Major Extra and Intracellular Electrolyte - Study Notes

a(IPC)UNIT:-21liMajor Extra and Intracellular electrolytesInorganic and Organic compounds of various types are presentin body fluids. The concentration of these substances invarious compartments is balanced so that the body cells andtissues have got the same environment.The chemical substances dissolved in the body fluidcan be categorised as:-(a) Electrolytes(b) Non-ElectrolytesThese include organic moleculescovalent bonds. Glucose, urea, creatine.In solution form, they do notgenerate ions.Electrolyte is a Substance that ionizes when dissolvedin a suitable ionising solvents such as Water'OR'These compounds dissociates into cations ( vely chargedfons) and anions (-vely charged ions) when they dissolvein body fluids. Acids, bases and salts are the examples.Electrolytes are used in replacement therapy andfor the correction of acid- base balance in variousbody fluids. The electrolyte concentration of body fluidhave been different in various body fluid compartments. 2The various body fluid compartments are:-1Intracellular fluid:- fluid which is present insidethe cell(45-50% of body weight, volume is 30Ltr)2Extracellular fluid:- fluid which is present outside theeg! cytoplasmORInterstitial fluid & cell( 12-15% of body weight, 10 Ltr.)eg, Blood plasma3Plasma or vascular fluid: which is present within theblood vascular System4-5% body weight, 3-5 Ltr.)The major electrolytes found in the body are.calcium potassium, phosphate , Iron, magnesium, chloride,Sodium.Extracellular fluid includes both interstitial andvascular fluids. These fluid compartments areseparated from each other by a membrane which arepermeable to Water and organic and inorganicsolutes. The membrane are impermeable to Macromoleculeslike proteins & Selectively permeable to certain ionsSuch as Nat, k+, Mg++Due to this permeability mechanism each fluidcompartment has a distinct solute pattern and the solution in each compartment is Conically balanced3Body has the capacity to adjust slight variationsin the electrolyte concentrations of the fluid compartmentsfor eg! if the concentration of ions in any compart-ment changes, water will migrate across the cellmembrane to reestablish osmotic equilibrium. However,Replacement Therapy has to be used when the bodyitself fails to correct an electrolyte imbalance dueto change in composition of the fluidMinerals salts (inorganic compounds) are necessarywithin the body for all body processes. They are usuallyrequired in small quantities.The main elements involves Calcium, phosphures, ironsodium, potassium and chloride.Calcium and phosphorus are constituents of bone &teeth.In the form of haemoglobin, iron helps to conveyoxygen and carbon dioxide.Sodium & Potassium are involved in transmissionof nerve impulses & in the contraction of muscles.Important functions sowed by electrolytes:-control of osmosis of Water b/w body compartmentMaintain activities acid-base balance required for normal cellularHelp to generate action Potential &control Secretion of Hormones. 4function of Major Physiological ions :-1Sodium:- sodium is the most abundant extracellular ion.This is principally responsible for maintaining properhydration and asmotic pressureThe normal sodium content in the body varies from5 to dogm and the daily requirement is in between3-5 gm. The main Source of sodium required for our bodyis tablesalt which is used in cooking.Excess sodium is excreted by kidneys. if the bodyfails to excrete excess sodium, its concentration startsaccumulating. which leads to hypertension.The Ma+ level in the blood is controlled byaldosterone and antidiuretic (ADH) hormones.Sodium loss from the body may occurs throughexcessive perspiration, vomiting or diarrhea; Such aloss can results in hyponatremia ( se serum Na+level)it could also result due to Addison's disease, kidneydamage, metabolic acidosis.Hypernatremia ( Tse serum Nat level) is found inhyperadrenalism c Ised aldosterone production.If Sodium is not eliminated from the body, theconcentration starts to 9se, Water is retainedis occurin the tissue to maintain osmotic balance R edema 52Chloride :- it is major Extracellular anion of both interstitialand vascular fluids compartments and is required formaintaining proper hydration, osmotic pressure and normalcation-anion balance.the total chloride ion present in the body is about 50mgqper body weight and body daily requirement is about5- 10 gm as Sodium chloride.chloride is completely absorbed from the Intestinal tract.They are excreted in urine and through Skin duringSweating. They are present in all body Secretions.it is responsible for maintenance of charge betweenIntracellular & Extracellular fluid. for eg:- Co2 passes intored blood cells and is converted to bicarbonate anion;equivalent chloride moves out of the cell to maintaincharge neutralityHypochloremia is resulting from salt - losing nephritis(inflammation of kindney kidney), chronic pyelonephritis(inflammation of kidney 4 its peluis); metabolic acidesiscausing either excessive production or excretion of acids 4leading to replacement of chloride by acetoacetatePhosphate, and prolonged vomitting c lass of chloride asgastric hydrochloric acid.Hyperchloremic :- observed in dehydration, these renealblood flow found c renal damage and excessivechloride intake 63Calcium:-caluium is an important constituents of teeth and bones andit also concerned c the functioning of Muscles and clottingof blood.The main Source of calcium include milk, cheese, green vige-dictary-tables, egg, cereals & fish.Average daily intake for calcium in adults is Bco- 1000mgwhile minimum requirement in an adult is about400mg per day.The level of calcium ions in the Plasma is regulatedby parathyroid hormone and calcitoninHypocalcaemia:- if the calcium concentration is law inthe body, resulted from hypoparathyrodism, vitaminD defeciency and disorder in bone metabolism.Paget's diseases :- (Bony diseases) due to inadequatecalcium metabolism. This is followed by calciumdeposition. This results in thickening and then deformity.At Night, When a person sleeps without food intake,reabsorption of the bone occurs in order to maintainblood calcium levels. 4Potassium:- it is the major intracellular cation, 7present as about 23 times higher than present inthe Extracellular fluid in the human body. Thisconcentration difference is maintained by an activetransport Mechanism.The main Source of Potassium in food includes milk,vegetables meat and Whole grainsPotassium ions are used to maintain the electrolytecomposition of various body fluid, helps to regulatePH by exchange against for hydrogen ions and inmany biochemical activities inside the cell.Excess of Potassium is rapidly excreted by the kidney.Hypokalemia (low serum Kt levels) may we developdue to vomiting, diarrhea, kidney damage. & causechanges in Myocardial function,craps, rseurinary outputHyperkalemia (Hyperpotassemia) is occurs duringkidney damage.5Magnesium (Mg2) :- it is another major cationin the intracellular fluid compartment.Adult human body contains about 25 gm of mgd+, about54% being present in the bones with phosphories.it helps in protein synthesis and for the Smooth 8functioning of neuromuscular system.( Mga activates enzymes involved in carbohydrates &Protein metabolism)its deficiency cause personality change, (Hypomagnesmis)loss in body Weight & cardiac disturbances.6phosphate :- (HPOY) is the principal anion of theIntracellular fluid compartmentGood Sources of phosphate are cereals, pulses, nets &oil- seeds.it is an important buffer system; related to theutilization of calcium, carbohydrates and fats andis also presents in the bone and teeth.About 415 of total body weight phosphate is presentin bones and teeth. Rest of phasphate present in thecells as phospholipidsPhosphonylation is very important in MetabolicProcess Combustion of glucose or its conversion toglycogen requires phospharylation.Phosphate defeciency is usually reported to occuronly in patients with calcium defeciency. Phasphatedepletion occurs as a results of renal tubularamount disorders or antacids in a patients consuming a largeof 97Bicarbonate :- (HCO3) is the second most common.anion in the extracellular fluid compartment.Along with carbonic acid it is utilised as thebody's most important buffer system.7.35 (metabolic acidasis) and excess cause metabolicA lack of bicarbonate cause blood pH to go belowalkalosis8Iron :- Iron form an important component ofhaemoglokin which act as a carrier of oxygenin bloodMain source of iren includes green leafy vegetables,millets like bajra and ragi.The deficiency of iron causes anaemia. 14UNIT-2Part. B scUNIT :-2 (ii)ToElectrolytes Used in Replacement therapy:-In Normal conditions, the body is able to adjust theelectrolyte balance while in Some conditions like prolongedfever, severe vomiting or diarrhia, there occurs a heavyloss of water and electrolyte So, there is need to adminis--tration of lost electrolytes.There are some electrolytes used in replacementtherapy are Sodium chloride and its salts such as sodiumchloride injections, Potassium chloride.(1)Sodium chloride:-chemical formula: NaclMolecular Weight:- 58.44category:- Electrolyte replenisherDescription:- it contains not less than 99.5% of Nacl. itoccurs as a white enystalline powder or a colourless cubiccrystals having a Saline taste. it is freely soluble in Water,soluble in glycerin and slightly soluble in alcohol.In Nature it is found in sea Water, in Salt lakes(Sambhar in India) and in deposits of rock salt (Mandi) (H.P)Preparation :-on commercial Scale, it is prepared by evaparation ofSea Water in shallaw pans. it contains certain impurities(Na2 Co3), Na2 Soy , Hgch), which are removed by dissolvingcommon salt in Water in cemented lanks. Some alumand lime are added. The impurities are settled down. physical properties: odownless, colourless crystalline powder. solubleit is Soluble in Water, glycerin and slightlyTest for Identification: it gives the reactions of sodiumin alcoholand chloride.Assay :- The assay is dependent on modified amount volhard'smethod in which an accurately weightof sample (0.5g) is dissolved in water (50ml) andtitrated with O.IN silver Nitrate sol' using Potassiumchromate as an indicator formation of silver chromate.Nael + AgNo3Agel+NaNo + Agalencted(excess)2AgN03 + K2 (804Agacrou + 2KNU3unreacteduses:-used as electrolyte replenisher, emetic.Isotonic Solution (0.9%W10) are used in Wet dressings.They are used to urigate body cavities or tissues.and used as injections when fluid & electrolytieshave been depleted in isotonic proportionsHypotonic solutions are used in case when patientscannot take fluid and nutrients orally for 1- 3daysHypertonic injections are given to patients whenthere is loss of Sodium 2 un an excess of water. 12may be used as eye-drops, Nasal drop (to relievenasal congestion) and as mouthwash (to remove debris,for throat infection).Excessive use cause Nausea, vomitting, diarrhea, abdominal]2Potassium chlondecramps, hypotension, tachycardia (rapid pulsecategory:- Electrolyte replenisherchemical formula:- KCImolecular Weight:- 74.5Description :- it occurs as a white colourless, adownless,cubical, elongated or prismatic crystals. it has a saline taste.it is freely sduble in water and insoluble in alcohol.In nature. it is friend as syline (kd) and caranallite( contaminated with magnesium Sulphateand chloride.preparationPotassium chloride is prepared by reacting hydrochloricacid with Potassium CarbonateKglo3 + 2HdKcl + H2CO3Test for Identification :- A solution gives the reactionof Potassium and of chloridesAssay:- An aqueous solution of the substance istitrated with O.IN silver nitrate, using Potassiumchromate solution as indicator.3 uses:- used as electrolyte replenisherused in treatment tlt of Mysthenia of Potassium gravis defectency. (muscle weakness),used and as in antidote the in digitalis intoxication.Excessive Hyperkalaemia of causing muscle Weakness, paralysis, Hypotensionuse Potassium leads to development of[cardiac arrest.3Calcium gluconate:-chemical formula:- (C12H22O14 Ca. H2O)molecular Weight:- 448.4gluconic acid with excess of calcium carbonate, filteringPreparation:- it is prepared by boiling a solution ofand erystallicing the Substance from filtrate.2(H2(OH) ((HOH)U 100H + cace, + Calo3 + CO2 + H2OProperties :- occurs as adourless, White crystalline powder,tasteless, freely soluble in heiling Water, sparinglySoluble in water and insoluble in alcohol, ether &chloroform.Assay:- Calcium gluconate is dissolved in dil Hcl.add mgsoy soi fi PH 10 buffer solution thenagain solution using erichrome Black T (EBT) indicatortitrate the content of flask against Mgsou soin4 14uses: used as a Source of calcium ion in +/t ofcalcium defeciency and hypocalcaemic tetany.Oral Rehydration Salt (ORS) :-oral Rehydration salt contain anhydraus glueose, Sodiumchloride, Potassium chloride and Sodium citrate or sodiumbicarbonate These dry preparations are to be mixed inspecific amounts of Water along with certain flavouringagents. These are used for oral rehydration which therapy.In ancient times, homemade ORS is usedconstitutes of one tablespoonful of salt, two tablespoonfulof sugar in 1 Ltr. of WaterThe Oral administration of fluid that containsa suitable combination of carbohydrates andelectrolyties is known as oral rehydration therapy.(ORT)it does not stop diarrhoca, but the diarrhoeausually continues for only a limited time.Glucose accelerates the absorption of Sodium &Water from the small intestine and this processis not impaired during diarrhea.A rational response to diarrhea involves preventionof dehydration using glucose - salt solutions The maintains its physiological Acids occurs are produced onlyphysiological Acid base balance :-within a very narraw PH range ofduring body Metabolism. Most metabolic 7.38-742 Therefore,the utilizes several suffer system;1 Bicarbonate body - carbonic acid (HLO5/H2(03) present in plasmaand kidney.2Monohydrogen phosphate- dihydrogen phosphate (HPO4-2/12Pai)which are found in the cells and kidneys.Hemoglasin (Hb) present in red blood cells acts the asa buffer System. This single buffer system bufferscarbonic acid produced during metabolic processes.Carbon dioxide is produced in the cells continously.is diffuses from the cells to plasma. A small portionof lo2 dissolved in plasma & other small portion of 102reacts with Water to form carbonie acid, which isbuffered by Plasma proteins.Most of the Co2 enters the erythrocytes where itcombines with haemoglobin and form carbonic acidby reacting with carbonic anhydraseCO2+H2O carbonicanhychoreH2 (036 The PH of erythrocytes Tsed due to the concentrationof carbonic acid is compensated by heemoglakin.H2CO3 + K+ + Hbo2K+ + HCO3 + HHb t O2In lungs, there occurs reversal of the above processas there is large canc' of oxygen present oxygenthen combines with the protonated deoxyhemoglobinand release protons.These then combines with bicarbonate and formcarbonic acid The carbonic acid then dissociates toCO2 and Water. The carbon dioxide is then exhaledby the lungs.So, by regulating the breathing process, body cancontrol HCO3/H2103 ratio.O2+ HHb + K+ + HCO3k++ Hbo2 + H2O + (02 + H2L03H2ot 1029 Dental products:- UNIT:-2 are those substance which(iii) Partis used for maintain the dental hygiene.orThe Substance used to produce effect an teeth andin dental cavity is called as Dental productsTypes:1Anticaries Agents :- sod fluoride2cleaning Agents:- Dibasic calcium phosphat3Polishing agents'- sod Metaphosphate4Desensitizing Agents :- zinc chlorideAnticaries Agents Dental carries is the medicalterm for tooth decay or cavities it is caused byspecific type of bacteria They produced acid thatdestroys tooth's enamel and the layer under it, thedentinmany different types of bacteria normally livein human math They build up an the teeth ina Sticky film called Plaque. This Plaque also containSaliva, bits of food. Plaque form most easily incertains parts like tracks, pits or grooves in theback teeth, in between teeth and near thegum line.10 2same of the Plaque bacteria turn Sugar andcarbohydrates (starches) of the food into the acids.The acid dissolves minerals in the hard materialthat covers the tooth crown li.e enamel).The enamel erods or develops spites.# Dentrifies :- A dentifice is a substance usedwith a tooth brush for the purpose of cleaningthe accessible surface of the teeth.commercial dentifices are available in theform of pastes & powdersDentrifices or tooth pastes are responsiblefor physically removing plaque and debris. Theymay also contain swectening agents. 3#Role of fluoride in the treatment of dental Products:-development of tooth in general and in theThe fluoride has very important role in thedevelopment of enamel in particularit the hydroxyl for of hydroxyapatite Ca-Paw) withthe fluoride replaces ion to form fluorapatite (by replacing(Hydroxyapatile is crystals of enamel).The fluorapatite is more resistant to careiswhen compared to hydroxyapatits Therefore, enamelbecomes move resistant to dental caries.it also converts the outer layer of enamel'shydroxyapatite into fluorapatite when a toothpastecontaining fluoride is used regularly.Therefore, we can canclude that fluoride helpsin the prevention of the development of dentalcarisHydroxyapatite is a naturally occuring mineralform of calcium apatiteo(15 H3)45thCH,1)IL6in2TENN 4Calo (Pou) (OH)(HydroxyapatiteCalo (Pol) f2(fluorapatite)it can be administend by two routu orally andTopically. fluoride in law concentration (1ppm), ifpresent in drinking Water also cause the the indevelopment of incidence of cares.Densensitizing Agents :-The desensitizers tend to dise hypersensitivity of the teeth.When applied to their outer surface, especially whereerosion has occured near the gum line, they reducethe sensivity of the teeth to hot and coldInorganic compounds of chloride desensitizers areStrontium chloride and zincqLine chloridethe formula - Znetznot Weight - 136Preparation it is prepared acid by heating granulatedSynonym - Butter of zinezinc with hydrochloric2nd 2ncl2 + H2Zn +13 5properties:- White, odownless, deliquescent crystallinepowder.it is soluble in Water or in alcoholuses:- used as an antiseptic, astringent to the skin.used as active ingredient to prepare magnesiacements for dental fillings & certain mouth washeseg!2 strontium chloride:-chemical formula! Srcl2 or Srcl2 6H20molecular lalt 158 (anhyd.)Properties it :- effloresces colourless, in odourless air crystalsit deliquescent in moist air.it is soluble in water & alcoholuses:- used in tooth paste for the relief of DentalhypersensitivityCalcium carbonate :-chemical formula:- Caco3malecular weight 100Synanym:- Precipiated chalkCalcium Calcite, iceland carbonate is dolomite found in nature as limestone,spar, 14 and shells of Sea animals 6method of Preparation :-calcium carbonate is precipitated when carbon dioxideis passed is through lime-Water or a Solution of Sodiumcarbonate added to calcium chlorideCaco3 + CO2 + H2O(a(H(03)2Cacl2 + Na2(03Caco3 + 2 Naclby Properties :- occus as white, odourless, tasteless,microcystalline powder which is Stable in air.Soluble in dil Hcl and Nitric acid but insolublein Water and alcoholthe Properties :- calcium carbonate is decomposed atabout 83° into (ao and CO2DCaO + CO2Ca CO3In the presence of Lo2 calcium carbonate carbonate dissolvesin Water due to formation of CalciumH2O (a (H(03)2Calo3 + (o2uses i dentifice (externally)Deu to used in fast the preparation ofused as its action, caco3 is Homoepathic used as antacid.medicine also (calcarea carbonica) 15 7Sodium fluoride:-chemical formula:- NafPreparation:- Weight it is prepared by realing hydrofluoric Huoride ismalecular :- 42acid with Sodium carbonate sodiumprecipitated in the reaction mixture2 Naf + H2 ot (0242HFNa2(03Alternatively, the another methods involves the doubledecomposition of calcium fluorideProperties:- white, odourless powder or colourless crystalitis soluble in Water & insoluble in Alcoholchemical reactions :-Treatment of Sodium fluoride c conc. H2SO4 liberatehydrogen fluoride. The gas attacts Silica & SilicatesNa,SiO3 + 6 HfNa2 sife + 3H2Ouses :.. used in dental productsused in insecticides & rodenticides16 fzine engenal cement :-compositionaLiquid - Eugenol- olive oil (used as plasticizer)bPowder - zinc oxide (principal ingredient)- zinc Stearate ( [Plasticizer)- zinc acetate (improves strength)- White rosin ( to reduce brittlenessof set cement)Properties 1. it is the cement of law strength, lowabrasive resistance and low flow after setting, So itis used for temporary filling.it has adhesive effect on exposed dentin. it isleast irritating than other dental cements.uses :- used as an impression material duringconstruction of complete dentures.