Dosing and uses of ammonium chloride
Adult dosage forms and strengths
injectable solution
- 26.75%
Hypochloremic States & Metabolic Alkalosis
Determined on the basis of patient's CO2 combining power
mEq of chloride ion (as ammonium chloride) = chloride deficit in mEq/L × 0.2 × kg body weight
Pediatric dosage forms and strengths
Safety & efficacy not established
ammonium chloride adverse (side) effects
Frequency not defined
Metabolic acidosis
Potassium depletion
Injection site reactions
Ammonia toxicity symptoms
Warnings
Contraindications
Severe hepatic impairment
Cautions
Pulmonary insufficiency, cardiac edema, severe renal impairment (do not give NH4Cl alone if concomitant Na loss)
Risk of ammonia toxicity
Monitor pt's CO2 combining power prior to IV administration to avoid serious acidosis
Pregnancy and lactation
Pregnancy category: C
Lactation: N/A
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of ammonium chloride
Metabolism: ammonium ion is converted to urea in the liver; chloride ion replaces bicarbonate
Excretion: urine
Mechanism of action
Replaces bicarbonate ions with chloride ions
Administration
IV Incompatibilities
Additive: dimenhydrinate(?), levorphanoL
Y-site: warfarin(?)
IV Preparation
Dilute the 26.75% concentrate by adding 100 or 200 mEq (20 or 40 mL) of NH4Cl to 500 or 1000 mL of Ns
IV Administration
NMT 5 mL/min in adults
