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ACUTE EXPOSURE INFORMATION

  1. USES: Used therapeutically as a parenteral crystalloid substitute for volume replacement or for maintenance therapy in the hospital setting. Also, commonly used as an additive for meals (ie, table salt) for electrolyte replacement during sports or outdoor activity, in water softening solutions, and in road salt for deicing roads.
  1. EPIDEMIOLOGY: Exposure is common, serious toxicity is very rare.
  1. PHARMACOLOGY: Sodium chloride can lead to increases in intravascular volume by adrenal glandular hormonal action. Also, potentially attenuates nitric oxide production.
  1. TOXICOLOGY: Sodium chloride can cause direct irritation to mucosal membranes, if ingested and may cause hypernatremia and hyperchloremia.
  1. WITH POISONING/EXPOSURE
    1. MILD TO MODERATE TOXICITY: Nausea, vomiting, diarrhea and abdominal discomfort may develop. Patients may complain of excessive thirst.
    1. SEVERE TOXICITY: Restlessness, seizures, mental status depression, coma, hypotension, and respiratory arrest are rare effects of severe sodium chloride toxicity. Acute ulcerative gastritis has been reported. Hypernatremia and hyperchloremia may develop, with associated fluid retention, and the potential for pulmonary and cerebral edema can occur. Hyperosmolarity of cerebral fluids may lead to cellular crenation and irreversible neurologic damage.
    1. PEDIATRIC: Poisoning from sodium chloride has resulted from gastric lavage with hypertonic saline and errors in the formulation of infant feeds. Intentional pediatric salt poisonings have been reported.
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