This document discusses oral rehydration therapy used to treat dehydration. It describes how oral rehydration salts (ORS) are used to restore electrolyte and fluid balance in the body through replacement therapy. ORS solutions contain specific concentrations of sodium, potassium, chloride, and glucose to be absorbed in the intestines. The document outlines the formulation, administration, and effectiveness of ORS in rehydrating patients suffering from diarrhea and dehydration.

1. ORAL REHYDRATION SALTS USED
IN REPLACEMENT THERAPY
Submitted By:-
Suyash Jain
B Pharm(1st sem)
Department of Pharmaceutical Sciences
Dr. Hari Singh Gour University Sagar(M.P.)

2. Electrolytes used in replacement
therapy
1.The basic objective of replacement therapy is to restore the
volume and composition of the body fluids to normal one.
2. Volume contraction is a life threatening condition because it
impairs the circulation, blood volume decreases, cardiac output
falls and the integrity of microcirculation is compromised.
3. In volume depletion of sufficient magnitude to threaten life, a
prompt infusion of isotonic sodium chloride solution is indicated.
4. In an extreme case, intravenous therapy at the rate of 100 ml
per minute for the first 1000ml has been considered necessary for
the successful treatment of cholera.

3. 1.Sodium replacement
Sodium Chloride: NaCl (MW 58.44)
1. It contains no added substances.
2. It occurs as colourless cubic crystals or as
white crystalline powder having saline taste.
3.It is freely soluble in water, and slightly
more soluble in boiling water, soluble in
glycerine and slightly soluble in alcohol.

4. Uses of sodium chloride
 1. Used as fluid and electrolyte replenisher,
manufacture of isotonic solution, flavour enhancer.
 2. Isotonic solutions are used in wet dressings, for
irrigating body cavities or tissues Hypotonic solutions
are administered for maintenance therapy when
patients are unable to take fluids and nutrients orally
for one to three days.
 3.Hypertonic solution/injection are used when there
is loss of sodium in excess.

5. 2. Potassium replacement
 Potassium Chloride: KCl (MW 74.56).
 1.Potassium chloride contains not less than 99%
calculated with reference to dried substance.
 2. It occurs as white crystalline solid, cubic
crystals. It is less soluble in water than sodium
chloride, and slightly more soluble in boiling
water, soluble in glycerine and insoluble in
alcohol.

6. Uses of potassium chloride
 Use:
 1. Electrolyte replenisher in potassium
deficiency, familial periodic paralysis,
myasthenia gravis.
 2. Contraindication: renal impairment.

7. Oral rehydration Therapy (ort)
 ORT is the giving of fluid by mouth to
prevent and/or correct the dehydration that
is a result of diarrhoea.
 As soon as diarrhoea begins, treatment
using home remedies to prevent
dehydration must be started.
 If adults or children have not been given
extra drinks, or if in spite of this
dehydration does occur, they must be

8. Formulation

9. Composition of standard and reduced
osmoLarity

10. Treatment
 Oral rehydration therapy is the mainstay of management of
children with mild to moderate dehydration.
 Intravenous fluidsare appropriate for children who are severely
dehydrated, are moderately dehydrated with persistent vomiting,
or have an underlying condition that can be exacerbated by
dehydration.
 As soon as the hydration statushas normalized and oral/enteral
fluids are tolerated, attempts at refeeding should be instituted.
 Early refeeding with complex carbohydrates, lean meats, fruits,
and vegetables, as well as milk products and infant formula, is
recommended.
 Normalized diet has been shown to decrease the duration
of diarrhea when compared with oral or intravenous hydration
alone.

11.  The American Academy of Pediatrics suggests that antimotility
agents should be avoided in children with acute gastroenteritis
 Children with diarrhea should be placed on contact isolation to
avoid spread to hospital personnel and other patients. Special
care should be taken with children who require diaper changing.
 Antibiotic treatment of bacterial gastroenteritides varies by the
organism, the clinical syndrome, and the host.
 The rationale for treating many enteric infections is to decrease
the duration of symptoms if treatment is initiated early in the
course of the illness. In cases of shigellosis, treatment may limit
spread of the infection. If results of the stool culture become
available after resolution of the patient's symptoms, antimicrobial
therapy may be unwarranted.

12.  ORT uses the sodium-glucose cotransport
mechanism to passively absorb water across
the intestinal mucosa. Hence, the oral rehydration
solution (ORS) should have the correct sodium-to-
glucose ratio,5 which is optimally 1:1.
 Rehydralyte and the WHO ORS packets are
examples of appropriate solutions for the rehydration
phase of treatment.
 The WHO ORS has a 1:1 ratio, whereas Rehydralyte
has a 1:2 ratio.

13.  Maintenance solutions, such as Pedialyte, are
acceptable alternatives for mildly and moderately
dehydrated patients.
 The ratio of sodium to glucose in Pedialyte is 1:3. The
proper procedure for administering ORT is shown
in Figure 57-1. The aim is to replace fluid losses over 4
to 6 hours.
 When vomiting is a prominent part of the clinical
picture, administration of small, frequent aliquots is
necessary.
 Ongoing assessment, including serial weight
measurement, is necessary to evaluate the progress of
treatment.
 ORT failure is defined as progression of signs
of dehydration, failure to replace the deficit over 8

14. REFERENCES
 Chaudhary NC , Gurbani NK , “Pharmaceutical chemistry – 1” , Vallabh
prakshan , Delhi , 2013 , 3rd edition , pg- 132 -164 .
 World Health Organization. 2009. pp. 349–
351. ISBN 9789241547659. Archived(PDF) from the original on 13 December
2016. Retrieved 8 January 2017.
 "WHO Model List of Essential Medicines (19th List)" (PDF). World Health
Organization. April 2015. Archived (PDF) from the original on 13 December
2016. Retrieved 8 December 2016.
 "Oral Rehydration Salts". International Drug Price Indicator Guide. Retrieved 8
December2016