(D) FLUIDS AND ELECTROLYTES - PHARMA Flashcards
fluid within the cell.
Intracellular
fluid outside the cell but in the interstitial
space and in intravascular fluid.
Extracellular
fluid between the cell – in the interspaces of a
tissue – situated between the parts.
Interstitial
within the vessel/s
Intravascular
the tendency of biological systems to
maintain relatively constant conditions in the internal
environment, while continuously interacting with and
adjusting to changes that originate within the system and
outside the system.
HOMEOSTASIS
fluid going through a filter under pressure or
passage through a material that prevents passage of
certain molecules.
FILTRATION
TRANSPORT OF FLUIDS (DOFA)
DIFFUSION
OSMOSIS
FILTRATION
ACTIVE TRANSPORT
the movement of molecules/solutes through a
semipermeable membrane from a high concentration to a
low concentration.
DIFFUSION
the one way passage of water through a
semipermeable membrane from a low concentration of
particles to a high concentration of particles.
OSMOSIS
electrolytes move from a low
concentration to a high concentration by moving against
the concentration gradient. ATP provides the energy
needed to do this.
ACTIVE TRANSPORT
1/3 EXTRACELLULAR F
➔ Interstitial fluid
➔ Plasma or intravascular
fluid
➔ Transcellular fluid
DISTRIBUTION OF FLUID
1/3 EXTRACELLULAR F
2/3 INTRACELLULAR F
2/3 INTRACELLULAR FLUID
➔ Fluid within a cell
➔ RBC
➔ Other cells
3 TYPES OF IV FLUIDS
CRYSTALLOIDS
COLLOIDS
BLOOD & BLOOD PRODUCTS
- Water with electrolytes that form a solution that can
pass through semi permeable membranes - Lost rapidly from the intravascular space into the
interstitial space - Can remain in the extracellular compartment for about
45 mins - Because of this, larger volumes than colloids are
required for fluid resuscitation - Eventually, water form this diffuses through the
intracellular fluid
CRYSTALLOIDS
- draws fluid into the intravascular
compartment from the cells and the interstitial
compartments.
Osmolarity is higher than serum osmolarity
HYPERTONIC
shifts fluid out of the intravascular
compartment, hydrating the cells and the interstitial
compartments.
Osmolarity is lower than serum osmolarity
HYPOTONIC
stays in the intravascular space, it expands
the intravascular component.
Osmolarity is the same as serum osmolarity
ISOTONIC
- Contain solutes in the form of a large proteins or other
similar sized molecules - Cannot pass through the walls of capillaries and into
cells - Remain in blood vessels longer and increase increase
intravascular volume - Attract water from the cells into the blood vessels
- But this is a short term benefit and prolonged
movement can cause the cells to lose too much water
and become dehydrated
COLLOIDS
- Minerals in body fluids that carry an electric charge
- It affect the amount of water, the acidity of blood (pH),
muscle function, and other important processes in the
body
ELECTROLYTES
6 MAJOR ELECTROLYTES
- Sodium - Na+ Major cation in extracellular fluid (ECF)
- Potassium - K+ Major cation in intracellular fluid (ICF)
- Calcium - Ca++ Major cation found in ECF and teeth and
bones - Chloride - CI- Major anion found in ECF
- Phosphate - PO43- Major anion found in ICF
- Magnesium - Mg++ Major cation found in ICF (closely
related to Ca++ and PO4)
Normal Serum Level 135 – 145 mmol/L
Function:
➔ Maintains extracellular function (ECF) osmolarity
➔ Influences water distribution
➔ Affects concentration, excretion and absorption of
potassium and chloride
➔ Helps regulate acid-base balance
➔ Aids nerve and muscle fiber impulse transmission
SODIUM (Na+)
- fatigue, muscle weakness, muscle twitching,
decreased skin turgor, headache, tremor, seizures, coma
HYPONATREMIA
- thirst, fever, flushed skin, oliguria,
disorientation, dry skin membranes
HYPERNATREMIA
Normal Serum Level 3.5 – 5.0 mmol/L
Function:
➔ Maintains cell electro-neutrality
➔ Maintains cell osmolarity
➔ Assists in conduction of nerve impulses
➔ Directly affects cardiac muscle contraction
(repolarization in the action potential)
➔ Plays a major role in acid-base balance
LNJ, A. | 11
➔ Sodium - Potassium gradient plays a major role in
fluid balance between extracellular (ECF) and
intracellular (ICF) compartments
POTASSIUM (K+)
decreased peristalsis, skeletal muscle and
cardiac muscle function, muscle weakness or
irritability/cramps, decreased reflexes, fatigue, rapid, weak
irregular pulse, cardiac arrhythmias/cardiac arrest, decreased
blood pressure, decreased bowel motility, paralytic ileus
HYPOKALEMIA
muscle weakness, nausea, diarrhea, oliguria,
paraesthesia (altered sensation) od the face, tongue, hands
and feet, cardiac arrest
HYPERKALEMIA
Normal Serum Level 2.15 – 2.55 mmol/L
Function:
➔ Enhances bone strength and durability
➔ Helps maintain cell-membrane structure, function and
permeability
➔ Affects activation, excitation and contraction of
sino-atrial node (intrinsic cardiac pacemaker), cardiac
and skeletal muscles
➔ Participates in neurotransmitter release at synapses
➔ Helps activate specific steps in blood coagulation
➔ Activates serum complement in immune system
function
CALCIUM (Ca++)
muscle tremor, muscle cramps, tetany,
tonic-clonic seizures, paresthesia, bleeding, arrhythmias,
hypotension, numbness or tingling in fingers, toes and around
the mouth
HYPOCALCEMIA
lethargy, fatigue, depression, confusion,
headache, muscle flaccidity, nausea, vomiting, anorexia,
constipation, hypertension, polyuria, cardiac arrhythmias and
ECG changes
HYPERCALCEMIA
Normal Serum Level 95 – 110 mmol/L
Function:
➔ Maintains serum osmolarity
➔ Combines with major cations to create important
compounds, such as sodium chloride (NaCl),
hydrochloride (HCl), potassium chloride (KCl), and
calcium chloride (CaCl₂) which contribute to acid/base
and/or electrolyte balance
CHLORIDE (Cl-)
Normal Serum Level 0.8 – 1.5 mmol/L
Function:
➔ Helps maintain bones and teeth
➔ Helps maintain cell integrity
➔ Plays a major role in acid-base balance (urinary
buffer)
➔ Promotes energy transfer to cells
➔ Plays essential role in muscle, RBC and neurological
function
PHOSPHATE (PO4)
- paresthesia (circumoral and
peripheral), lethargy, speech defects (stuttering), muscle pain
and tenderness
HYPOPHOSPHATEMIA
renal failure, vague
neuronal-excitability to tetany and seizures, arrhythmias and
muscle twitching with sudden rise in phosphate (PO₄)level
HYPERPHOSPHATEMIA
Normal Serum Level 0.70 – 1.05 mol/L
Function:
➔ Activates intracellular enzymes; active in
carbohydrate and protein metabolism
➔ Acts on myo-neural vasodilation
➔ Facilitates Na+ and K+ movement across all
membranes
➔ Influences Ca++ levels
MAGNESIUM (Mg++)
dizziness, confusion, seizures, tremor,
leg and foot cramps, hyperirritability, arrhythmias, vasomotor
changes, anorexia, nausea
HYPOMAGNESEMIA
drowsiness, lethargy, coma,
arrhythmias, hypotension, vague neuromuscular changes
(tremor), vague GI symptoms (nausea), peripheral
vasodilation, facial flushing, sense of warmth, slow, weak
pulse
HYPERMAGNESEMIA
