Oral Rehydration Salt (ORS)

By:- Makahaniya Rahul V Roll No.:- 22 B. Pharm Sem V K.B.I.P.E.R.

BACKGROUND
Diarrhea is a Great public health problem in developing countries like India II killer disease High Morbidity & Mortality. 70% deaths due to dehydration. ORS brought revolution : Greatest invention of century. 5 Millions - 1.5 millions deaths/ annum now.

Physiological Definition of Diarrhea

Loss of fluid and electrolytes via stools is net result of imbalance between secretory and absorptive processes in small & large intestine. Electrolytes have a critical role in the regulation of water absorption and secretion across the intestine.

Treatment of Acute Diarrhea

Oral Rehydration Therapy Dietary therapy Zinc therapy Antimicrobials Others

Oral Rehydration Therapy (ORT)

Oral Rehydration Solution (ORS)

WHO - ORS = Physiological Basis

Other Fluids & Liquid Diets

Recommended Salt sugar solution Lemon water(Sikanjabi) Rice water / Kanjee Soups Dal water Lassi Coconut water Plain water

Home Available Fluids

Not recommended Simple sugar solution Glucose solution Carbonated soft drinks Fruit juicestinned or fresh Fluids for athletes Gelatin desserts Tea/Coffee

Composition of WHO High & Low Osmolality ORS

----------------------------------------------------------------------------------------------------------------------------------Ingredients / L High Osmolality Low Osmolality Components / Litre_________ Sodium Chloride 3.5 2.6 Na 90 75 Sodium Citrate 2.9 2.9 Citrate 10 10 or Sodium Carbonate 2.5 2.5 H CO3 30 30 Potassium Chloride 1.5 1.5 K 20 20 Glucose 20 13.5 Glucose 111 75 Osmolality 311 245 ------------------------------------------------------------------------------------------------------------------------------------

Limitations of WHO High Osm-ORS

Does not lower volume, frequency and duration of diarrhea Induces vomiting due to taste, acceptability poor Enhances volume, purge rate & duration of diarrhea due to high osmolality More chances of dehydration Dehydrating fluid So more oftenly IV fluids required Hypernatremia Good to correct deficit fluids but not good for maintenance therapy

Need of Low Osm-ORS

Does lower volume, frequency & duration Equally effective in cholera, toxin related & RV diarrhea : Deficit & maintenance therapy No need of IV fluids Good for all ages infancy to adulthood Asymptomatic hyponatremia.

 to conclude

ORS plays a very important role in our vision to save children died due to diarrhea

THANK

YOU