Saunders Handbook of Veterinary Drugs by Mark G. Papich DVM MS DACVCP

Author:Mark G. Papich, DVM, MS, DACVCP
Language: eng
Format: mobi
ISBN: 9781437701920
Publisher: Saunders
Published: 2011-11-29T22:00:00+00:00

L

Lactated Ringer’s Solution

Trade and Other Names: LRS

Functional Classification: Fluid replacement

Pharmacology and Mechanism of Action

Lactated Ringer’s solution is a fluid solution for replacement intended for intravenous administration. Lactated Ringer’s solution contains a balanced combination of electrolytes and an alkalinizing buffer. This solution contains 28 mEq/L of lactate.

Indications and Clinical Uses

Lactated Ringer’s solution is indicated as a replacement or maintenance fluid. It also is used as a vehicle to deliver intravenous medications via constant rate infusion (CRI). It has been administered SQ, intraosseous (in bone medullary cavity), and intraperitoneal (IP) in animals when intravenous access is not possible. It contains lactate, a metabolizable base, but will not correct acidosis as quickly as bicarbonate. Severely acidemic animals may already have high lactate serum levels.

Precautionary Information

Adverse Reactions and Side Effects

No significant adverse effects.

Contraindications and Precautions

Administer intravenous fluids only in patients monitored carefully.

Drug Interactions

Lactated Ringer’s solution has a pH of 6-7.5. Do not add medications to this solution if they are unstable at this pH. Lactated Ringer’s contains calcium. Do not add drugs to this solution that may bind (chelate) to calcium.

Instructions for Use

Fluid requirements vary depending on animal’s needs (replacement vs. maintenance). For shock therapy, administer one-half the calculated dose in the first 30 minutes and in 10-mL/kg increments every 15 minutes, followed by a CRI. For severe acidemia, consider fluids supplemented with bicarbonate instead of lactate.

Patient Monitoring and Laboratory Tests

Monitor patient’s hydration status and electrolyte balance. With high administration rates, monitor patient for signs of pulmonary edema.

Formulations

Lactated Ringer’s solution is available in 250-, 500-, and 1000-mL fluid bags.

Stability and Storage

Store in a tightly sealed container. If container has been punctured or transferred to another container, sterility cannot be assured.

Small Animal Dosage

Dogs and Cats

• Moderate dehydration: 15-30 mL/kg/hr IV.

• Severe dehydration: 50 mL/kg/hr IV

• Maintenance: 55-65 mL/kg/day IV, SQ, or IP (2.5 mL/kg/hr).

• During anesthesia: 10-15 mL/kg/hr IV.

• Shock therapy: (for dogs) 90 mL/kg IV and (for cats) 60-70 mL/kg IV.

Large Animal Dosage

Cattle, Horses, and Pigs

• Maintenance: 40-50 mL/kg/day IV.

• Moderate dehydration: 15-30 mL/kg/hr IV.

• Severe dehydration: 50 mL/kg/hr IV.

Calves and Foals

• Moderate dehydration: 45 mL/kg at a rate of 30-40 mL/kg/hr IV.

• Severe dehydration: 80-90 mL/kg at a rate of 30-40 mL/kg/hr IV. In severe cases it may be given as rapidly as 80 mL/kg/hr.

Regulatory Information

There is no risk of harmful residues in animals intended for food. No withdrawal times are necessary.

Lactulose

lak′tyoo-lose

Trade and Other Names: Chronulac and generic brands

Functional Classification: Laxative

Pharmacology and Mechanism of Action

Laxative. Lactulose is a disaccharide sugar containing one molecule of fructose and one molecule of galactose. Lactulose produces a laxative effect by osmotic effect in the colon. It is a nonabsorbed sugar and retains water in the intestine after oral administration via an osmotic effect. Lactulose also will decrease the pH of the intestinal lumen.

Indications and Clinical Uses

Lactulose is administered orally for treatment of hyperammonemia (hepatic encephalopathy) because it decreases blood ammonia concentrations via lowering the pH of the colon; thus ammonia in the colon is not as readily absorbed. Lactulose also is administered orally to produce a laxative effect for treatment of constipation.

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