Q J Med 2003; 96: 549-552
© 2003 Association of Physicians
Editorial |
Salt and water: read the package insert
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Salt and water are probably the most common therapeutic agents that we give to patients: used improperly, they can be lethal weapons. Rational management of fluid and electrolyte disorders requires that we think of salt (or saline) and water as drugs that have indications, contraindications, and appropriate doses. Such drug information, typically supplied in what Americans call the ‘package insert’, can be found in Tables 1 and 2.
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Water is available in oral form or in parenteral preparations. Because it cannot be infused directly into a small vein without causing haemolysis, intravenous water is usually mixed with glucose. A 4% or 5% dextrose solution is used because the osmolality approximates that of plasma, and thus prevents haemolysis. However, after metabolism of the infused glucose, a
Department of Medicine
Rochester General Hospital
University of Rochester School of Medicine and
Dentistry
Rochester
New York
USA
e-mail: Richard.Sterns@viahealth.org
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