PLASMA-LYTE R IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for PLASMA-LYTE R IN PLASTIC CONTAINER (PLASMA-LYTE R IN PLASTIC CONTAINER).
Plasma-Lyte R provides electrolytes and water to maintain or restore fluid balance, with bicarbonate precursors (acetate, gluconate) to buffer metabolic acidosis.
| Metabolism | Not metabolized; acetate and gluconate are metabolized to bicarbonate in the liver and peripheral tissues. |
| Excretion | Renal: >90% (electrolytes and water); Biliary/fecal: negligible (<5%) |
| Half-life | Not applicable (Plasma-Lyte R components are endogenous electrolytes and water; administered crystalloid redistributes rapidly; half-life of approximately 20-30 minutes for volume expansion due to renal excretion and redistribution into interstitial space) |
| Protein binding | Minimal (<5%); ions remain free in solution |
| Volume of Distribution | Approximately 0.25-0.3 L/kg (limited to extracellular fluid compartment; distributes primarily in plasma and interstitial fluid) |
| Bioavailability | Intravenous: 100% |
| Onset of Action | Intravenous: Immediate (within seconds) for electrolyte and volume effects |
| Duration of Action | Intravenous: 1-2 hours for volume expansion (depending on renal function and hydration status); electrolyte effects persist until renal excretion |
| Molecular Weight | Not applicable (mixture of electrolytes and water; individual ions: Sodium 23.0, Potassium 39.1, Magnesium 24.3, Chloride 35.5, Acetate 59.0, Gluconate 196.2 Da) |
Intravenous infusion at a rate of 25-50 mL/kg body weight per 24 hours, adjusted for fluid and electrolyte needs. Typical adult maintenance dose: 1-2 L/day.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (creatinine clearance < 30 mL/min) due to risk of hyperkalemia and fluid overload. For mild-to-moderate impairment (CrCl 30-89 mL/min), reduce infusion rate by 25-50% and monitor serum potassium. |
| Liver impairment | Child-Pugh Class A: No adjustment. Child-Pugh B: Reduce infusion rate by 25% and monitor for fluid overload. Child-Pugh C: Avoid use due to risk of exacerbating ascites and electrolyte imbalances. |
| Pediatric use | Weight-based dosing: 20-100 mL/kg/day as a continuous infusion, with rate not exceeding 50 mL/kg/hour. Adjust based on hydration status, serum electrolytes, and renal function. |
| Geriatric use | Initiate at low end of dosing range (e.g., 25-30 mL/kg/day) due to age-related renal decline and increased risk of fluid overload. Monitor serum potassium, creatinine, and fluid balance closely. |
| 1st trimester | PLASMA-LYTE R is generally considered safe in pregnancy when clinically indicated. No known teratogenic effects. |
| 2nd trimester | Safe for use during second trimester when indicated for fluid and electrolyte replenishment. |
| 3rd trimester | Safe for use during third trimester. Monitor for fluid overload in conditions like preeclampsia. |
Clinical note
Comprehensive clinical and safety monograph for PLASMA-LYTE R IN PLASTIC CONTAINER (PLASMA-LYTE R IN PLASTIC CONTAINER).
| Placental transfer | Electrolytes and water freely cross the placenta. No specific studies on PLASMA-LYTE R, but components are endogenous and regulated. |
| Breastfeeding | PLASMA-LYTE R is compatible with breastfeeding. Electrolytes and water pass into breast milk but are not expected to cause adverse effects in the infant. Use as clinically indicated. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | No evidence of teratogenicity. Plasma-Lyte R is an isotonic crystalloid solution; components (sodium, potassium, magnesium, chloride, acetate, gluconate) are physiological ions. No fetal risk identified in any trimester when used as indicated. |
| Fetal Monitoring | Monitor maternal serum electrolytes, fluid balance, and renal function during prolonged infusion. Fetal heart rate monitoring not specifically required unless maternal condition warrants. |
| Fertility Effects | No known adverse effects on fertility. Components are physiological and do not impair reproductive function. |
■ FDA Black Box Warning
None.
| Serious Effects |
HyperkalemiaHypernatremiaHypercalcemiaSevere renal impairment (anuria or oliguria)Fluid overload states (e.g., congestive heart failure, pulmonary edema)
| Precautions | Use with caution in patients with heart failure, renal impairment, or conditions with sodium retention, Monitor serum electrolytes and fluid balance, Risk of hypervolemia, Do not use if solution contains precipitate or if container is damaged |
| Food/Dietary | No known food interactions. However, patients on a sodium- or potassium-restricted diet should consult their physician before receiving this solution. |
| Clinical Pearls | Plasma-Lyte R is an isotonic crystalloid solution used for fluid and electrolyte resuscitation. It contains acetate and gluconate as buffers, which may be preferable in patients with lactic acidosis or hepatic dysfunction. Rapid infusion can cause volume overload; monitor renal function and serum electrolytes. Not recommended for patients with preexisting hyperkalemia. |
| Patient Advice | Inform your healthcare provider if you have kidney problems, heart failure, or are on a sodium-restricted diet. · Report any signs of fluid overload, such as shortness of breath, swelling in the ankles or feet, or sudden weight gain. · This solution contains potassium; avoid potassium supplements or salt substitutes unless directed by your doctor. |
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