PRISMASOL BGK 2/3.5 IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for PRISMASOL BGK 2/3.5 IN PLASTIC CONTAINER (PRISMASOL BGK 2/3.5 IN PLASTIC CONTAINER).
Prismasol BGK 2/3.5 is a sterile, non-pyrogenic hemofiltration solution used in continuous renal replacement therapy (CRRT). It does not have a pharmacological mechanism of action; rather, it provides electrolyte composition (sodium, potassium, calcium, magnesium, chloride, lactate) and glucose to replace fluid and electrolyte losses during hemofiltration or hemodialysis, maintaining acid-base balance and electrolyte homeostasis. The lactate in the solution serves as a bicarbonate precursor, metabolized to bicarbonate by the liver, helping to correct metabolic acidosis.
| Metabolism | The lactate component is metabolized primarily in the liver via gluconeogenesis and the Krebs cycle to bicarbonate. Glucose is metabolized through glycolysis and oxidative phosphorylation. Electrolytes (sodium, potassium, calcium, magnesium, chloride) are not metabolized but are regulated by renal and hormonal mechanisms. |
| Excretion | The components are primarily excreted renally: sodium, potassium, and glucose are eliminated via urine; bicarbonate is consumed or excreted as CO2; lactate is metabolized to bicarbonate. ~100% renal for electrolytes. |
| Half-life | Not applicable as a single terminal half-life; components are endogenous substances with rapid turnover (e.g., lactate t1/2 ~10-20 min, electrolytes adjust within minutes to hours). |
| Protein binding | Negligible for electrolytes (<5%); bicarbonate and lactate not significantly protein-bound. |
| Volume of Distribution | Electrolytes distribute in total body water: ~0.5 L/kg for sodium and potassium; glucose Vd ~0.2 L/kg; bicarbonate ~0.4 L/kg. |
| Bioavailability | Intravenous: 100% (not administered via other routes). |
| Onset of Action | Intravenous: immediate (minutes) for correction of electrolyte and acid-base disturbances upon infusion. |
| Duration of Action | Duration depends on infusion rate and patient status; typically 6-24 hours for continuous replacement therapy; effects persist as long as infusion continues. |
PRISMASOL BGK 2/3.5 is a hemofiltration solution for continuous renal replacement therapy (CRRT). Administered intravenously via CRRT circuit. Typical adult dose: 1000-2000 mL/hour infusion rate adjusted to achieve effluent rate of 20-35 mL/kg/hour.
| Dosage form | INJECTABLE |
| Renal impairment | No dose adjustment needed as solution is used specifically for renal replacement therapy in acute kidney injury. GFR not applicable; dosing based on CRRT prescription. |
| Liver impairment | No specific adjustment for hepatic impairment. Use standard CRRT protocols; monitor lactate and electrolyte levels in severe hepatic failure. |
| Pediatric use | Weight-based dosing for CRRT: 2000-4000 mL/1.73 m²/hour or 35-45 mL/kg/hour effluent rate, adjusted to clinical needs. |
| Geriatric use | No specific dose adjustment; use standard CRRT protocols with careful monitoring of fluid balance, electrolytes, and hemodynamic status due to age-related changes. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for PRISMASOL BGK 2/3.5 IN PLASTIC CONTAINER (PRISMASOL BGK 2/3.5 IN PLASTIC CONTAINER).
| Breastfeeding | No data on excretion into breast milk. The components (electrolytes, glucose, bicarbonate/lactate) are endogenous substances and unlikely to cause adverse effects in breastfeeding infants at concentrations present in CRRT. No M/P ratio available. Use with caution. |
| Teratogenic Risk | Prismasol BGK 2/3.5 is a sterile, non-pyrogenic solution for continuous renal replacement therapy (CRRT) containing electrolytes, glucose, and buffer. No specific teratogenic risk data exist for this formulation. However, during pregnancy, the underlying condition requiring CRRT (e.g., acute kidney injury) poses significant maternal and fetal risks. The solution components (e.g., glucose, electrolytes) are physiological and not known to be teratogenic at therapeutic levels. No trimester-specific risks identified beyond those associated with CRRT procedure and maternal disease. |
■ FDA Black Box Warning
None
| Serious Effects |
["Hypersensitivity to any component of the solution.","Hyperlactatemia or severe lactic acidosis (lactate >5 mmol/L) due to impaired lactate metabolism (e.g., severe hepatic failure, shock).","Severe metabolic alkalosis.","Clinically significant electrolyte disorders that cannot be corrected by adjustment of the solution (e.g., severe hyperkalemia, hypercalcemia).","Contraindicated for direct intravenous infusion; only for use in CRRT."]
| Precautions | ["Monitor serum electrolytes (especially potassium, calcium, magnesium, and bicarbonate) frequently during therapy.","Use with caution in patients with severe hepatic impairment due to risk of lactate accumulation and worsening metabolic acidosis.","Avoid rapid correction of severe hyponatremia; may cause osmotic demyelination syndrome.","May cause hyperglycemia in diabetic patients; monitor blood glucose levels.","Do not administer if solution is discolored, cloudy, or contains particulate matter.","Use only with compatible CRRT equipment; ensure proper fluid balance to avoid volume overload or depletion.","Risk of air embolism if not used with appropriate air detection systems.","Not for intravenous administration directly; for use only in CRRT circuits."] |
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| Fetal Monitoring | Monitor maternal electrolytes (Na, K, Ca, Mg, Cl, HCO3/lactate), acid-base status, blood glucose, fluid balance, and renal function. Fetal monitoring: heart rate, growth, and amniotic fluid volume via ultrasound, especially if maternal acidosis or electrolyte disturbances occur. Adjust CRRT prescription based on maternal and fetal status. |
| Fertility Effects | No known direct effects on fertility. The solution is not systemically absorbed beyond the CRRT circuit; effects on fertility are unlikely. Underlying renal disease may impair fertility. |