central pontine myelinolysis CPM ; sodium replacement therapy should be tailored to stay well below established limits. Hemolysis of red blood cells can occur during the infusion of hypotonic solutions. In the presence of a hypotonic fluid, water enters the red blood cells across a diffusion gradient, causing the cells to swell and burst.
After lysis, the intracellular contents of the cells e. Because of this phenomenon, isotonic or near-isotonic solutions are preferred for fluid administration. Normal saline 0. In contrast, 0. Hypotonic solutions should never be used for fluid resuscitation or rehydration; however, they are sometimes used in patients with high serum osmolarity e.
Additionally, hypotonic saline solutions offer a maintenance infusion option with less sodium content, which may be desirable in specific circumstances e. However, the most hypotonic fluid that can be safely administered is 0.
The risk of hemolysis increases as the tonicity decreases ; of the commercially available saline products, 0. Mixing hypotonic saline solutions with dextrose increases their tonicity and makes the overall solution approach isotonicity, making it feasible to administer an intravenous infusion with a lower sodium content.
For example, 0. Because hemolysis is accentuated by an increased ratio of hypotonic solution to blood and prolonged cell contact time with the solution, it has been suggested that administering hypotonic solutions at a slower rate or through a central line may decrease the risk of cell lysis; however, hemolysis can still occur with such precautionary measures and use of any hypotonic solution in patients should be used with extreme caution. According to the manufacturer, it is not known whether sodium chloride can cause fetal harm or affect reproduction capacity; only administer sodium chloride during pregnancy if it is clearly needed.
However, normal saline 0. Saline nasal preparations and topical solutions are safe for use during pregnancy. According to the manufacturer, it is not known whether sodium chloride is excreted in human milk.
Because 0. Use caution when using sodium chloride bacteriostatic injection, as the benzyl alcohol preservative is associated with the development of metabolic acidosis, kernicterus, and intraventricular hemorrhage in the neonatal population; bacteriostatic injection is contraindicated for direct use in the neonatal population.
Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition.
If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. Bacteriostatic sodium chloride products contain benzyl alcohol and are contraindicated in neonates and premature neonates. Gasping syndrome is characterized by central nervous depression, metabolic acidosis, and gasping respirations.
If a sodium chloride solution is required for preparing medications or intravascular flush, only preservative-free injection should be used. Many physiological changes occur during the first weeks of life that affect the neonate's handling of fluid and sodium, especially in premature neonates. Carefully assess fluid and sodium status and adjust therapy as appropriate. In general, volume expansion in neonates should only be used when clearly needed e. Premature neonates younger than 30 weeks gestational age should receive fluid resuscitation with 0.
Children, including neonates and infants, are at increased risk of developing hyponatremia and hyponatremic encephalopathy. Rapid correction of hypo- or hypernatremia requires an experienced clinician. Due to the risk of serious neurologic complications, dosage, rate, and duration of administration should be determined by a physician experienced in intravenous fluid therapy.
Sodium chloride ophthalmic formulations i. There are no data to determine if geriatric patients respond differently to sodium chloride compared to younger patients. However, sodium chloride is excreted by the kidney, and elderly patients are more likely to have decreased renal function. In general, dose selection for the elderly should be cautious and start at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, and cardiac function as well as concomitant disease or drug therapy.
Monitor renal function in the elderly when receiving sodium chloride. Azelastine; Fluticasone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Assess sodium chloride intake from all sources, including intake from sodium-containing intravenous fluids and antibiotic admixtures. Carefully monitor sodium concentrations and fluid status if sodium-containing drugs and corticosteroids must be used together.
Beclomethasone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Benzalkonium Chloride: Major Sodium chloride saline solutions should not be used to dilute benzalkonium chloride as saline solutions may decrease the antibacterial potency of the antiseptic. Stored tap water should also not be used for dilution since it may contain microorganisms.
Resin deionized water may also contain pathogens and it may inactivate benzalkonium chloride. Betamethasone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention.
Budesonide: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Budesonide; Formoterol: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Ciclesonide: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention.
Corticosteroids: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Corticotropin, ACTH: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention.
Cortisone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Deflazacort: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention.
Dexamethasone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Fludrocortisone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Flunisolide: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention.
Fluticasone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Fluticasone; Salmeterol: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Fluticasone; Umeclidinium; Vilanterol: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention.
Fluticasone; Vilanterol: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Formoterol; Mometasone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention.
Hydrocortisone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Lithium: Moderate Moderate to significant dietary sodium changes, or changes in sodium and fluid intake, may affect lithium excretion.
Systemic sodium chloride administration may result in increased lithium excretion and therefore, decreased serum lithium concentrations. In addition, high fluid intake may increase lithium excretion. For patients receiving sodium-containing intravenous fluids, symptom control and lithium concentrations should be carefully monitored.
It is recommended that patients taking lithium maintain consistent dietary sodium consumption and adequate fluid intake during the initial stabilization period and throughout lithium treatment. Supplemental oral sodium and fluid should be only be administered under careful medical supervision. Methylprednisolone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Mometasone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention.
Prednisolone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Prednisone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention.
Tolvaptan: Moderate Coadministration of tolvaptan and hypertonic saline e. The use of hypertonic sodium chloride in combination with tolvaptan may result in a too rapid correction of hyponatremia and increase the risk of osmotic demyelination i. Triamcinolone: Moderate Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention.
Sodium is the principle cation of the extracellular fluid, while chloride is the principle anion. Both ions are physiologically important.
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