PLASMA-LYTE 148 IN WATER IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for PLASMA-LYTE 148 IN WATER IN PLASTIC CONTAINER (PLASMA-LYTE 148 IN WATER IN PLASTIC CONTAINER).
Plasma-Lyte 148 is an isotonic crystalloid solution that provides electrolyte replacement and volume expansion. It mimics plasma electrolyte composition, with acetate and gluconate as bicarbonate precursors that are metabolized to bicarbonate in the liver and kidneys, helping to maintain acid-base balance.
| Metabolism | Acetate and gluconate are metabolized in the liver and kidneys to bicarbonate. Water and electrolytes are not metabolized but undergo renal excretion. |
| Excretion | Renal: >90% of infused electrolytes and water are excreted unchanged in urine. Biliary/fecal excretion is negligible (<1%). |
| Half-life | Not applicable; Plasma-Lyte 148 contains electrolytes and water that distribute according to body fluid compartments; infusion rate and renal function dictate elimination; clinical context: in normal renal function, excess fluids and electrolytes are cleared with a half-life of approximately 2-4 hours. |
| Protein binding | Not applicable; individual electrolytes do not bind to plasma proteins (e.g., sodium, chloride, potassium, magnesium, acetate, gluconate have negligible protein binding). |
| Volume of Distribution | Not applicable as a single value; electrolytes distribute into total body water (approximately 0.6 L/kg in adults); clinical meaning: initial distribution reflects extracellular fluid expansion. |
| Bioavailability | Intravenous: 100% (directly into systemic circulation). |
| Onset of Action | Intravenous: Immediate upon infusion; volume expansion and electrolyte effects occur within minutes. |
| Duration of Action | Intravenous: Duration depends on infusion rate and patient status; volume expansion lasts 1-2 hours after infusion stops; electrolyte effects persist until renal excretion; continuous infusion maintains steady state. |
| Molecular Weight | Sodium 23.0 Da, Potassium 39.1 Da, Magnesium 24.3 Da, Chloride 35.5 Da, Acetate 59.0 Da, Gluconate 195.0 Da (compound, not single molecule) |
Intravenous infusion; dose determined by electrolyte and fluid requirements. Typical adult rate: 25-100 mL/hour.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment; use with caution in renal impairment due to risk of electrolyte imbalances. Monitor serum electrolytes and renal function. |
| Liver impairment | No specific adjustment; use with caution in severe hepatic impairment due to potential for fluid and electrolyte disturbances. |
| Pediatric use | Intravenous infusion; dose based on weight and clinical status. Typical rate: 5-20 mL/kg/hour, adjust based on response. |
| Geriatric use | Use with caution due to potential for fluid overload and electrolyte disturbances; monitor renal function and adjust infusion rate accordingly. |
| 1st trimester | Plasma-Lyte 148 is an isotonic crystalloid solution containing electrolytes similar to plasma. No known teratogenic effects; use only if clearly needed during pregnancy, as volume overload and electrolyte disturbances (e.g., hypernatremia) may affect the fetus. |
| 2nd trimester | Same as t1; monitor maternal volume status and electrolytes, as fluid shifts may impact placental perfusion. Use cautiously in preeclampsia or renal impairment. |
| 3rd trimester | Same as t2; avoid excess volume in context of third-trimester hemodilution. Monitor for peripheral edema and pulmonary congestion. |
Clinical note
Comprehensive clinical and safety monograph for PLASMA-LYTE 148 IN WATER IN PLASTIC CONTAINER (PLASMA-LYTE 148 IN WATER IN PLASTIC CONTAINER).
| Placental transfer | Electrolytes (Na+, K+, Mg2+, Cl-) and small organic ions (acetate, gluconate) cross the placenta freely via passive diffusion and active transport; concentrations equilibrate with maternal plasma. No accumulation concerns at therapeutic doses. |
| Breastfeeding | Plasma-Lyte 148 components (sodium, potassium, magnesium, chloride, acetate, gluconate) are normal plasma constituents and are excreted into breast milk in small amounts. No known adverse effects on breastfed infants with standard infusion rates. Consider maternal hydration status and potential for transient electrolyte imbalance in the infant with large volumes. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | No fetal risks have been associated with Plasma-Lyte 148 in Water. It is an isotonic crystalloid solution containing electrolytes and water, lacking known teratogenic properties. No trimester-specific risks reported. |
| Fetal Monitoring | Monitor maternal fluid and electrolyte balance, urine output, and signs of fluid overload during infusion. Fetal monitoring as per standard obstetric care if used during labor/delivery. |
| Fertility Effects | No known effects on fertility. Clinical data on reproductive impact are absent. |
■ FDA Black Box Warning
None
| Serious Effects |
Hypersensitivity to any componentSevere hypernatremiaSevere hyperkalemiaSevere hypermagnesemiaSevere hypercalcemiaSevere metabolic alkalosisSevere renal impairment (anuria/oliguria not responsive to fluid challenge)
| Precautions | Risk of fluid overload, especially in patients with heart failure or renal impairment, Electrolyte disturbances (hypernatremia, hyperkalemia, hypokalemia, hypercalcemia, hypermagnesemia) may occur, Monitor serum electrolytes, fluid balance, and renal function, Not recommended for use in patients with severe renal impairment or anuria, Use with caution in patients with metabolic alkalosis or conditions with predisposing factors for electrolyte imbalances |
| Food/Dietary | None; PLASMA-LYTE 148 is administered intravenously and does not interact with food. However, patients with electrolyte imbalances may require dietary adjustments (e.g., low potassium or low sodium diet) as directed by their physician. |
| Clinical Pearls | PLASMA-LYTE 148 is a balanced crystalloid solution with physiologic concentrations of electrolytes and pH 7.4. It is preferred over normal saline in patients with hyperchloremic metabolic acidosis or renal impairment. Avoid in patients with severe hyperkalemia, hypercalcemia, or metabolic alkalosis. Do not administer simultaneously with blood products through the same IV line due to risk of hemolysis from calcium content. |
| Patient Advice | This solution is given intravenously to replace fluids and electrolytes. · Report any signs of allergic reaction like rash, itching, or difficulty breathing immediately. · Tell your healthcare provider if you have kidney disease, heart failure, or are on a low-sodium diet. · Inform your doctor if you are pregnant, breastfeeding, or taking any medications. · The infusion site should be monitored for redness, swelling, or pain. |
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