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Sodium PhosphatePronunciation: SOE-dee-um FOS-fate
- Injection, solution, concentrate phosphate 3 mmol and sodium 4 mEq/mL
Exerts a modifying influence on the steady state of calcium levels, a buffering effect on acid-base equilibrium, and a primary role in the renal excretion of hydrogen ion. Plays a significant intracellular role in the synthesis of high-energy organic phosphates. Essential to maintain red cell glucose utilization, lactate production, and the concentration of both erythrocyte adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (DPG).
IV-infused phosphorus not taken up by the tissues is excreted almost entirely in the urine.
Indications and Usage
Treatment of hypophosphatemia; as an additive for preparing specific parenteral fluid formulas.
High phosphorus or low calcium levels; hypernatremia.
Dosage and AdministrationHypophosphatemia
Adults and Children
IV Dose and rate of administration dependent upon the individual needs of the patient.Adults
TPN phosphorus 10 to 15 mmol/L of TPN solution containing dextrose 250 g.Infants
TPN 1.5 to 2 mmol/kg/day.Off-label dosing
IVMild hypophosphatemia (serum phosphorus 2.3 to 3 mg/dL)
0.16 mmol/kg. Administer at a rate no faster than 7.5 mmol/h.Moderate hypophosphatemia (serum phosphorus 1.6 to 2.2 mg/dL)
0.32 mmol/kg. Administer at a rate no faster than 7.5 mmol/h.Severe hypophosphatemia (serum phosphorus less than 1.6 mg/dL)
0.64 mmol/kg. Administer at a rate no faster than 7.5 mmol/h.Children
0.16 to 0.32 mmol/kg per dose IV over 6 h.Maintenance dosage
0.5 to 1.5 mmol/kg per dose IV over 24 h.TPN Adults
IV 20 to 40 mmol/day.Children
1 to 2 mmol/kg/day.Infants/children
0.5 to 2 mmol/kg/day.Adolescents and children weighing more than 50 kg
10 to 40 mmol/day.
- Must be diluted and thoroughly mixed before use.
- To avoid phosphorus intoxication, infuse solutions containing sodium phosphate slowly.
- The concomitant amount of sodium (4 mEq/mL) must be calculated into total electrolyte dose of prepared solutions.
- phosphate 1 mmol = phosphorus 31 mg.
Store between 59° and 86°F.
Caution must be exercised in the administration of parenteral fluids, especially those containing sodium ion, to patients receiving corticosteroids or corticotropin.Thiazides
Concurrent use with thiazides may cause renal damage.
Laboratory Test Interactions
None well documented.
Frequent monitoring of serum sodium, phosphorus, and calcium levels, as well as renal function, is recommended.
Category C .
Safety and efficacy have been established in children (neonates, infants, children, and adolescents).
Dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
In patients with diminished renal function, administration of solutions containing sodium ions may result in sodium retention.
Special Risk Patients
Use with caution in patients with cirrhosis or cardiac failure, or in conjunction with other edematous medications. Do not use with sodium-retaining medications.
May contain aluminum. Aluminum may reach toxic levels with parenteral administration if kidney function is impaired.
Infusing high concentrations of phosphorus may result in a reduction of serum calcium and symptoms of hypocalcemic tetany.
Use solutions containing sodium ion with great care in patients with CHF or severe renal insufficiency, and in clinical states in which edema with sodium retention exists.
- Advise patient or caregiver that medication will be prepared and administered by health care provider in a health care setting.
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