PRISMASOL BGK 4/0/1.2 IN PLASTIC CONTAINER
Clinical safety rating: caution
PRISMASOL BGK 4/0/1.2 is a sterile, non-pyrogenic electrolyte solution used as a replacement fluid in continuous renal replacement therapy (CRRT) to correct fluid, electrolyte, and acid-base imbalances in patients with acute kidney injury or chronic renal failure. It provides bicarbonate, glucose, and specified electrolyte concentrations to maintain homeostasis during hemofiltration.
Prismasol BGK 4/0/1.2 is a bicarbonate-buffered hemofiltration solution used in continuous renal replacement therapy (CRRT). It provides electrolyte replacement and buffer to correct metabolic acidosis, maintain electrolyte balance, and remove waste products through hemofiltration or hemodiafiltration.
| Metabolism | Prismasol is not metabolized; components are electrolytes and buffer (bicarbonate) that participate in normal physiological processes. Bicarbonate is converted to carbon dioxide and water via carbonic anhydrase. |
| Excretion | Prismasol BGK 4/0/1.2 is a dialysis solution; its components (glucose, electrolytes, buffer) are not systemically absorbed in significant amounts. The solution is removed via the dialysis effluent. No renal/biliary/fecal elimination applies; the solutes are cleared by the dialysis process itself. |
| Half-life | Not applicable as a drug; the half-life of infused components is governed by the dialysis session duration and the body's own metabolic clearance. Glucose half-life in circulation is ~1-2 hours, but in the context of dialysis, the solution is ultrafiltered and removed continuously. |
| Protein binding | Components (glucose, calcium, magnesium, lactate, sodium, chloride) are minimally bound to plasma proteins (<10%). |
| Volume of Distribution | Not applicable; the solution distributes into the peritoneal cavity and equilibrates with plasma water. For electrolytes and glucose, Vd approximates extracellular fluid volume (~0.2 L/kg). |
| Bioavailability | 100% when administered intraperitoneally; all components are available for dialysis exchange. |
| Onset of Action | Immediate upon initiation of peritoneal dialysis; the solution begins dialyzing as soon as it fills the peritoneal cavity, with solute exchange starting within minutes. |
| Duration of Action | Duration of a single dwell is determined by the dialysis prescription (typically 4-6 hours for continuous ambulatory peritoneal dialysis). The solution is replaced after each dwell; no sustained drug effect. |
Dosing is individualized based on patient's fluid status, electrolyte levels, and acid-base balance. Typically, the infusion rate is titrated to achieve desired ultrafiltration and clearance goals, often ranging from 1 to 3 L/hour in adults, adjusted according to clinical response.
| Dosage form | INJECTABLE |
| Renal impairment | Dosing is inherently titrated to renal replacement therapy parameters; no separate renal adjustment necessary as the therapy replaces renal function. |
| Liver impairment | No adjustment required; constituents are not hepatically metabolized. |
| Pediatric use | Use in pediatric patients should be based on body weight and clinical condition; dosing rates are typically lower (e.g., 20–50 mL/kg/hour) and require careful monitoring. |
| Geriatric use | Standard adult protocols apply; however, elderly patients may be more sensitive to fluid shifts and electrolyte changes, necessitating close monitoring. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
PRISMASOL is used in pregnancy only if clearly needed; although electrolytes are essential for homeostasis, the effects of large-volume hemofiltration during pregnancy are not well studied; maternal and fetal status must be closely monitored.
| Placental transfer | Electrolytes and glucose cross the placenta; however, during CRRT, the fetal exposure is indirect and related to maternal plasma levels. |
| Breastfeeding | Not systemically absorbed; therefore, no excretion into breast milk. M/P ratio is not applicable. Compatible with breastfeeding. |
| Teratogenic Risk |
■ FDA Black Box Warning
Not for intravenous injection directly into the body; for extracorporeal use only. Must be used in a controlled CRRT system with proper monitoring.
| Common Effects | Hypotension, Muscle cramps, Nausea, Vomiting, Hypothermia, Infection at catheter site |
| Serious Effects | Severe electrolyte imbalances (hypernatremia, hypokalemia, hypercalcemia, etc.)Metabolic alkalosis or acidosisFluid overload or excessive ultrafiltration leading to hypotensionShockAir embolismSepsis from contaminated solution |
["Severe hypercalcemia","Severe metabolic alkalosis","Known hypersensitivity to any component","Contraindicated if adequate anticoagulation cannot be maintained (due to circuit clotting risk)"]
| Precautions | ["Monitor serum electrolytes, acid-base status, and fluid balance closely","Risk of electrolyte disturbances (hypokalemia, hyperkalemia, hypophosphatemia, hyperphosphatemia)","Risk of metabolic alkalosis or acidosis","Do not administer unless solution is clear and container undamaged","Discard unused portion; single-use container","Use aseptic technique during connection"] |
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| PRISMASOL BGK 4/0/1.2 is a dialysis solution for continuous renal replacement therapy (CRRT). It is not systemically absorbed; thus, no direct fetal exposure occurs. However, maternal metabolic acidosis or electrolyte disturbances during CRRT may pose risks. No teratogenic effects are expected, but use in pregnancy should be based on maternal necessity. |
| Fetal Monitoring | Monitor maternal electrolytes, acid-base status, fluid balance, and hemodynamics. Fetal monitoring includes heart rate assessment and growth scans if CRRT is prolonged. |
| Fertility Effects | No direct effects on fertility expected; infertility may result from underlying renal disease requiring CRRT. |