Pharma

1. Oral Rehydration Solution
ORAL
REHYDRATION
SOLUTION

2. AIM:
Prepare oral rehydration solution
from ORS packet and explain its
use

3. Introduction:
 ORS Powder is a compound powder containing more than one
ingredient i.e. sodium chloride, Potassium chloride, Trisodium
citrate and glucose.
 Uses:
- Dehydration
- Diarrhoea
 Non –diarrhoeal Uses:
- Post-surgical, post -burn and post- trauma maintenance of
hydration and nutrition.
- Heat Stroke
- During change over from intravenous to enteral alimentation

4. Old WHO –ORS formula
Substance Weight Components mmol/litre
Sodium chloride 3.5 gm Na+ 90
Potassium chloride 1.5 gm K+ 20
Trisodium citrate 2.9 gm Citrate 10
Glucose 20gm Chloride 80
water 1 litre Glucose 111

5. New modified WHO –ORS formula
Substance Weight Components mmol/litre
Sodium chloride 2.6 gm Na+ 75
Potassium chloride 1.5 gm K+ 20
Trisodium citrate 2.9 gm Citrate 10
Glucose 13.5 gm Chloride 65
Water 1 Litre Glucose 75
Total osmolarity 245

7. Actions of individual ingredients
1) Sodium Citrate- Facilitates water absorption in small intestine in
addition to replacement of sodium losses.
2) Potassium chloride- Maintains nerve muscle activity.
3) Trisodium citrate- corrects acidosis
4) Glucose- Facilitates sodium and water absorption in small
intestine
5) Water- To replace fluid loss, and as vehicle

8. Advantages of ORS
 Easy ,simple, less expensive and an effective therapy
 Reduces stool volume by 20% and vomiting by 30%
 Faster water absorption
 Low risk of hypernatremia
 Effective and safe in cholera too
 Potassium replacement is safer orally than intravenous
 No risk of fluid overload,pulmonary congestion and oedema
 Effective for all age groups
 No expertise is needed, can be administered at home

9. Disadvantages
 Difficult to administer in presence of vomiting or shock.

10. Steps for preparation of ORS Solution
1. Wash hands with soap and water before preparing ORS
2. Pour 1 litre of drinking water in a container
3. Empty the contents of ORS sachet into the container(1 litre water)
and stir until contents dissolves completely.
4. Administer ORS as much as per the patients requirements and
degree of dehyadration at regular intervals.
5. Do not store it after 24 hours and discard the leftover.

11. Other Types of ORS
 Super ORS=Adding of Glycine(amino acid) results in
improvements in sodium and water absorption but very
expensive.
 Rice water ORS= Glucose 20 gm is replaced by 50 gm of cooked
rice powder, provides more calories.
 Wheat ,mazie,potato or cereal based ORS.

12. Home –made Fluids
 Rice water, lemon juice, Fruit juices, coconut water, tea and coffee
,buttermilk, soups.
 (Lemon juice= Fist of sugar (20 g) + 1 pinch of salt(5 gm)+ ½ lemon + 1 litre of
water).

13. Adminstration of ORS
I. Treatment Plan A: Treatment of diarrhea in children with NO dehydration. If
the child is less than 2 years old, teaspoonful should be given every 1-2
mins.For an older child,frequent sips from a cup can be given.If the child
vomits it out,wait for 10 mins.Later given the solution more slowly,ie. Every 2
– 3 mins.
II. Treatment Plan B: Treatment of diarrhoea in children with some dehydration.
Commencement of ORS for the correction of existing water and electrolyte
loss as well as maintenance of normal daily fluid requirements.
III. Treatment Plan C: Treatment of diarrhoea in children with severe
dehydration. For intravenous rehydration ,Dhaka fluid or Ringer Lactate is
administered. Volume equivalent to 10% body weight should be infused over 2
– 4 hours and later shifted to oral rehydration.

14. Zinc in Pediatric Diarrhoea
o Addition of Zinc reduces the duration and severity of acute
diarrhoea in children less than 5 years age by reducing the fluid
loss, strengthening immunity and regenerating intestinal
epithelium.
o WHO recommends zinc supplementation to all children with
acute diarrhoea for 10 – 14 days with a dose of 10 mg/day(<6
months age) and 20 mg/day(children and adults).