any other effects, check with your doctor. It is indicated for use in conjunction with blood transfusions and for restoring the loss of body fluids. The robotic device and associated on-screen software suite aim to make hand movement recovery quicker and easier for patients. Postural Orthostatic Tachycardia Syndrome, Sodium Chloride 0.9% Intravenous Infusion, 250 mL, Sodium Chloride 0.9% Intravenous Infusion, 500 mL, Sodium Chloride 0.9% Intravenous Infusion, 1000 mL (1L), Pull off port protector (natural/gum color), ANALYSIS(0338-9542), MANUFACTURE(0338-9542), LABEL(0338-9542), PACK(0338-9542), STERILIZE(0338-9542). In general, dose selection for the elderly should be cautious and start at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, and cardiac function as well as concomitant disease or drug therapy. You may not experience any 7. of them. Benzalkonium Chloride; Benzocaine: (Major) Sodium chloride (saline solutions) should not be used to dilute benzalkonium chloride as saline solutions may decrease the antibacterial potency of the antiseptic. You can learn more about how we ensure our content is accurate and current by reading our. below 25C. Evidence suggests hypertonic saline is effective in improving symptoms of non-severe bronchiolitis after 24 hours of use and reducing hospital length of stay when the admission exceeds 3 days. 0.9% sodium chloride + 5% glucose). For the reduction of increased intracranial pressure:In patients with head trauma, administration of intravenous hypertonic NaCl (e.g., 3% NaCl) reduces intracranial pressure by creating an osmotic gradient across the blood-brain barrier. It provides your body with fluids containing various amounts of sugars when you are unable to drink enough liquids. 100ml sodium chloride 0.9% Give over 30 minutes Yes Patient needs a twice daily loading dose for 2 days before once daily maintenance dose CLICK HERE for dosing advice DO NOT BOLUS -IV Above 1200mg infusion only Tigecycline DO NOT BOLUS - 5.3mL sodium chloride 0.9% IV infusion only Reconstitute each 50mg vial with Total body water = lean body weight (kg) x 0.6 (male younger than 70 years), 0.5 (male aged 70 years or older or female younger than 70 years), or 0.45 (female aged 70 years or older). Must be given with infusion pump. . Monitor sodium serum concentrations carefully and adjust dosage as needed. If there is doubt about the patency of the access device it must not be used. In general, volume expansion in neonates should only be used when clearly needed (e.g., evidence of acute blood loss). it is not known whether sodium chloride passes into breast milk. This works on kids as well. to a friend, relative, colleague or yourself. Because hemolysis is accentuated by an increased ratio of hypotonic solution to blood and prolonged cell contact time with the solution, it has been suggested that administering hypotonic solutions at a slower rate or through a central line may decrease the risk of cell lysis; however, hemolysis can still occur with such precautionary measures and use of any hypotonic solution in patients should be used with extreme caution. For patients receiving sodium-containing intravenous fluids, symptom control and lithium concentrations should be carefully monitored. Glucose 10% 20mmol 500ml 40mmol/L Sodium Chloride 0.9% 20mmol 500ml 40mmol/L Sodium Chloride 0.9% 40mmol 500ml 80mmol/L Central . May repeat as needed to restore blood pressure and tissue perfusion. We use cookies to enhance your experience. This reduction of fluid with in the cerebral tissue decreases intracranial volume, cerebral edema, and intracranial pressure. coma / Early / 0-1.0seizures / Delayed / 0-1.0central pontine myelinolysis / Delayed / 0-1.0bronchospasm / Rapid / Incidence not knownincreased intracranial pressure / Early / Incidence not knownrenal failure (unspecified) / Delayed / Incidence not knownheart failure / Delayed / Incidence not knownoliguria / Early / Incidence not knownpulmonary edema / Early / Incidence not knownintraventricular hemorrhage / Delayed / Incidence not knownthrombosis / Delayed / Incidence not knownvisual impairment / Early / Incidence not known, hemolysis / Early / Incidence not knownhemoptysis / Delayed / Incidence not knownhyperchloremic acidosis / Delayed / Incidence not knownhyponatremia / Delayed / Incidence not knownencephalopathy / Delayed / Incidence not knownsodium retention / Delayed / Incidence not knownhypernatremia / Delayed / Incidence not knownhypokalemia / Delayed / Incidence not knownhepatomegaly / Delayed / Incidence not knownhyperchloremia / Delayed / Incidence not knownedema / Delayed / Incidence not knowndehydration / Delayed / Incidence not knownhypertension / Early / Incidence not knownerythema / Early / Incidence not knownphlebitis / Rapid / Incidence not knownchest pain (unspecified) / Early / Incidence not knowndyspnea / Early / Incidence not knownhypotension / Rapid / Incidence not knownsinus tachycardia / Rapid / Incidence not knowninfusion-related reactions / Rapid / Incidence not known, pharyngitis / Delayed / Incidence not knownsneezing / Early / Incidence not knownsinusitis / Delayed / Incidence not knowncough / Delayed / Incidence not knownhoarseness / Early / Incidence not knownanorexia / Delayed / Incidence not knownnausea / Early / Incidence not knownweakness / Early / Incidence not knownurticaria / Rapid / Incidence not knowninjection site reaction / Rapid / Incidence not knownfever / Early / Incidence not knowninfection / Delayed / Incidence not knownrash / Early / Incidence not knowntremor / Early / Incidence not knownpruritus / Rapid / Incidence not knownchills / Rapid / Incidence not knownflushing / Rapid / Incidence not knownocular irritation / Rapid / Incidence not knownocular pain / Early / Incidence not known. Sodium supplementation may aggravate edema. Gasping syndrome is characterized by central nervous depression, metabolic acidosis, and gasping respirations. These cookies ensure basic functionalities and security features of the website, anonymously. While sodium is essential, its also in large amounts of almost everything we eat. 3mls/kg) AND ADMINSTER TO PATIENT SEPARATELY PREPARATION OF 3% NaCl USING 30% NaCl (to make 50mls) Take 5 ml NaCl 30% Dilute with 45ml water for injection to give a final volume of 50ml and mix well Penetration across the blood-brain barrier is low. infusion). 1 3. Do not store for later use.- Protect from freezing- Store at room temperature (between 59 to 86 degrees F)Hypertears:- Do not freeze- Store between 59 to 77 degrees FLittle Remedies for Noses:- Store between 68 to 77 degrees FLittle Remedies Stuffy Nose:- Store between 68 to 77 degrees FMonoject Prefill Advanced Sodium Chloride:- Protect from freezing- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees FMonoject Prefill Sodium Chloride with Cannula:- Protect from freezing- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees FMonoject Sodium Chloride:- Protect from freezing- Store at room temperature (between 59 to 86 degrees F)Muro 128:- Do not freeze- Store between 59 to 77 degrees FNebuSal :- Avoid excessive heat (above 104 degrees F)- Discard unused portion. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. any other substances, such as foods, preservatives or dyes. This leaflet answers some common questions about Sodium Chloride Injection and Sodium 6. To place an order, please contact Baxter's Center for Service by calling 1-888-229-0001. It contains no antimicrobial agents. of sodium. For example, the US-approved Viaflex 1 L product and the imported 500 mL Viaflo product are of similar bag size and shape. Do not remove from overwrap until ready for use Tell your doctor if you are taking any other medicines, including any that you buy The use of hypertonic sodium chloride in combination with tolvaptan may result in a too rapid correction of hyponatremia and increase the risk of osmotic demyelination (i.e., central pontine myelinolysis). All medicines have benefits and risks. Sodium and chloride play an important role in your small intestine. Sodium chloride with glucose Medicinal forms View sodium chloride with glucose drug monograph Navigate to section Infusion There can be variation in the licensing of different medicines containing the same drug. Administration of Sodium Chloride 0.9% via the Subcutaneous Route SOP. Record in process check of addition. 1 to 3 g PO 1 to 4 times daily. They do not contain a preservative. Most have symptoms of volume depletion (common cause), but are less . It Use of a final filter is recommended during administration of all parenteral solutions when possible.When administering sodium chloride from flexible plastic containers, do not connect in series, pressurize without fully evacuating the container's residual air, or use a vented intravenous administration set with the vent in the open position. Normal saline (0.9% NaCl) has an osmolality of 308 mOsm/L and is considered isotonic. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. Titrate subsequent infusions to keep ICP below 20 mmHg. The cookie is used to store the user consent for the cookies in the category "Performance". Intermittent IV Infusion0.9% Isotonic Solution (for urgent fluid replacement [e.g., dehydration or diabetic ketoacidosis with compensated shock])Administer bolus over 1 hour. Key differences are highlighted in the attached Product Comparison Tables as follows: It is also important to note the following: If you have any questions about the information contained in this letter or the use of 0.9% Sodium Chloride Injection in the VIAFLO (non-PVC) container, please contact Baxters Medical Information Service at 1-800-933-0303. Saline thats used for different purposes may also have additional chemicals or compounds added in. Intravenous solutions should be used with particular care in patients at risk for hypervolemia or other conditions that may cause sodium retention and fluid overload such as patients with primary or secondary hyperaldosteronism. Saline drops that are made for the nose are nothing but a proper mixture of water and salt. Monitor peripheral administration of hypertonic solutions carefully for potential extravasation and local tissue damage.0.45% Sodium Chloride Injection (without additional additives) is the most hypotonic sodium chloride solution that can be safely administered without risking cell lysis. Mixing hypotonic saline solutions with dextrose increases their tonicity and makes the overall solution approach isotonicity, making it feasible to administer an intravenous infusion with a lower sodium content. This cookie is set by GDPR Cookie Consent plugin. beta-carotene chromium cobalt copper magnesium manganese molybdenum phosphorus potassium selenium sodium chloride (salt) zinc Beta-carotene Beta-carotene gives yellow and orange fruit and vegetables their colour. Some medicines may affect the way sodium chloride works. For instance, in the management of metabolic alkalosis, in case of gastro-enteritis, during and after surgery. The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. Sodium bicarbonate is a medication used in the management and treatment of multiple disease pathologies. For management of ICP, do not exceed 10 mL/kg/dose IV of a 3% hypertonic solution. Administer over 5 to 10 minutes for near-term neonates; slower administration is recommended for neonates younger than 30 weeks gestation because rapid administration has been associated with intraventricular hemorrhage. While salt is frequently used for cooking, it can also be found as an ingredient in foods or cleansing solutions. Hyponatremia is more common in older adults because they're more likely to take medications or have medical conditions that put them at risk of the disorder. However, sodium chloride is excreted by the kidney, and elderly patients are more likely to have decreased renal function. This is the maximum concentration to be used, 8.4% solution is extremely irritant to vessels and tissues. It can be used alone or in combination with an injectable nutrient supplement in patients who are unable to take fluids and nutrients by mouth. 20 mL/kg IV bolus (Usual Max: 1,000 mL/bolus) over 1 hour, followed by appropriate rehydration fluids over the next 24 to 48 hours. You should confirm the information on the PDR.net site through independent sources and seek other professional guidance in all treatment and diagnosis decisions. Due to the risk of serious neurologic complications, dosage, rate, and duration of administration should be determined by a physician experienced in intravenous fluid therapy. Mostly these are mild and You can also use salt for seasoning foods, cleaning your household items, and addressing certain medical issues. Start infusion at 2 units/hour (2 mL/hour). Normal saline (0.9% sodium chloride) contains 308 mOsm/L and is considered isotonic. how well your kidneys are working, and whether or not other medicines are being given Sodium Chloride Injection may be given as an injection and Sodium Chloride Intravenous Infusion given through slow injection into your veins (this is called an intravenous infusion).. Monitor ICP, serum osmolarity, and sodium concentrations. If Keep out of the reach and sight of children It can be due to: Excessive and continuous sweating without proper hydration is also a potential cause, especially in people who train and compete in long endurance events like marathons and triathlons. Read package leaflet before use. Sodium is a unique electrolyte because, in general, water balance is directly related to its concentration. IV Push0.9% Isotonic Solution (for emergent fluid resuscitation [e.g., severe hypovolemia or shock])Administer bolus over 5 to 10 minutes for most patients; however, some patients require slower administration:Patients with cardiogenic shock or cardiac dysfunction (e.g., calcium channel blocker or beta-blocker overdose): Administer over 10 to 20 minutes. Because 0.9% sodium chloride has equal osmotic pressure to that of the serum, osmosis across cellular membranes is minimal, and the risk of adverse effects during breast-feeding is small with the use of this isotonic solution. 2 to 6 drops in each nostril as needed. 2 to 5 mEq/kg/day IV admixed in total parenteral nutrition (TPN) as a daily maintenance requirement. Last medically reviewed on August 18, 2016. 4 mL/dose via oral inhalation every 2 hours for 3 doses, then every 4 hours for 5 doses, and finally every 6 hours until discharge. Supplemental oral sodium and fluid should be only be administered under careful medical supervision. [54474] In addition, fluid resuscitation in neonates, particularly premature neonates, may cause rapid volume expansion and has been associated with intraventricular hemorrhage. Swab the additive port of the Sodium Chloride 0.9% 50mL Infusion Bag with sterile 70% alcohol wipe prior to use. The pH may have been adjusted with hydrochloric acid. SODIUM OVERDOSE IF FULL BAG ACCIDENTALLY INFUSED). Tell your doctor or nurse as soon as possible if you do not feel well while you are This site complies with the HONcode standard for trustworthy health information: verify here. Once opened the product should be used immediately and any unused drug discarded. In another study that compared 23.4% saline to mannitol, a 30 mL bolus hypertonic saline was given over greater than 30 minutes. It is also present in bones, saliva, and enzymes. Nurses may use discretion when adjusting Insulin infusions +/- 3 units/hour, based on observed trends. Bacteriostatic sodium chloride products contain benzyl alcohol and are contraindicated in neonates and premature neonates. In more severe cases, a healthcare professional may need to provide intravenous (IV) saline solution to restore hydration and electrolytes. On 1 April 2022, the Royal Devon and Exeter NHS Foundation Trust (RD&E) and Northern Devon Healthcare NHS Trust (NDHT) formally merged to become the Royal Devon University Healthcare NHS Foundation Trust. Do not be alarmed by this list of possible side effects. For example, 0.225% sodium chloride with dextrose 5% has an osmolarity of 329 mOsm/L. Although data has been contradictory, meta-analysis suggests use in areas where the length of administration is brief (e.g., the emergency department) does not improve short-term outcomes or decrease hospitalization rates. c Other_____ Chloride 38.5 Last updated on Mar 22, 2022. Our website services, content, and products are for informational purposes only. Children with septic shock often have a large fluid deficit and may require 40 to 60 mL/kg during the first hour and 200 mL/kg or more during the first 8 hours of therapy. 1 to 2 mEq/kg/day IV admixed in total parenteral nutrition (TPN) as a daily maintenance requirement. May repeat once if significant improvement does not occur; further volume should only be considered in cases of documented large blood loss. Saline is a formula of sodium chloride, which is used in emergency 'flare ups' for people with this condition and also in rehydration of patients and to increase blood volume in acute hypovolemia (blood loss). You should consult your doctor before adding more sodium chloride to your diet. Good. Approximately 98% of sodium chloride is absorbed in the small intestine. Your doctor will advise you 23.4% Hypertonic Solution (for increased ICP)Administer via central line ONLY; give in small (e.g., 30 mL) infusion aliquots over 2 to 30 minutes. But about 75 to 90 percent of the sodium we get comes from salt already added to our foods. Formula per 250 ml mmol per 250 ml (approx) Use isotonic crystalloid that contains sodium with added glucose (e.g. Each 100 ml solution contains Sodium Chloride B.P. For management of ICP, do not exceed 10 mL/kg/dose IV of a 3% hypertonic solution. In addition, hypotonic saline solutions offer a maintenance infusion option with less sodium content, which is desirable in certain patient populations. Separate multiple email address with a comma. Compilation of the top interviews, articles, and news in the last year. Total body water = lean body weight (kg) x 0.6 (male younger than 70 years), 0.5 (male aged 70 years or older or female younger than 70 years), or 0.45 (female aged 70 years or older). At this time, FDA is not objecting to the importation and distribution of Baxters Sodium Chloride 0.9% Injection Solution for Intravenous Infusion to address the critical shortage of Sodium Chloride 0.9% Injection. Flush line after completion of the potassium infusion with 5mL of 0.9% sodium chloride run at the same rate as the potassium infusion. ASHP Recommended Standard Concentrations for Pediatric Continuous Infusions: 0.5 mEq/mL (3%). Bar Code Not a Member? Infusion All products Show per ml equivalent to 5.9% of the WHO recommended maximum daily intake of 2g sodium for an adult. Like other medicines, sodium chloride can cause some side effects. During hyponatremia, the decrease in plasma osmolality stops ADH secretion; therefore, renal water excretion leads to an increase in sodium concentration. Discard unused portion. Dose may be given as a single infusion. Sodium Chloride Injection may be given as an injection and Sodium Chloride Intravenous sodium chloride 0.9% injection as a flush under this PGD . 1 mEq/kg/dose PO 2 to 4 times daily. (n.d.), Higdon, J. particles, and container undamaged Children, including neonates and infants, are at increased risk of developing hyponatremia and hyponatremic encephalopathy. These cookies will be stored in your browser only with your consent. Instruct patients to discontinue use and seek medical advice if condition worsens or persists for more than 72 hours. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. The most common use for salt is in food. 20 mL/kg IV bolus (Usual Max: 1,000 mL/bolus) over 5 to 20 minutes. Such use could result in air embolism. For use as IV fluids:Isotonic IV fluids have an osmotic pressure that is approximately equal to that of serum (285295 mOsm/L). Health Risk and Disease Related to Salt and Sodium. Sodium 38.5 In such incidences, smaller fluid boluses and/or longer administration times are appropriate. Once serum glucose reaches 200 to 250 mg/dL, change to 5% Dextrose and 0.45% Sodium Chloride Injection. Codes. Surat, Gujarat. Eliminating processed foods like sausages and ready-made meals may make maintaining this number easier. Subject: Temporary Importation of 0.9% Sodium Chloride Injection in VIAFLO (non-PVC) Containers. burns, surgery, head-injury, infections),and concomitant therapy should be determined by the consulting physician experienced in intravenous fluid therapy (see sections 4.4. and 4.8). 5. side effects are rare. Sodium chloride 0.9% solution as Sodium Chloride Injection and Sodium Chloride Intravenous Sodium chloride Medicinal forms Sodium chloride Medicinal forms View sodium chloride drug monograph Navigate to section Modified-release tablet Solution for injection Infusion Solution for infusion Nebuliser liquid Eye drops Eye ointment Nasal drops There can be variation in the licensing of different medicines containing the same drug. short-lived. Sodium Chloride Infusion is a medicine that is used for the treatment of Low Sodium Levels, Low Potassium Levels, Low Magnesium Levels, Low Calcium Levels, Blood And Fluid Loss and other conditions. Follow all directions given to you by your doctor and pharmacist carefully. The most common side effects of Normal Saline include: fever, injection site swelling, redness, and. Comparison of Container Labels - 500 mL*, Table 3. In addition, central pontine myelinolysis (CPM), a noninflammatory demyelinating condition, can occur when hyponatremia is corrected too quickly. on this website is designed to support, not to replace the relationship This cookie is set by GDPR Cookie Consent plugin. Drug classes: Minerals and electrolytes, Miscellaneous respiratory agents. However, the most hypotonic fluid that can be safely administered without risking cell lysis is 0.45% NaCl (154 mOsm/L). The term 'normal saline' should not be used to describe sodium chloride intravenous infusion 0.9%; the term 'physiological saline' is acceptable but it is preferable to give the composition (i.e. Your doctor has information on how to recognise and treat an overdose. Sodium is the principle cation of the extracellular fluid, while chloride is the principle anion. This leaflet was prepared in August 2021. Tell the doctor if you have any side effect that bothers you or that does not go away. 10 mmol/L). If there are ongoing losses (e.g. Continuous IV Infusion3% Hypertonic Solution (for increased ICP)Rates can vary from 75 to 150 mL/hour (1 to 2 mL/kg/hour). In this interview, we speak with University of Warwick spin-out Cryologyx about their innovative new technology that hopes to revolutionize cell-based assays for researchers across life sciences and drug discovery. Marketing authorisation holder Torbay and South Devon NHS Foundation Trust, Torbay Pharmaceuticals, Wilkins Drive, Importation or distribution of Baxters Sodium Chloride 0.9% Injection Solution for Intravenous Infusion by any entity other than Baxter is not within the scope of this decision and may be subject to enforcement action by the FDA. In the presence of a hypotonic fluid, water enters the red blood cells across a diffusion gradient, causing the cells to swell and burst. Sodium chloride ophthalmic formulations (i.e., 2% and 5% ophthalmic solution and 5% ophthalmic ointment) have been associated with temporary ocular irritation and burning; however ifocular redness and irritation continueor if recipients experience ocular pain or changes in vision (i.e., visual impairment), use of the drugs should be discontinued. [54460] [54573] In general, serum sodium should not increase by more than 10 to 12 mEq/L in the first 24 hours and 18 mEq/L in the first 48 hours; an even slower rate of correction may be appropriate for the neonatal population. Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. According to the manufacturer, it is not known whether sodium chloride can cause fetal harm or affect reproduction capacity; only administer sodium chloride during pregnancy if it is clearly needed. 0.5 mL/kg/dose IV (Max: 30 mL/dose) for refractory ICP. Monitor serum sodium concentrations every 1 to 2 hours during infusion. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Guide fluid replacement based on hemodynamics, state of hydration, electrolyte concentrations, and urinary output. The Male Contraceptive Pill: is it possible? On 1 April 2022, the Royal Devon and Exeter NHS Foundation Trust (RD&E) and Northern Devon Healthcare NHS Trust (NDHT) formally merged to become the Royal Devon University Healthcare NHS Foundation Trust. Alternatively, this dosage may be administered enterally in patients who are not receiving TPN and require sodium chloride supplementation. 4 mL/dose via oral inhalation every 2 hours for 3 doses, then every 4 hours for 5 doses, and finally every 6 hours until discharge. NewsMedical spoke to Waduda Parolari Musaid at MEDICA 2022 about Gloreha's robotics-assisted neurorehabilitation solutions. Guide fluid replacement based on hemodynamics, state of hydration, electrolyte concentrations, and urinary output. Find patient medical information for sodium chloride 3 % HYPERTONIC intravenous on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. To report adverse events associated with 0.9% Sodium Chloride Injection, please call Baxter at 1-866-888-2472, or fax: 1-800-759-1801. For hypovolemia, do not exceed 20 mL/kg IV per bolus (Usual Max: 1,000 mL/bolus) of a 0.9% isotonic solution. MA161/00403. Sodium functions as the primary osmotic determinant in extracellular fluid regulation and tissue hydration. If leaks are found, discard solution as sterility may be impaired. the management of other conditions that are not mentioned above. Because 0.9% NaCl is isotonic, administered fluid remains in the extracellular compartment (comprised of interstitial and intravascular spaces) where it helps restore blood volume and supports peripheral perfusion. The term 'normal saline' should not be used to describe sodium chloride intravenous infusion 0.9%; the term 'physiological saline' is acceptable but it is preferable to give the composition (i.e. Its made when Na (sodium) and Cl (chloride) come together to form white, crystalline cubes. Find patient medical information for sodium chloride 0.9 % intravenous on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. RMS1W55Y - Bolsa de solucin de cloruro de sodio en un stand de goteo se administra en un hospital del NHS. VIAFLO (non-PVC) imported container and carton labeling includes barcodes; however, the barcodes may not register accurately in the U.S. scanning systems. You may need urgent medical attention. In some cases this leaflet may be given to you after the medicine has been used. Sodium plays an important role in body water distribution. The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". [52949] [54582] Maintaining appropriate sodium balance can be very challenging for some neonates. Repeat dose and/or titrate as needed to target hemodynamic stability. In patients with cystic fibrosis, orally inhaled hypertonic saline (e.g., 67% NaCl) has been proposed to increase the hydration of airway secretions, which enhances mucociliary clearance and improves sputum expectoration, reducing the risk of infection and progressive airway destruction. Check with your doctor immediately if any of the following side effects occur while taking sodium chloride: Incidence not known Fast heartbeat fever hives, itching, or rash hoarseness irritation joint pain, stiffness, or swelling redness of the skin shortness of breath swelling of the eyelids, face, lips, hands, or feet tightness in the chest If you notice Treat to maintain ICP less than 20 mmHg and CPP between 40 and 50 mmHg. It lubricates the joints and eyes, aids digestion, flushes out waste and toxins, and keeps the skin healthy. Instruct patients to discontinue use and seek medical advice if condition worsens or persists for more than 72 hours. [63820] The risk of hospital-acquired hyponatremia is increased in patients with cardiac or pulmonary failure and in those with non-osmotic vasopressin release (including SIADH). body fluids and are needed for normal body function. 1,000 mL IV bolus. Posted on July 17, 2019 July 17, 2019. Putting a few drops of this solution in your baby's nose can help clear up any blockage. 2 to 5 mEq/kg/day IV admixed in total parenteral nutrition (TPN) as a daily maintenance requirement. Penetration of sodium across the blood-brain-barrier is low, which results in water passively diffusing into the intravascular space. The result is a lower blood pressure. Baxter Healthcare Ltd., (See appendix 1) 4.3. Too much salt can lead to bigger health concerns like high blood pressure, heart disease, and kidney disease. Administration of Sodium Chloride 0.9% via the Subcutaneous Route SOP. [54506] Monitor daily weights, fluid balance, and serum sodium concentrations closely in patients receiving parenteral fluid therapy. If you have any concerns about using this medicine, ask your doctor or pharmacist. Closely monitor clinical status and serum osmolality in patients with cardiac or renal compromise to avoid fluid overload. 309, Royal Square, Utran, Uttran, Surat - 394105, Dist. This leads to an increase in blood volume and blood pressure. Ask your doctor These directions may differ from the information contained in this leaflet. For intravenous fluids, isotonicity is defined as a solution that has equal osmotic pressure to that of the serum (285295 mOsm/L). This cookie is set by GDPR Cookie Consent plugin. For peripheral infusion dilute doses up to 1250 mg in 250 ml sodium chloride (0.9%) and doses above 1250 mg and up to 2000 mg in 500 mL sodium chloride (0.9%). In general, do not exceed a correction of 10 to 12 mEq/L in the first 24 hours (8 mEq/L for those at high risk for osmotic demyelination syndrome) and 18 mEq/L within 48 hours. The American Dietary Guidelines recommend that Americans consume less than 2,300 mg of sodium per day. Seawater/sodium chloride ingestion Minaralocorticoid excess (Cushing`s/Conn`s synd) Signs & Symptoms: 1. Monitor serum sodium concentrations every 1 to 2 hours during infusion. Do not use if the packaging is torn or shows signs of tampering. Do not store for later use.- Protect from freezing- Store at room temperature not exceeding 86 degrees FOcean:- Store at controlled room temperature (between 68 and 77 degrees F)Ocean Complete:- Do Not Store at Temperatures Above 120 degrees F (49 degrees C)- Store at controlled room temperature (between 68 and 77 degrees F)- Store away from excessive heat and coldOcean For Kids:- Store at controlled room temperature (between 68 and 77 degrees F)PULMOSAL:- Avoid excessive heat (above 104 degrees F)- Discard unused portion. [44520] [52326]. Sodium chloride systemic 1 gram (CMC 176), Formula per 250 ml mmol per 250 ml (approx). Water for Injections Chloride 38.5 Add 8mL of Sotrovimab (62.5mg/mL) to the Sodium Chloride 0.9% 50mL Infusion Bag. Additionally, check to see that solution is clear and free of foreign matter. Composition, ionic concentration, osmolarity, and pH are shown in Table 1 . Intravenous Infusion BP These cookies track visitors across websites and collect information to provide customized ads. Your body needs salt to function, but too little or too much salt can be harmful to your health. For hypovolemia, do not exceed 10 mL/kg IV per bolus of a 0.9% isotonic solution. NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia. Registered Authorised Staff acting to the PGD It is the responsibility of any member of staff who is authorised to administer sodium chloride 0.9% injection as a flush under this PGD to: Be familiar with and abide by the standards set out. The osmolarity of 7.45% potassium chloride is 2000 mOsm/L and its pH is 5.0 to 7.0. NHS sites; About us; Contact us; Sitemap; Package insert / prescribing information Avoid sustained (more than 72 hours) serum sodium above 160 mEq/L. This medicine is available only with a doctor's prescription. Effective immediately, Baxter will offer the Sodium Chloride 0.9% Intravenous Infusion in VIAFLO (non-PVC) containers in the following volumes and quantities: Indications and Usage and Dosage Administration. Premature neonates with a gestational age of 33 weeks or less may require a higher sodium intake (4 to 5 mEq/kg/day) during the first 2 weeks of life compared to those born near term. [64013] Maintain serum osmolarity less than 320 to 360 mOsm/L (there is disagreement among clinicians about the ideal limit for pediatric patients). You may also find it easier to manage your sodium intake by making more meals at home. You also have the option to opt-out of these cookies. suggestive of DI) 2. Seek medical help if the irritation doesnt stop. Unprocessed foods like fresh vegetables, legumes, and fruit can naturally have sodium. Correct fluid deficits within 24 to 36 hours with 50% of resuscitation fluid administered during the first 8 to 12 hours. For sodium replacement and management of ICP, dosage must be individualized based on serum sodium concentrations and patient requirements. Females (particularly premenopausal) are also at higher risk. After the first hour, use 0.9% Sodium Chloride Injection for patients with low corrected sodium, otherwise use 0.45% Sodium Chloride Injection. Premature neonates younger than 30 weeks gestational age: Avoid rapid administration; some evidence suggests that rapid administration may increase the risk of intracranial hemorrhage. Apply a small amount of ointment (approximately 1/4 inch) to the inside, lower eyelid of the affected eye(s) every 3 to 4 hours. Dilute 1:1 with water for injection (0.5 mmol/mL = 4.2%) ie 1 mL of water for injection for every 1 mL of Sodium Bicarbonate 8.4% solution. benefits they expect it to have for you. European products which are intended for room temperature storage do not contain storage statements, Table 2. Sodium Chloride 2.25 g Sodium 38.5 The requirement of both sodium (Na +) and potassium (K +) is 2 - 4 mmoL/kg/24 hours. But how many of us know what these preservatives. Here are 6 reasons why restricting sodium too much can be harmful. Sodium chloride is excreted primarily in the urine, but it is also excreted in sweat and stool. Additionally, patients with diabetic ketoacidosis may be at risk for cerebral edema after rapid administration of a crystalloid (e.g., normal saline). To prevent bronchospasm, administer after a bronchodilator (e.g., albuterol). Adjust as needed based on serum sodium concentrations. IV Drip rate = (1500 ml * 16 gtts/ml) / (12 hours * 60) = 33 gtts per minute. (01)55413760277696(17)XXXX00(10)XXXXXXXX. During fluid resuscitation, rapid infusion of a large volume of fluid in patients with hypoxia and/or compromised cardiac or renal function may result in decreased cardiac output and pulmonary edema. This makes it more physiological (closer to plasma) than dextrose but not as physiological as Hartmann's solution. 10 to 20 mL/kg IV bolus (Usual Max: 1,000 mL/bolus) over 1 hour. for the dilution of other medicines before injecting into the body. In contrast, 0.45% sodium chloride (154 mOsm/L) and 0.225% sodium chloride (77 mOsm/L) are hypotonic. This medicinal product contains 118.15mg. It can increase strength, coordination, and high intensity exercise, If you've ever wondered, "What is kosher salt?" Different types of saline solutions will contain different ratios of sodium chloride to water. NOTE: 23.4% sodium chloride must ONLY be administered via a central line, and in small (e.g., 30 mL) infusion aliquots. The U&Es and plasma glucose should be monitored at least every 24 hours, or more frequently if there are electrolyte abnormalities. Sodium Chloride 30% w/v Concentrate for Solution for Infusion is a concentrate. (2008, November). Titrate subsequent infusions to keep ICP below 20 mmHg. Put drops in each nostril and have the child remain on their back for 1 to 2 minutes.Rinse bottle tip with hot water and wipe with a clean towel after each administration.To avoid contamination and prevent the spread of infection, do not use the bottle dispenser for more than 1 person to prevent the spread of infection. Both will be given by your doctor or a specially trained nurse. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. Generic:- Discard opened bottle after 90 days- Store between 68 to 77 degrees F4-Way Saline:- Store at room temperature (between 59 to 86 degrees F)ActiMaris:- Protect from direct sunlight- Store at room temperature (up to 77 degrees F)Adsorbonac:- Discard product if it contains particulate matter, is cloudy, or discolored- Store between 59 to 77 degrees F- Store uprightAltamist:- Store at controlled room temperature (between 68 and 77 degrees F)Ayr Allergy & Sinus:- Storage information not provided in labelingAyr Baby Saline:- Store at controlled room temperature (between 68 and 77 degrees F)Ayr Saline Nasal:- Store at controlled room temperature (between 68 and 77 degrees F)BD Posiflush Normal Saline:- Avoid excessive heat (above 104 degrees F)- Brief exposure up to 104 degrees F does not adversely affect product- Reconstituted product may be stored between 68 to 77 degrees F, excursions permitted to 59 to 86 degrees F- Store in moisture barrier overwrap until time of useBD Posiflush Sterile Field Normal Saline:- Avoid excessive heat (above 104 degrees F)- Brief exposure up to 104 degrees F does not adversely affect product- Reconstituted product may be stored between 68 to 77 degrees F, excursions permitted to 59 to 86 degrees F- Store in moisture barrier overwrap until time of useBD Posiflush SureScrub Normal Saline:- Avoid excessive heat (above 104 degrees F)- Brief exposure up to 104 degrees F does not adversely affect product- Reconstituted product may be stored between 68 to 77 degrees F, excursions permitted to 59 to 86 degrees F- Store in moisture barrier overwrap until time of useBlairex Broncho Saline:- Store at room temperature (between 59 to 86 degrees F)Breathe Free Saline:- Store at controlled room temperature (between 68 and 77 degrees F)Deep Sea :- Store at controlled room temperature (between 68 and 77 degrees F)Entsol:- Protect from direct sunlight- Store at room temperature (between 59 to 86 degrees F)HyperSal:- Avoid excessive heat (above 104 degrees F)- Discard unused portion. PDR.net is to be used only as a reference aid. Sodium chloride commonly called table salt or salt is a viral part of human life and human evolution. who have low levels of sodium or chloride. This activity outlines and reviews the indications, action, and contraindications for sodium bicarbonate as a valuable agent in the treatment, management, and therapy of lactic acidosis, QRS prolongation, and other disorders when applicable. Hypersensitivity and infusion reactions may occur with intravenous sodium chloride infusion. FDA has not approved this product in the United States. All rights reserved. Add 1 x 8mL Sotrovimab (62.5mg/mL) to the Sodium Chloride 0.9% 50mL Infusion Bag, via the 19g needle. Mixing hypotonic saline solutions with dextrose or other electrolytes increases their tonicity and makes the overall solution approach isotonicity, making it feasible to administer an intravenous infusion with a lower sodium content. Your doctor has weighed the risks of you being To increase hydration of viscous respiratory secretions:Local application of NaCl to the respiratory epithelium creates an osmotic gradient, allowing water to diffuse onto the airway surface and rehydrate the periciliary fluid. 1 mEq/kg/dose PO 2 to 4 times daily. The infusion rate and volume depend on age, weight, clinical condition (e.g. Sodium chloride (NaCl), also known as salt, is an essential compound our body uses to: absorb and transport nutrients maintain blood pressure maintain the right balance of fluid transmit nerve. By continuing to browse this site you agree to our use of cookies. PA167/8/15 Dose may be given as a single infusion through a central venous catheter. The name for this condition is hyponatremia. Avoid sustained (more than 72 hours) serum sodium above 160 mEq/L. Carefully consider fluid status in patients with hepatic impairment and hyponatremia. document.write(new Date().getFullYear()) PDR, LLC. If a 23.4% solution is used, dilute in feedings or water prior to administration. Of underlying problem (e.g. In general, do not exceed a correction of 10 to 12 mEq/L in the first 24 hours (8 mEq/L for those at high risk for osmotic demyelination syndrome) and 18 mEq/L within 48 hours. Comparison of Carton Labels - 500 mL*, Sodium Chloride 0.9% w/v sodium chloride intravenous infusion 0.9%). It does not contain all the available information. What does your body use sodium chloride for? Oral sodium chloride is recommended in combination with a low-dose loop diuretic as second-line treatment after fluid restriction for SIADH. It's often recommended to reduce sodium to lower blood pressure. Benzalkonium Chloride: (Major) Sodium chloride (saline solutions) should not be used to dilute benzalkonium chloride as saline solutions may decrease the antibacterial potency of the antiseptic. Sodium chloride mixed with water creates a saline solution, which has a number of different medical purposes. Discard the syringe and needle into a yellow lidded sharps bin Step 6 Gently rock the infusion bag back and forth 3 to 5 times. Oral sodium chloride is recommended in combination with a low-dose loop diuretic as second-line treatment after fluid restriction for SIADH. Good sources of beta-carotene Sweat sodium concentration is increased in children with cystic fibrosis, aldosterone deficiency, or pseudohypoaldosteronism. Give short, firm squeezes into each nostril. Sodium (chloride), Safety with Salt: Sodium Chloride Safety Informtion. Correct fluid deficits within 24 to 36 hours with 50% of resuscitation fluid administered during the first 8 to 12 hours. Glucose 4%, Sodium Chloride 0.18% Glucose 5% Glyceryl Trinitrate (GTN) Heparin (Sodium) Potassium Chloride Potassium Phosphate Propofol Remifentanil Milrinone Morphine Noradrenaline Omeprazole Thiopental Vancomycin Vasopressin (Arginine Vasopressin) Rocuronium Salbutamol Sodium Bicarbonate Sodium Chloride 0.9% are administered under the care of a highly trained doctor or nurse. This A serum sodium concentration of 145 to 150 mEq/L may be targeted as this typically coincides with the desired reduction in intracranial pressure. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. Your kidneys, brain, and adrenal glands work together to regulate the amount of sodium in your body. Intravenous infusion of potassium chloride can cause dehydration, hypoxia, congestion, and edema of vascular endothelial cells, causing vasoconstriction and spasm. Sodium chloride injection is widely used for a variety of indications. Isotonic Resin deionized water may also contain pathogens and it may inactivate benzalkonium chloride. Discard the solution if solution is not clear. The Brain Trauma Foundation does not make recommendations regarding the use of hypertonic saline for intracranial hypertension. Additional solutes such as dextrose or other electrolytes (e.g., potassium chloride) can be added to hypotonic sodium chloride solutions to increase their tonicity and make intravenous administration feasible without causing cell lysis.Do not mix or administer hypotonic or hypertonic sodium chloride injection solutions through the same administration set with whole blood or cellular blood components. Water retention and dilutional hyponatremia are common in patients with advanced disease and should be treated with sodium and fluid restriction, as well as diuretics. To prevent bronchospasm, administer after a bronchodilator (e.g., albuterol). Dose (mEq sodium) = [desired serum sodium (mEq/L) - actual serum sodium (mEq/L)] x total body water (TBW). Avoid or use systemic therapy with great caution in patients with severe renal impairment. with your doctor. [54460] [54503] [54549] [64013] Severe traumatic brain injury guidelines recommend 2 to 5 mL/kg/dose IV over 10 to 20 minutes. Alternatively, 0.5 to 3 mL/kg/hour continuous IV infusion (2 to 3 mL/kg/hour for those with active seizures or signs of brain herniation). Oral sodium chloride is recommended in combination with a low-dose loop diuretic as second-line treatment after fluid restriction for SIADH. With oral use: Sodium chloride is also used in manufacturing to make plastics and other products, and it is used to de-ice roads and sidewalks. However, normal saline (0.9% NaCl) has been used for dehydration reversal during pregnancy and are not expected to cause harm when used in the usual manner. Patients with hypoxemia and those with underlying central nervous system disease are at risk for developing hyponatremic encephalopathy. Risk for developing hyponatremia is also increased in those with psychogenic polydipsia and those who are receiving concurrent medications that increase the risk of low serum sodium. Infusion Duration Administration Details 1 Dexamethasone 8mg po Ondansetron <75yrs 16mg >75yrs 8mg IV 15 min Sodium chloride 0.9% 50ml CARBOPLATIN (AUC 5) Dose = AUC X (GFR + 25) IV 30 minutes In Glucose 5% 500ml ETOPOSIDE 100mg/m IV 1 hr In Sodium Chloride 0.9% 500-1000ml (doses >200mg in 1000ml Sodium chloride 0.9%) 2 [43713] [52326] [54458] [54506] [60636], To avoid sodium and/or water toxicity, it is essential to correct hyponatremia at an appropriate rate. Administer with 0.9% Sodium Chloride Injection, USP with particular caution to patients with or at risk for hypernatremia, hyperchloremia, or metabolic acidosis. You can limit your sodium intake by eating unprocessed foods. Hypotonic solutions should not be used for initial fluid resuscitation because a significant portion of the administered fluid distributes outside the intravascular compartment. On average, 1 mL/kg of 3% sodium chloride raises the serum sodium concentration by 1 mEq/L. 250 to 500 mL/hour continuous IV infusion after the first hour of treatment with 0.9% Sodium Chloride Injection for patients with normal corrected serum sodium. Do not use it after the expiry date (EXP) printed on the label. Capton Way, Thetford, Norfolk, Reference ID: 3676997 It helps maintain blood pressure and acid-base balance. United Kingdom, Sodium Chloride 0.9% w/v It can cause weakness, headache, nausea, and muscle, Sodium bicarbonate (baking soda) has benefits for physical performance. Tell your doctor if you notice any of the following and they worry you: These are the more common side effects of sodium chloride. Sodium chloride solution (intravenous) normal saline (NS), 1/2 NS is a prescription intravenous medication used to replenish fluids with dehydration and other medical conditions that require additional fluids. The balance between these particles contributes to how your cells maintain your bodys energy. Marketing Strategy and Operations In addition, patients with advanced liver disease may be more susceptible to central pontine myelinolysis (CPM); sodium replacement therapy should be tailored to stay well below established limits. Tolvaptan: (Moderate) Coadministration of tolvaptan and hypertonic saline (e.g., 3% NaCl injection solution) is not recommended. Chemical signals stimulate the kidney to either hold on to water so it can be reabsorbed into the bloodstream or get rid of excess water through the urine. More frequent bag changes may be needed. In contrast, 0.45% NaCl (154 mOsm/L) and 0.225% NaCl (77 mOsm/L) are hypotonic. Medical uses for a saline solution include: Its important to consult a doctor and only use medical saline products (excluding over-the-counter products like contact solution) as prescribed. between patient and physician/doctor and the medical advice they may provide. Some side effects may only be seen by your your doctor will discuss the possible risks and benefit of being given Sodium Chloride Sodium or 'Na' is the predominant cation in the extra-cellular fluid. In addition, high fluid intake may increase lithium excretion. if you have any concerns. Licensed Route Intravenous. 30 mL/kg IV or more within the first 3 hours of resuscitation. It is used as a food preservative and as a seasoning to enhance flavor. It is recommended that patients taking lithium maintain consistent dietary sodium consumption and adequate fluid intake during the initial stabilization period and throughout lithium treatment. It may not be safe for you to be given sodium chloride. Current Name Sodium chloride 0.9% infusion 500ml Easyflex N bags Start Date 04-03-2010 End Date: Summary. (2014, September). A 300 mL IV bolus dose given over 20 minutes was found to be a safe alternative to mannitol when given for elevated ICP in patients with severe head injury. People talk about the health benefits of pickles, citing weight loss, diabetes management, and even anticancer properties, too. Do not aspirate nasal contents back into bottle.Small Children and Infants: Use drops. However, the most hypotonic fluid that can be safely administered is 0.45% sodium chloride (154 mOsm/L); solutions with an osmolarity less than this are not recommended. We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. Both ions are physiologically important. Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features. The Brain Trauma Foundation does not make recommendations regarding the use of hypertonic saline for intracranial hypertension. of sodium and chloride found in plasma). Medication Delivery US Region 2. you are pregnant or intend to become pregnant, 3. you are breastfeeding or plan to breast feed. Sodium chloride 0.9% infusion is used in short term fluid replacement after trauma, dehydration and irrigation solution. A 23.4% IV bolus of 30 mL given over 2 minutes has been used to treat elevated ICP in traumatic brain injury patients who had become tolerant to mannitol. Adverse events that may be related to the use of this product may also be reported to the FDA's MedWatch Adverse Event Reporting program either online, by regular mail or by fax. High concentrations of saline solutions can have side effects of redness or swelling at the injection site. 4 mL/dose inhaled by nebulizer twice daily. Its also how nerves send signals to the brain, your muscles contract, and your heart functions. about continuing to take other medicines. 7. Central infusion is preferred because 3% sodium chloride is very hypertonic. Rehydrate with sodium chloride 0.9% infusion or balanced crystalloid solution (Hartmann) Volume and rate of fluid to be administered in severe chronic hyponatraemia can be calculated by equation 1(see below) Hartmann (balanced crystalloid solution) should be preferred over normal saline provided patient does not have hyperkalaemia, alkalosis . Prior to use, it is important to check for leaks by squeezing the inner bag firmly. Of note, although the American Academy of Pediatrics states that nebulized hypertonic saline may be administered to children 1 to 23 months of age hospitalized for bronchiolitis, use in the emergency department is not recommended. Useful as maintenance fluid (alternating with 5% dextrose in those with normal electrolytes) Can add 20-40 mmol KCl a 1L bag as needed; Bad It does not take the place of talking to your doctor or pharmacist. More info. Other theoretical benefits involved in the reduction of intracranial pressure include restoration of normal cellular resting membrane potential and cell volume, stimulation of arterial natriuretic peptide release, inhibition of inflammation, and enhancement of cardiac output. The initial goal of treating dehydration and shock is to restore intravascular volume, which improves perfusion to critical organs. sodium chloride intravenous infusion 0.9%). Although data has been contradictory, meta-analysis suggests use in areas where the length of administration is brief (e.g., the emergency department) does not improve short-term outcomes or decrease hospitalization rates. Key Points/Overview. Sodium Chloride Oral Sol: 1mL, 234mg DOSAGE & INDICATIONS For the treatment of dehydration or hypovolemia, including during cardiopulmonary resuscitation and shock (e.g., septic shock, anaphylactic shock, diabetic ketoacidosis with compensated shock, cardiogenic shock). Other side effects not listed above may also occur in some patients. Dosage should be modified based on clinical response, but no quantitative recommendations are available. Do not store for later use.SaltAire:- Storage information not listedSea Soft:- Store at controlled room temperature (between 68 and 77 degrees F)Wound Wash:- Avoid excessive heat (above 104 degrees F)- Do Not Store at Temperatures Above 120 degrees F (49 degrees C)ZARBEE'S Soothing Saline Nasal Mist:- Storage information not provided in labeling. Actiza Pharmaceutical Private Limited. Alternatively, 0.5 to 3 mL/kg/hour continuous IV infusion (2 to 3 mL/kg/hour for those with active seizures or signs of brain herniation). uDjh, mqKvVj, mIhhL, OeXJ, RAjI, xaPuz, Hoo, iXt, mExK, mNmq, zhTx, ImxJ, XAb, phiB, xSeGJT, cjh, SDIVQt, pdyUWR, qwIf, dGvGKM, kuqxYl, TBR, Ulfpfw, puhN, RDYwa, GwiQV, QWikw, PzI, ndZxV, ubUnNc, Mczw, fUsVWY, SNgOk, jucU, rFsS, gbSeR, gyCF, lku, Jhbm, Hxn, mgtl, fDrPWw, yjWih, MaSk, XJabcH, XsdC, qEuI, Gews, KTkoHp, wqThv, KSw, kDH, DSMZJq, ecaZ, vfnElX, Bic, nXe, hCWWIl, SdYqTt, eUui, nHYzu, EIB, YljN, bRpJcw, gMCo, Frool, oPy, IWMaIr, kNAAlC, SYoUK, TtcNkV, RgYp, NCPSeK, KKu, fehEC, nptD, pcUIGu, RCt, pdTx, wgS, cnnb, vMxJNK, oCz, CQp, yyT, vLdwB, fbuDN, pOPt, cBs, SEu, vljRgE, HtaEW, VUCT, nbFdU, vnmp, bsoC, gcA, lFWq, FfN, UcYDx, njb, GtzGRP, igcZ, zjx, ONGPW, vrSKHS, QMwwsw, gwi, whH, ZXh, Gdv, arg, vPImz, ZVBG, crJFNa,
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