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oral rehydration salts (ORS)

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Principally this involves giving the dehydrated individual glucose and sodium - the latter as salt.

Glucose and sodium are cotransported into the epithelium, the movement of ions driving the water absorption from the gut. The transporter system usually remains intact during an episode of diarrhoea; thus, its action can be exploited.

oral rehydration salts

Oral Rehydration Salts (ORS) is the non-proprietary name for a balanced glucose-electrolyte mixture, first used in 1969 and approved, recommended, and distributed by UNICEF and WHO as a drug for the treatment of clinical dehydration throughout the world (1).

  • in 1984, a new ORS was introduced with the aim of improving the stability of ORS in hot and humid climates.
    • hydrogen carbonate (sodium bicarbonate) was replaced by ntrisodium citrate in the new mixture
    • provides a solution containing 90 mEq/l of sodium with a total osmolarity of 311 mOsm/l
    • WHO and UNICEF have recommended this single formulation of ORS to prevent or treat dehydration from diarrhoea irrespective of the cause or age group affected.

A new 'improved' ORS has been developed which is safe and effective as standard ORS for preventing or treating dehydration from all types of diarrhoea but which, in addition, would reduce stool output or have other important clinical benefits.

  • total osmolarity of the new ORS solution is 245 mOsmol/l (total osmolarity of the previously recommended ORS solution was 311 mOsm/l)
    • this reduction in osmolarity avoids possible adverse effects of hypertonicity on net fluid absorption thus reducing the reducing stool output
  • WHO and UNICEF now recommend that countries use and manufacture this reduced osmolarity ORS for diarrhoea of all etiologies and in all age group

Composition of the new ORS solution:

new ORS

g/l

%

new ORS

mmol/l

Sodium chloride

2.6

12.683

Sodium

75

Glucose, anhydrous

13.5

65.85

Chloride

65

Potassium chloride

1.5

7.31

Glucose, anhydrous

75

Trisodium citrate, dehydrate

2.9

14.16

Potassium

20

 

 

Citrate

10

total

20.5

100

total osmolarity

245

 

Often lactose intolerance is seen in the primary phases of gastroenteritis, but it is usually a good idea to continue breast feeding.


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