Brand Name, Dosage Format and Strength
Hydrite Tablet ORS -90 Replacement Hydrite Tablet ORS -90 Replacement Sodium Chloride 350 mg + Sodium Bicarbonate 250 mg + Potassium Chloride 150 mg + Glucose, Anhydrous 2 g Tablet
Therapeutic Category
Nutrition
Class
Appetite Enhancers, ORS 75-replacement, ORS 90-replacement, Enteral, Nutritional Products
HOW MUCH AND HOW OFTEN SHOULD YOU USE THIS MEDICINE?
The 2005 WHO Manual for the Treatment of Diarrhea provides the following information on the assessment and treatment of dehydration:
I. HOW TO ASSESS THE DEGREE OF DEHYDRATION AND CHOOSE A TREATMENT PLAN
|
CLINICAL MARKERS |
USE TREATMENT PLAN A (Treat diarrhea at home) |
USE TREATMENT PLAN B (Consult a doctor or health care worker) |
PATIENT REQUIRES URGENT HOSPITALIZATION |
|
|
|
|
Condition
Eyes
Tears
Mouth and Tongue
Thirst |
Well, alert
Normal
Present
Moist
Not thirsty, drinks normally |
*Restless irritable*
Sunken
Absent
Dry
*Thirsty, drinks eagerly* |
*Lethargic or unconscious; floppy*
Very sunken and dry
Absent
Very dry
*Drinks poorly, or not able to drink* |
Skin Pinch |
Goes back quickly
|
*Goes back slowly* |
*Goes back very slowly* ( > 2 seconds) |
|
The patient has No Signs of Dehydration |
If the patient has two or more signs, including at least one of the signs with double asterisk marks (*sign*), there is SOME DEHYDRATION |
If the patient has two or more signs, including at least one of the signs with double asterisk marks (*sign*), there is SEVERE DEHYDRATION |
II. HOW MUCH ORS SOLUTION TO USE BASED ON PATIENT ASSESSMENT AND TREATMENT PLAN
- TO PREVENT DEHYDRATION (TREATMENT PLAN A)
Direction: Dissolve two tabs or one sachet in one glass (200 mL) of clean drinking water.
Give as much fluid as the child or adult wants until diarrhea or vomiting stops or you may use the following guide according to the WHO:
Age Group |
Amount of ORS Solution to Give After Every Watery Stool |
|
Children under 2 yrs |
¼ to ½ glass (50 to 100 mL) |
|
Children 2 to 10 yrs |
½ to 1 glass (100 to 200 mL) |
|
Older children & Adults |
As much fluid as they want |
- Give other suitable fluids including plain clean water, rice water, vegetable or chicken soup, green coconut water, yoghurt drink, weak tea (unsweetened), unsweetened fresh fruit juice. Do not use sports drink or foods with a lot of sugar.
CONTINUE USUAL FEEDING, AS TOLERATED. CONTINUE BREASTFEEDING.
· TO TREAT DEHYDRATION (TREATMENT PLAN B)
(To Replace Mild to Moderate Fluid Loss)
Direction: Dissolve two tabs or one sachet in every glass (200 mL) of drinking water.
|
Age Group |
Approximate Weight (kg) |
Amount of ORS Solution to Give Within the First 4 hrs |
|
Less than 4 mos |
Less than 5 |
1 to 2 glasses (200 to 400 mL) |
|
4 to 11 mos |
5 to 7.9 |
2 to 3 glasses(400 to 600 mL) |
|
12 to 23 mos |
8 to 10.9 |
3 to 4 glasses (600 to 800 mL) |
|
2 to 4 yrs |
11 to 15.9 |
4 to 6 glasses (800 to 1,200 mL) |
|
5 to 14 yrs |
16 to 29.9 |
6 to 11 glasses (1,200 to 2,200 mL) |
|
15 yrs or older |
30 or more |
4 to 7 glasses (2,200 to 4,000 mL) |
Alternatively, one can multiply the patient’s weight (in kg) by 75 mL to obtain the approximate volume (mL) of this ORS solution to be given in the first 4 hrs.
- Continue breastfeeding even during the initial rehydration period
- After 4 hrs, reassess the patient using the assessment chart and select the appropriate Treatment Plan.
If there are no signs of dehydration, shift to Treatment Plan A.
If signs indicating some dehydration are still present, repeat
Treatment Plan B and continue to reassess the patient frequently.
If signs of severe dehydration have appeared, bring the patient to the hospital immediately for urgent intravenous rehydration. For this to happen is unusual, however, occurring only in children who drink ORS solution poorly and pass large watery stools frequently during the rehydration period.
- When rehydration is complete, skin pinch is normal, thirst subsides, urine is passed, and the patient is no longer irritable.
CONTINUE USUAL FEEDING, AS TOLERATED, AFTER THE INITIAL 4-HOUR DEHYDRATION PERIOD