what volume of a 0.4 m mg would i need to produce 5 grams of mg(oh)2

Muriatic acid (HCL)

Usual Diluents

D5W, NS

Standard Dilutions [Amount of drug] [Infusion volume] [Infusion rate]

Training of 0.1 N solution [100 ml (100 meq ) of 1.0N HCL] [1000 ml] [Infusion charge per unit: see bottom department] Filter HCL with 0.22 micron filter before adding information technology to the IV bag . Alternatively (Using 37% HCL stock bottle): [eight.3 ml of 37% HCL] [1000 ml NS or D5W] Grooming of 0.fifteen N solution [150 ml (150 meq) of 1.0 N HCL] [thousand ml] - This agent must be infused in drinking glass or polyolefin container. - Muriatic acid solution should be administered through a central venous line to preclude vein irritation, thrombophlebitis, or tissue necrosis. Exercise Not infuse via a peripheral vein! Injection of HCl into a peripheral vein may cause extravasation and can produce severe tissue necrosis. - Solutions for infusion should NOT exceed 0.2 Northward (increased gamble of hemolysis and increased venous irritation). Concentrations >0.i N take been reported to cause corrosive effects, even when administered through a key venous catheter. - Serum electrolytes and blood gases should be measured every 4 hours. - Solution should be filtered with a teflon 0.22 micron filter before adding to an IV handbag. Sample filter: GE PTFE (Teflon®) Syringe Filters: Membrane uniform with most aggressive solutions. https://www.osmolabstore.com/OsmoLabPage.dll?BuildPage&1&1&1051 Dosing: H+ ion deficit (mEq) = 0.3 X weight (kg) X (measured HCO3 - desired HCO3 [mEq/L]) Rate of H+ replacement: 0.1 - 0.two mEq/kg/hour For instance, 0.i N solution IV at 100 mL/h provides about 10 mEq/h Stock bottle of 37% HCL. Determination of molarity of 37% HCL V/V 37 ml of solute/100 ml of solution. HCL - 37% five/five. Specific gravity: i.19 yard/ml 37ml/100 ml or 370 ml/1000 ml ten i.19 g/ml = 440.3 g/Fifty HCL Molecular weight = 36.5 Molarity: 440.3 grams /36.5 grams = 12.06 M or ~12M ==================== Compounding 1 liter of 0.1N Solution ==================== M1V1 = M2V2 (0.1)(1000) = (12) (x) x = (0.1) (grand) / 12 x = eight.3 ml Therefore add together 8.iii ml of 37% HCL to 1 liter of D5W or NS to create a 0.1N HCL solution. ---OR ---(Alternative calculation) 12M (37% HCL) = 12 moles/L = 12 ten 36.v = 438 g/L = 438 mg/ml. Need 0.ane N = 0.one M 0.ane M x 36.five = 3.65 g/50 = 3650 mg. 3650 mg / 438 mg = 8.33 ml*

Stability / Miscellaneous

Stability/storage: 24 hour (RT) Indication: treatment of severe or refractory metabolic alkalosis. Iv HCl may exist indicated in astringent metabolic alkalosis (pH >7.55) or when NaCl or KCl cannot be administered considering of volume overload or advanced renal failure. May also be indicated if rapid correction of severe metabolic alkalosis is warranted (eg, cardiac arrhythmia or hepatic encephalopathy.) Equations : Base excess in blood (BE-B) Base excess in blood (BE-B) is the number of mmol of potent acrid that is needed to adjust to pH seven.4 a claret sample tested at pCO2 of 40 mm Hg and 37 C.Information technology indicates the divergence in mmol/fifty of the buffer bases from the normal value. Exist - B = (1 - 0.014[Hb])([HCO3-] - 24 + (ane.43[Hb] + 7.seven)(pH - 7.iv)) The BE requires the measurement of claret pH, hemoglobin, and HCO3. H+ deficit (mEq) = 0.3 x Wt(kg) x ([HCO3-] - 35) Rate of H+ replacement =0.1 to 0.2 meq/kg per 60 minutes. Definitions : The 'Normality' of a solution is the 'Molarity' multiplied by the number of equivalents per mole. The 'Molarity' of a solution is the number of moles of solute in ane liter of solution. Source: https://www.uab.edu/clabsc/solution.htm Source: DRUGDEX® : Storage and Stability: HYDROCHLORIC ACID (0.1N) is stable and compatible in VIAFLEX(R) PLASTIC CONTAINERS over a 24 hour storage period (Pers Comm, 1987). About studies recommend a 0.1 to 0.15 Normal muriatic acid solution prepared in sterile h2o, five% dextrose in water or normal saline (Wagner et al, 1980g; Williams & Lyons, 1980g). Ane group of clinicians prepared a 0.1 Normal hydrochloric acrid solution by drawing 100 milliequivalents of concentrated muriatic acid into a syringe and filtering it through a disposable 0.22 micron filter as it was added to a liter of v% dextrose in water or normal saline (Wagner et al, 1980g). Others prepared a 0.15 Normal hydrochloric acid solution by diluting 12.five milliliters of concentrated hydrochloric acid (35% to 38%) to a full volume of 1 liter with sterile water (Williams & Lyons, 1980g). INTRAVENOUS Rate OF ADMINISTRATION: The rate of infusion was 100 to 125 milliliters/hour of a 0.15 Normal hydrochloric acid solution in sterile water (Williams & Lyons, 1980g). One group of practitioners infuses a liter of 0.ane Normal hydrochloric acid in 5% dextrose and water or normal saline over iv to 6 hours (Wagner et al, 1980g). Some clinicians take corrected severe metabolic alkalosis with prolonged infusion of muriatic acid (over a period of 17 days), administering 100 to 400 milliequivalents muriatic acid daily through a central venous catheter every bit 0.1 Normal hydrochloric acid (Reisman & Puri, 1982f). The amount of muriatic acid (HCL) administered is based upon base of operations excess (milliequivalent/liter), with an equivalent amount beingness administered. One report recommends the post-obit formula (Wagner et al, 1980g): HCL (mEq) = Weight (kilogram) x 0.3 X base of operations excess (mEq/liter). The amount of hydrochloric acid administered to each of the 21 patients treated was based upon 1 of three equations: Bicarbonate Backlog = (0.5 X Weight in kg) 10 (serum bicarbonate -24); OR Chloride Arrears = (0.2 Ten Weight in kg) X (103- serum chloride); OR Base Backlog = (0.3 X Weight in kg) 10 (measured base excess). The pH of amino acrid solutions containing added muriatic acid was significantly higher than that observed with hydrochloric acid added to normal saline. The addition of 100 milliequivalent/liter hydrochloric acid to normal saline produced a pH of approximately 1.5, whereas, add-on of the aforementioned corporeality to a 3.five%, v.five%, and 8.v% amino acrid solution increased the pH to approximately 3, 4.v, and 5, respectively. The infusion mostly continues until the total base excess is between 0 and 50 milliequivalent (Williams & Lyons, 1980g). Source: UpToDate® : Hydrochloric acid — If acetazolamide is ineffective, the metabolic alkalosis can be corrected direct past the intravenous infusion of HCl, which buffers the excess bicarbonate. HCl is usually given as an isotonic solution (150 meq per liter) over 8 to 24 h. It can be infused into a major vein (since HCl is very corrosive) or into a peripheral vein if the HCl is buffered in an amino acid solution and given with a fat emulsion. The corporeality of HCl required (in meq) can be estimated from the space of distribution of bicarbonate in metabolic alkalosis (approximately equal to 50 per centum of lean trunk weight [LBW] in kg) times the bicarbonate backlog per liter: HCO3 backlog = 0.v x LBW x (Plasma HCO3 - 24) In a 60 kg woman with a plasma bicarbonate concentration of 38 meq/50, for example: HCO3 excess = 0.5 x 60 x 14 = 420 meq Information technology is of import to remember that this formula is but an estimate and that information technology does non have into account whatsoever continuing acrid loss, equally with nasogastric suction. Minimizing continuing acid loss in this setting with an H2-blocker also may exist helpful. Source: Merck Manual : https://www.merck.com/mmpe/sec12/ch157/ch157d.html Metabolic Alkalosis: Underlying conditions are treated, with detail attention paid to correction of hypovolemia and hypokalemia. Patients with Cl-responsive metabolic alkalosis are given 0.ix% saline solution Iv; infusion rate is typically l to 100 mL/h greater than urinary and other sensible and insensible fluid losses until urinary Cl rises to > 25 mEq/50 and urinary pH normalizes after an initial ascension from bicarbonaturia. Patients with Cl-unresponsive metabolic alkalosis rarely do good from rehydration. Patients with astringent metabolic alkalosis (eg, pH > 7.6) sometimes require more urgent correction of serum pH. Hemofiltration or hemodialysis is an option, particularly if volume overload is present. Acetazolamide 250 to 375 mg po or IV in one case/day or bid increases HCO3 − excretion but may also accelerate urinary losses of K+ and PO4 −; book-overloaded patients with diuretic-induced metabolic alkalosis and those with posthypercapnic metabolic alkalosis may peculiarly benefit. Muriatic acid in a 0.1 to 0.two normal solution IV is safe and effective just must be given through a central catheter because information technology is hyperosmotic and scleroses peripheral veins. Dose is 0.ane to 0.two mmol/kg/h, with frequent monitoring of ABG and electrolytes. Alternatives (usage depends on patient specific conditions): - Ammonium chloride (NH4Cl) (Note: Hydrochloric acid is the drug of choice in patients with hepatic dysfunction who are unable to tolerate ammonium chloride.) CLINICAL PHARMACOLOGY: The ammonium ion (NH4+) in the body plays an important role in the maintenance of acid-base residual. The kidney uses ammonium (NH4+) in place of sodium (Na+) to combine with fixed anions in maintaining acrid-base balance, especially as a homeostatic compensatory mechanism in metabolic acidosis. When a loss of hydrogen ions (H+) occurs and serum chloride (Cl−) decreases, sodium is made available for combination with bicarbonate (HCO3−). This creates an backlog of sodium bicarbonate (NaHCO3) which leads to a ascension in blood pH and a state of metabolic alkalosis. The therapeutic effects of ammonium chloride depend upon the ability of the kidney to utilize ammonia in the excretion of an excess of fixed anions and the conversion of ammonia to urea by the liver, thereby liberating hydrogen (H+) and chloride (Cl−) ions into the extracellular fluid. Dosing: Ammonium Chloride Injection, USP is administered intravenously and must be diluted before use. Solutions for intravenous infusion should non exceed a concentration of 1% to 2% of ammonium chloride. Dosage is dependent upon the status and tolerance of the patient. It is recommended that the contents of one to two vials (100 to 200 mEq) be added to 500 or k mL of isotonic (0.ix%) sodium chloride injection. The rate of intravenous infusion should not exceed five mL per infinitesimal in adults (approximately 3 hours for infusion of 1000 mL). Dosage should be monitored past repeated serum bicarbonate determinations. Supplied: 100 mEq (v mEq/mL) - 20 ml vial 267.5 mg/ml. For the treatment of hypochloremia or hypochloremic metabolic alkalosis in patients who cannot receive sodium chloride and who exercise not have finish-stage hepatic disease: Intravenous dosage: Adults: Individualize dosage based on the patient'due south carbon dioxide combining power. Each gram of ammonium chloride will reduce the carbon dioxide combining power of a 70-kg adult by about 1.1 volume %, or 16 mg/kg will lower the carbon dioxide combining power by 1 book %. In the absence of edema or hyponatremia, the dosage may be calculated on the footing of the chloride arrears by the post-obit formula: mEq of chloride ion (as ammonium chloride) = chloride deficit x 0.ii L/kg x weight (kg). The chloride deficit is 103 — serum Cl in mEq/50. Half of the calculated value should be administered, the carbon dioxide combining power should be rechecked and the need for further handling assessed. Do not exceed a concentration of ane—2% of ammonium chloride or an infusion rate greater than 5 ml/minute. - Acetazolamide (Diamox): chloride-resistant metabolic alkalosis. Metabolic alkalosis (unlabeled use): I.V. 250 mg every 6 hours for four doses or 500 mg single dose; reassess need based upon acid-base status. Alternatively: 5-10 mg/kg/d PO/Four divided q6h. Carbonic anhydrase inhibitor that blocks HCO3 reabsorption in the proximal renal tubules.

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