Sodium Acetate

Pronunciation: SOE-dee-um AS-e-tate
Class: Electrolyte

Trade Names

Sodium acetate
- Injection, solution, concentrate 2 mEq/mL
- Injection, solution, concentrate 4 mEq/mL

Pharmacology

Sodium ion exerts a primary role in controlling total body water and its distribution. The acetate ion is completely metabolized in the body, providing a source of hydrogen ion acceptors.

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Indications and Usage

As a source of sodium for addition to large volume IV fluids to prevent or correct hyponatremia in patients with restricted or no oral intake; as an additive for preparing specific IV fluid formulas when the needs of the patient cannot be met by standard electrolyte or nutrient solutions.

Contraindications

Hypernatremia; fluid retention.

Dosage and Administration

IV The dose and rate depend upon individual needs. Monitor serum sodium as a guide to dosage.

General Advice

• Administer IV only after dilution.
• Infuse sodium-containing solutions slowly to avoid sodium overload and water retention.
• Discard vial within 4 h of initial entry or any unused portion.
• 20 mL vial contains 164 mg of sodium acetate in each mL, which provides 2 mEq each of sodium and acetate.
• 50 mL vial contains 16.4 g of sodium acetate, which provides 200 mEq each of sodium and acetate.

Storage/Stability

Store between 59° and 86°F.

Drug Interactions

Alkalinization of the urine by sodium acetate may decrease amphetamine elimination, prolonging the effects. Toxic effects, such as excessive CNS stimulation (eg, restlessness, insomnia, agitation) and CV effects, may occur. Avoid coadministration.

Alkalinization of the urine by sodium acetate may increase chlorpropamide elimination, decreasing the pharmacologic effect. Monitor blood glucose and adjust the chlorpropamide dose as needed.

Risk of sodium retention and hypernatremia may be increased. Coadminister with caution. Monitor serum sodium.

Alkalinization of the urine may increase lithium elimination, reducing lithium plasma concentrations and decreasing the effectiveness. Avoid the administration of regular or large doses of sodium acetate. Monitor lithium serum concentrations and the clinical response; adjust the lithium dose accordingly.

Alkalinization of the urine may reduce quinidine elimination, increasing quinidine concentrations and effects on the heart (eg, prolongation of the QT interval). Monitor serum quinidine concentrations and the ECG if sodium acetate is added to or removed from a stable quinidine regimen.

Urinary alkalinization by sodium acetate may increase the half-life and decrease the elimination of ephedrine or pseudoephedrine, increasing the therapeutic or toxic effects. The dose of the sympathomimetic agent may need to be decreased during coadministration of sodium acetate.

Coadministration of tetracyclines with urinary alkalinizers may increase excretion of the tetracycline and reduce serum concentrations, resulting in a decrease in therapeutic response. Separate use of these agents by 3 to 4 h. However, if the pH of the urine is increased by sodium acetate, this may not be effective in minimizing the interaction. Increased doses of the tetracycline may be necessary.

Adverse Reactions

Sodium overload.

Precautions

Pregnancy

Category C .

Lactation

No data available.

Children

Premature neonates are particularly at risk for aluminum toxicity because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.

Renal Function

Administration of solutions containing sodium ions may result in sodium retention.

Hepatic Function

Use with caution in patients with severe hepatic impairment.

Special Risk Patients

Use with caution in patients with CHF, severe renal impairment, or cirrhosis; in clinical states in which edema and sodium retention exists; and in patients with oliguria or anuria.

Aluminum toxicity

Product contains aluminum, which may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk.

Fluid/Solute overload

May cause fluid/solute overload, resulting in dilution of other serum electrolyte concentrations, overhydration, congested states, or pulmonary edema.

Metabolic/Respiratory alkalosis

Use with caution in patients with metabolic or respiratory alkalosis. Excess administration may result in metabolic alkalosis.

Overdosage

Symptoms

Sodium overload.

Patient Information

• Advise patient that medication will be prepared and administered by a health care provider in a hospital setting.

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