Singapore Drugs Database

Indication

Used for continuous ambulatory peritoneal dialysis (CAPD) of diabetic patients or automated peritoneal dialysis (APD) for the management of end-stage renal disease.

Mechanism of Action

Icodextrin is a starch-derived, water-soluble glucose polymer linked by alpha (1-4) and alpha (1-6) glycosidic bonds with an average molecular weight between 13,000 and 19,000 daltons. It functions as a colloid osmotic agent to achieve ultrafiltration during long (12-16 hour) peritoneal dialysis dwells. In other words it helps clean waste out of the body when the kidneys are not functioning properly. Icodectrin acts in the peritoneal cavity by exerting osmotic pressure across small intercellular pores resulting in transcapillary ultrafiltration through the dwell. This is due to the fact that the polymer is minimially absorbed across the peritoneal membrane. Icodextrin achieves superior fluid removal compared with glucose-based dialysates.

Pharmacokinetics

Absorption

40% of instilled icodextrin was absorbed from the peritoneal solution during a 12-hour dwell.

Distribution

Metabolism

Icodextrin is metabolized by alpha-amylase into oligosaccharides with a lower degree of polymerization), including maltose, maltotriose, maltotetraose, and higher molecular weight species.

Elimination

Active Ingredient/Synonyms

Icodextrin | Icodextrina | Icodextrine | Icodextrinum | Icodextrin |

Indication

Magnesium chloride is used in several medical and topical (skin related) applications. Magnesium chloride usp, anhydrous uses as electrolyte replenisher, pharmaceutic necessity for hemodialysis and peritoneal dialysis fluids.

Mechanism of Action

Mechanism of action of magnesium chloride studied in 10 adult volunteers. Results suggested magnesium ion in duodenum is relatively weak stimulus to pancreas and gall bladder. It is weak stimulant to cholecystokinin release and inhibits net jejunal water absorption. The oral administration of a single 800 mg dose of magnesium chloride in healthy volunteers resulted in a diminished rate of intraluminal lipid and protein digestion. The most pronounced effect of magnesium chloride, however, was a decreased gastric emptying rate of both test meals. After correction for gastric emptying, no differences were noted in intraluminal lipid or protein digestion. Therefore, the lower lipid levels noted after magnesium supplementation are unlikely to be the result of altered lipid assimilation. Magnesium chloride slows gastric emptying but does not influence lipid digestion.

Pharmacokinetics

Absorption

Oral: Inversely proportional to amount ingested; 40% to 60% under controlled dietary conditions; 15% to 36% at higher doses

Distribution

Bone (50% to 60%); extracellular fluid (1% to 2%)

Metabolism

Magnesium levels are efficiently regulated by the kidneys. Magnesium also undergoes efficient enterohepatic circulation

Elimination

Clearance

Maximum magnesium clearance is directly proportional to creatinine clearance.

Toxicity

Mouse LD50 775mg/kg (intraperitoneal) Mouse LD50 : 7600mg/kg (oral) Rat LD 50 : 8100mg/kg (oral) Rat LD50 176mg/kg (intravenous) Severe toxicity occurs most often after intravenous infusions. It can also occur after chronic excessive oral doses, often in patients with renal insufficiency. Early manifestations are lethargy, hyporeflexia, followed by weakness, paralysis, hypotension, ECG changes (prolonged PR and QRS intervals), CNS depression, seizures, and respiratory depression. In overdose, magnesium impairs neuromuscular transmission, manifested as weakness and hyporeflexia.

Active Ingredient/Synonyms

Anhydrous magnesium chloride | Magnesium chloride anhydrous | Magnesium chloride |

Indication

This intravenous solution is indicated for use in adults and pediatric patients as a source of electrolytes and water for hydration. Also, designed for use as a diluent and delivery system for intermittent intravenous administration of compatible drug additives.

Mechanism of Action

Sodium and chloride — major electrolytes of the fluid compartment outside of cells (i.e., extracellular) — work together to control extracellular volume and blood pressure. Disturbances in sodium concentrations in the extracellular fluid are associated with disorders of water balance.

Pharmacokinetics

Absorption

Absorption of sodium in the small intestine plays an important role in the absorption of chloride, amino acids, glucose, and water. Chloride, in the form of hydrochloric acid (HCl), is also an important component of gastric juice, which aids the digestion and absorption of many nutrients.

Distribution

The volume of distribution is 0.64 L/kg.

Metabolism

The salt that is taken in to gastro intestinal tract remains for the most part unabsorbed as the liquid contents pass through the stomach and small bowel. On reaching the colon this salt, together with the water is taken in to the blood. As excesses are absorbed the kidney is constantly excreting sodium chloride, so that the chloride level in the blood and tissues remains fairly constant.Further more, if the chloride intake ceases, the kidney ceases to excrete chlorides. Body maintains an equilibrium retaining the 300gm of salt dissolved in the blood and fluid elements of the tissue dissociated into sodium ions and chloride ions.

Elimination

Toxicity

The rare inadvertent intravascular administration or rapid intravascular absorption of hypertonic sodium chloride can cause a shift of tissue fluids into the vascular bed, resulting in hypervolemia, electrolyte disturbances, circulatory failure, pulmonary embolism, or augmented hypertension. ( toxnet)

Active Ingredient/Synonyms

Sodium Chloride | Sodium Chloride |