ELECTROLYTE SOLUTIONS

INTRODUCTION
Electrolytes in human body fluids are prominent in
maintaining acid-base balance in body.
Electrolytes help regulate metabolism in the body and
control volume of water in the body.

Dissociate Electrolytes NaCl Na+ Cl-

Cation Anion

Donot Non
Molecules Compound Electrolytes Urea, Dextrose
Dissociate
BODY FLUIDS - 60% BODY WEIGHT
WATER IS LARGEST
SINGLE COMPONENT
Dec. to 45-50 % body
weight in elderly
Variations occur based
on age, gender & amt.
of body fat
80% neonate is water*
 MAJOR COMPARTMENTS FOR FLUIDS

INTRACELLULAR EXTRACELLULAR
FLUID (ICF) FLUID (ECF)
Inside cell Outside cell

Most of body fluid Intravascular fluid -

here - 40% weight within blood vessels (5%)
Decreased in elderly Interstitial fluid -
between cells & blood
vessels (15%)
Transcellular fluid -
cerebrospinal, pericardial ,
synovial
 ELECTROLYTES

Substance when dissolved in solution separates

into ions & is able to carry an electrical current
CATION - positively charged electrolyte

ANION - negatively charged electrolyte

# Cations must = # Anions for homeostatsis to

exist in each fluid compartment
Commonly measured in milliequivalents / liter
(mEq/L)
PHARMACEUTICAL APPLICATION
Various electrolyte ions in the human blood are

Cations Na+, K+, Ca++, Mg++

Anions Cl-, HCO3-, HPO4- -, SO4- -

Electrolyte Preparations employed to treat fluid and

electrolyte imbalance in the body.
Available as oral solutions, syrups, dry granules to be
dissolved in water/juice, capsules, tablets and also
intravenous infusions.
MILLIEQUIVALENTS - SIGNIFICANCE
Most exclusively employed unit by pharmacists, physicians,
manufacturers and clinicians across USA to express
electrolyte concentration in solution is Milliequivalents
(mEq)
Internationally (European and many other nations), molar
concentration (mmol/L or mol/L) are employed.

Atomic / Formula /
Equivalent Molecular weight
= --------------------------------
Weight
Valence

A mEq represents amount in milligrams taking into account

valence of the ions.
A mEq expresses the chemical activity / combining power
of a substance relative to the activity of 1 mg of hydrogen.
Converting milligrams to milliequivalents
The following formula can be employed:

Atomic/formula/molecular weight
= Equivalent Weight
Valence
mg Valence
mEq =
Atomic/formula/molecular weight

Problem:
Given the molecular weight of calcium is 40, Represent 10
mg of calcium as mEq? Also, how many mg will be there in
1 mEq of calcium?
Solution

mg Valence
mEq =
Atomic/formula/molecular weight

10 2
mEq =
40

10 mg of calcium = 0.5 mEq

1 mEq will contain --- 10 / 0.5 = 20 mg of calcium
 To convert milliequivalents to milligrams
mEq Atomic/formula/molecular weight
mg =
Valence

Convert 8 mEq of potassium to mg?

8 39
mg = = 312
1

Majority of electrolyte substitutes are available in liquid

form. The concentration of electrolytes in i.v. infusion
fluids is represented as mEq/L
To convert mEq/mL to mg/mL

mEq/mL Atomic/formula/molecular weight

mg/mL =
Valence

Calculate the concentration in mg/mL, of a solution

containing 3 mEq of Kcl per mL?
 3 74.5
mg/mL =
1
= 223.5 mg/mL
What is the concentration in g/mL of a solution containing 4
mEq of Calcium chloride / mL?

Calcium chloride = CaCl2.2H2O

Molecular weight = 147
Eq. Wt = 147 / 2 = 73.5

mg/mL = 4 73.5 = 294 mg/mL = 0.294 g/mL

Estimation of % w/v from mEq
What is the % w/v conc. of a 100 mEq/L solution of
NH4Cl?
M.W of NH4Cl = 53.5
Eq. Wt of NH4Cl = 53.5
1 mEq of NH4Cl = 53.5g/1000 = 0.0535 mg

100 mEq of NH4Cl = 5.35 g/L or 0.535 g/100 mL

= 0.535%
Problem
A solution has 10 mg / 100 mL of K+ ions. Express the
concentration in mEq/Lit?

mEq/mL Atomic/formula/molecular weight

mg/mL =
Valence

mEq/mL 39
100 =
1

mEq/mL = 2.56 mEq/L

 A solution contains 10 mg/100 mL of Ca++ ions. Express
the concentration in mEq/Lit

10 mg/100 mL == 100 mg / Lit

 A mg++ ion level in plasma is found to be 2.5 mEq/L.
Express the conc. in mg?
 Model Problem Solve Imp*
How many mEq of Kcl is present in a 15 mL dose of a
10% w/v Kcl elixir?
Solution
M.W of Kcl = Eq.Wt of Kcl = 74.5
1 mEq of Kcl = 74.5/1000 = 0.0745 g = 74.5 mg

15 ml dose of 10% w/v elixir formulation = 1.5 g of Kcl

74.5 mg ---- 1 mEq

1500 mg ---- ?

Ans: 20.1 mEq

Model Problem Solve Imp*

Calculate the mEq of Na+ present in 30 ml of following

solution?
Disodium Hydrogen Phosphate 18g
(Na2HPO4.7H2O - 268)
Sodium Biphosphate 48 g
(NaH2PO4.H2O - 138)
Purified Water 100 mL
Solution
Eq.Wt - (Na2HPO4.7H2O - 268) 268/2 134

18 g / x g = 100 mL / 30 mL
x = 5.4 g / 30 mL
1 mEq 134 mg
mEq of Na2HPO4.7H2O 40.3
Eq.Wt - (NaH2PO4.H2O - 138) 138

mEq of NaH2PO4.H2O 104.3

Total mEq of Na+ -- 144.6
Clinical Application Model Problem
A person will receive 2 mEq of NaCl / kg of body weight.
He weighs 132 lb. Calculate the ml of 0.9% sterile NaCl
that should be administered?
Solution
M.Wt / Eq. Wt of NaCl = 58.5
1 mEq of NaCl = 0.0585 g

2 mEq - 0.117 g

Wt in Kg 132 / 2.2 60 kg

Drug is administered at 2 mEq (0.117 g) / kg

Total amt of drug in body 0.117 * 60 - 7.02 g of NaCl

0.9% sterile NaCl solution has 9 g of NaCl / Lit

9 g --------- 1000 ml
7.02g ---- ? = 780 mL
Millimoles and Micromoles

A mole is the molecular weight of substance in grams.

A millimole one thousandth of a mole
A micromole One millionth of a mole
SI expresses, electrolyte conc. in mmol/L

How many millimoles of monobasic sodium phosphate

is present in 100 gms of substance?
Solution
Mol.wt - (NaH2PO4.H2O - 138)
1 mole 138 g

100 g represent ---- 100/138 = 0.725 moles

= 725 mmoles
Model Problems
Calculate the weight in mg of 1 mmol of HPO4-
1 mole weighs --- Atomic weight -- 95.98 g
1 mmol of HPO4- weighs - 0.09598 g = 95.98 mg

Convert plasma levels of 0.5 g/mL of tobramycin (mw

467.52) to mol/L?

1 mol - 467.52 gms

1 mol - 467.52 g

0.5 g/1 ml * 1 mol/467.52 g * 1000 ml/1 L

= 1.07 mol/L
 OSMOSIS
Movement of the solvent or water across a
membrane
Involves solution or water

Equalizes the concentration of ions on each side

of membrane
Movement of solvent molecules across a
membrane to an area where there is a higher
concentration of solute that cannot pass through
the membrane
Osmolarity
Osmotic pressure is an important biologic parameter
which involves diffusion of solutes or the transfer of fluids
through semi permeable membranes.
Per US Pharmacopeia, knowledge of osmolar
concentrations of parenteral fluids is important.
Labels of pharmacopeia solutions providing intravenous
replenishment of fluids, nutrients, electrolytes and
osmotic diuretic mannitol are required to state osmolar
concentration.
Information provides the doctor to decide, if the solution
is, hypoosmotic, iso-osmotic or hyperosmotic with regard
to biological fluids and membranes
 Osmotic pressure is (total number of particles in
solution)
Unit of measurement is milliosmoles

For non-electrolytes like dextrose, 1 mmol represents 1

mosmol
However, with electrolytes, as total number of particles in
solution depends on degree of dissociation of a
substance.
For e.g. Assuming complete dissociation, 1 mmol NaCl
represents 2 mOsmol (Na+ + Cl-) of total particles
1 mmol of CaCl2 represents 3 mOsmol (Ca++ + 2Cl-)

1 mmol of sodium citrate (Na3C6H5O7) represents 4

mOsmol (3 Na+ + C6H5O7-) of total particles
 The milliosmolar value of the complete solution is equal
to the sum of milliosmolar values of individual ions.
U.S. Pharmacopeia lists the following formula for
calculation of ideal osmolar concentration:

Wt. of substance (g/L)

mOsmol/L = ------------------------------ No. of Species 1000
Mol. Wt (g)

E.g. Calculate of ideal osmolarity for 0.9% Sodium

Chloride Solution?
Solution
Wt. of substance (g/L)
mOsmol/L = ------------------------------ No. of Species 1000
Mol. Wt (g)

9 (g/L)
mOsmol/L = ------------------------------ 2 1000
58.5 (g)
= 308 mOsmol/L
 However, because of the bonding forces, n is slightly less
than 2 for NaCl at 0.9% Nacl concentration. Hence, the
actual osmolarity of solution is 286 mOsmol/L

Some Pharmaceutical manufacturers label electrolyte

solutions with ideal or stoichiometric osmolarities
calculated by the equation just provided, whereas others
list experimental or actual osmolarities.

Pharmacist should appropriate this distiction.

 Osmolarity -- Milliosmoles of solute per liter of
solution
Osmolality Milliosmoles of solute per kilogram of
solvent
For dilute aqueous solutions both terms are nearly
identical
For more concentrated solutions Two values are not
identical

pharmacist should make distinction between

Osmolarity and Osmolality
Contribution of components of normal human serum to
the Serum Osmotic Pressure
Constituent Mean Conc. Osmotic Pressure % of total osmotic
(mEq/L) (mOsmol/kg of pressure
water)

Sodium 142 139 48.3%

Potassium 5 4.9 1.7
Calcium 2.5 1.2 0.4
Magnesium 2 1 0.3
Chloride 102 99.8 34.7
Bicarbonate 27 26.4 9.2
Proteinate 16 1.0 0.3
Phosphate 2 1.1 0.4
Sulfate 1 0.5 0.2
Organic anions 3.5 3.4 1.2
Urea 30mg/100 mL 5.3 1.8
Glucose 70 mg/100 mL 4.1 1.4
Total 287.7 mOsmol/Kg 99.9%
 Normal serum osmolality - ranges from 275-300
mOsmol/kg.
Equipment used in laboratories to measure osmolality
Osmometers.

Electrolyte imbalance
Shock
Trauma
Burns Abnormal Blood Osmolality
Hyperglycemia

Water intoxication
Renal failure
 Problems
A solution has 5% anhydrous dextrose in water for injection.
Represent the concentration in mosmol/lit?

Solution: Molecular weight of dextrose 180

As it donot dissociate 1 mmol --- 1 mOsmol

5% solution contains ---- 50 g / L

From the formula discussed above 50,000 / 180

= 278 mOsmol/L
 A solution contains 10 mg% of Ca+2 ions. How many
milliosmoles are present in 1 lit of solution?

Solution

1 mmol of Ca++ (40 mg) --- 1mOsmol

10 mg% of Ca++ = 100 mg / Lit
100 / 40 - 2.5 mOsmol/Lit
WATER and Electrolyte Balance Clinical Consideration

Good Homeostasis -- Maintaining body water and

electrolyte balance is component of good health

Dietary Input
OutPut Kidneys, Lungs, Optimum Osmolality
GI tract, Skin Maintain
of Body Fluids

Endocrine Process
 Fluid / Electrolyte therapy is provided to rectify any
imbalance of osmolality of body fluids
Treatment can be Customized based on patient needs

Patient on Diuretic Therapy A K+ supplement along

with adequate water intake.
Total body water in adults 55-60% of the body weight

Increase in body fat --- Lesser proportion of water

Infants have 75% of body water

For adults - A minimum of 2.5 L of daily water intake

(Ingested liquids, food and oxidative metabolism) are
required for maintaining Homeostasis.
 General terms..
1500 mL of water / Sq.meter of body surface might be
employed for calculating daily requirements of adults.
On weight basis.

32 mL/kg Adults and 100-150 mL/kg Infants ---

Daily requirements for healthy intake
Careful estimation should be made in human subjects
with any disorders affecting homeostasis.
Also, composition is described in literature with respect to
body compartments --- Intracellular (within cells),
Intravascular (In blood plasma), Interstitial (Between cells
in tissue).
Intervascular and Interstitial --- Together called --
Extracellular
 Sodium and Chloride have principle affect on Extracellular
Fluid
Potassium and Phosphate --- on --- Intracellular fluids

Cell membranes are freely permeable to water

Hence, Osmalility of extracellular fluid (290 mOsmol/kg) is
approximately equal to intracellular fluid.

Therefore, osmolality of the plasma is accurate guide to

estimate osmolality of intracellular fluid.
 The following formula may be employed to estimate
plasma osmolality

Plasma Osmolality (mOsmol/Kg)

= 2([Na] + [K]) plasma + BUN/2.8 + Glucose / 18

Where Na and K are in mEq/L, BUN and Glucose are in
mg/dL
Various Clinical calculations Determination of body water
requirement, Plasma osmolality estimation, Osmolality and
Milliequivalent contents of physiologic electrolyte
solutions.
Probelms
Based on the discussion above, Calculate the daily water
requirement of a healthy human adult with a body surface
area of 1.8 m2?

Solution:

Water Requirement -- 1500 mL/m2

Hence 1.8 m2 contains --- 2700 mL

 Estimate the plasma osmolality of the given data:
Na2+ -- 135 mEq/L, K+ -- 4.5 mEq/L, BUN 14 mg/dL,
Glucose 90 mg/dL

Solution:
Plasma Osmolality (mOsmol/Kg)

= 2[(Na) + (K)] Plasma + BUN/2.8 + Glucose / 18

Where Na and K are in mEq/L, BUN and Glucose are
in mg/dL

= 2(135+4.5) + 14/2.8 + 90/18

= 289
 Calculate the mEq of Na+, K+ and Cl-, millimoles of
dextrose and osmolality of following parentaral fluid?

Dextrose anhydrous 50g

NaCl 4.5g
KCl 1.49g
Water for Injection, ad 1000mL
Solution
NaCl: 1 EqWt of NaCl - 58.5 g
1 mEq of NaCl - 58.5 mg
4500 mg of NaCl 76.9 mEq of Na+ and 76.9
mEq of Cl-
Similarly for KCl we can calculate, 20 mEq of K+ and Cl-

For dextrose - Mol. Wt 180

1 mmol of anhydrous dextrose 180 mg

50 gms of anhydrous dextrose 50,000 mg
50,000 mg represent -- 277.7 mmol
 Hence Osmolarity is calculated as

Dextrose anhydrous: 278 mmol * 1 particle/mmol = 278

mOsmol

NaCl: 77 mEq * 2 particles / mEq (or mmol) = 154

mOsmol

KCl : 20 mEq * 2 particles / mEq (or mmol) = 40

mOsmol

Total = 278 + 154 + 40 = 472 mOsmol

 Reference

Lecture material taken from the book Pharmaceutical

Calculations, 13th Edition by Howard C. Ansel.
Lecture material from Dr. Karlas lecture notes.