Friday, March 2, 2018

Urinary Alkalinizer

Availability
Shohl’s Solution
Potassium Citrate Mixt.
Polycitra
mEq
1ml = 1 mEq base
1ml = 3 mEq base
1ml = 2 mEq base
Indication
  • To correct the acidosis of certain renal tubular disorders
  • To treat metabolic acidosis for long term urine alkalization for prevention
  • Treatment of uric acid and calcium kidney stones and as no particulate neutralizing buffers
For systemic or urine
alkalization
For treatment of calcium
and uric acid stones
Dose
  • ADULT: 10 - 20 ml
  • CHILD
  • up to 1 year: 2.5 ml tds
  • 1-5 year: 5 ml tds
  • 6-12 years: 10 ml tds
  • ADULT: 15-30 ml
  • CHILD
  • up to 1 year: 2.5 ml tds
  • 1 - 5 years: 5 ml 3 times daily
  • 6 - 12 years: 10 ml 3 times daily. To be taken at bedtime
  • The usual dose of potassium citrate is 30 - 60 mEq/day orally in 3 or 4 doses with meals or within 30 minutes after meals.
  • ADULT: 15 ml tds.
  • CHILD 5-15 ml tds, after meals and at bedtime

Need to be well diluted with water
Contraindication
  • Severe renal impairment with
  • Oliguria
  • Azotemia
  • Untreated Addison disease
  • Acute dehydration
  • Heat cramp
  • Anuria
  • Severe myocardial damage
  • Hyperkalemia
  • Sodium-restricted diet
  • Hyperkalaemia
  • Renal dysfunction
  • Ventricular arrhythmias
  • Addison's Disease.
  • Severe renal impairment with
  • Oliguria
  • azotemia
  • Untreated Addison’s disease
  • Severe myocardial damage


Content
Weight
(mg)
Molecular weight (g/mol)
Dosage equivalent
Shohl’s solution
(1ml)
Sodium Citrate
90
258.07
1ml = 1 mEq base
Citric Acid
Anhydrous
Monohydrous
140

192.12
210.14
Shohl’s solution in HKGU
(1ml)
Sodium Citrate
200
258.07
1ml = 2 mEq base
Citric Acid Anhydrous
36.6
192.12

Polycitra (1ml)
Potassium citrate
110
306.395
1ml = 2 mEq base
Sodium Citrate
100
258.07
Citric Acid
Anhydrous
Monohydrous
66.8

192.12
210.14
Potcit
Potassium Citrate
300
306.395
1ml = 3 mEq base
Citric Acid
50


Shohl’s solution (Phis worksheet)
  • Bicitra: Sodium citrate 500 mg and citric acid 334 mg/5 ml (1 mEq sodium and 1 mEq bicarbonate equivalent per ml) (15 ml unit dose, 480 ml).
  • Oracit: Sodium citrate 490 mg and citric acid 640 mg/5 ml (1 mEq sodium and 1 mEq bicarbonate equivalent per ml).
References

1. Therapy of Renal Diseases and Related Disorders edited by Wadi N. Suki, Shaul G. Massry
2.https://www.drugs.com/pro/potassium-citrate-sodium-citrate-citric-acid-solution.html
3. PhIS worksheet
4. Lexicomp
5. http://www.rch.org.au/nephrology/protocols/5415_CITRATE_AND_CITRIC_ACID_SOLUTIONS/