Products
Various oral rehydration powder products are commercially available in many countries (Normolytoral, Elotrans, Oralpädon). The solution was developed in the 1960s.
Structure and properties
Oral rehydration solution contains water, glucose (dextrose), sodium, potassium, chloride, and citrate. Powder composition (excluding water, WHO-ORS):
- Anhydrous glucose
- Sodium chloride (table salt)
- Potassium chloride
- Trisodium citrate dihydrate
- Optional excipients, for example, to improve the taste.
Effects
Oral rehydration solution (ATC A07CA) improves the absorption of water and electrolytes in the intestine, counteracting dehydration. It compensates for disturbances in water and electrolyte balance. By combining glucose with sodium, sodium, glucose and water are better absorbed into the body. Transport occurs via sodium–glucose cotransporter 1 (SGLT1) and is maintained during disease. Citrate is a prodrug of the base bicarbonate and counteracts metabolic acidosis. Oral rehydration solution is considered the first-line treatment for diarrheal disease and has been shown to reduce mortality. Oral therapy is much easier than intravenous fluid administration. This is particularly-but not exclusively-important when medical care is inadequate.
Indications
For electrolyte and fluid delivery in acute diarrhea or vomiting.
Dosage
According to the package insert. The powder should be dissolved in the prescribed amount of water or in cooled tea:
- It sometimes takes a lot of persuasion to get children to take it.
- The dosage is based on the body weight or age of the patient.
- Prescribed amount of liquid and do not use fruit juice.
- Administer by the spoonful or drink a sip regularly from a cup or bottle.
- Boil the water for preparation if possible and leave to cool.
- After the diarrhea subsides, the solution is discontinued.
- Administer the solution despite vomiting and diarrhea!
- Mix the solution yourself only in an emergency, do not administer home remedies such as cola and Salzstängeli.
- The prepared remedy should usually be consumed immediately. Storage in the refrigerator is possible during 24 hours.
Contraindications
- Renal insufficiency
- Insatiable vomiting
- Severe clouding of consciousness
- Shock
- Metabolic alkalosis
- Anuria
- Glucose malabsorption
Full precautions can be found in the drug label.
Interactions
Drug-drug interactions have been described with cardiac glycosides.
Adverse effects
Possible adverse effects include reversible hypernatremia.