EXPERIMENT 11: PREPARATION OF ORAL REHYDRATION SOLUTION (ORS)

ORAL REHYDRATION SALTS

SYNONYM: Sales perorales ad rehydratationem

Sodium chloride NaCl 2.6g

Sodium citrate C6H5Na3O7.2H2O 2.9g
Potassium chloride KCl 1.5g
Anhydrous glucose C6H12O6 13.5g
Water qs ad 1000ml

DESCRIPTION: white, crystalline powder; odorless

ADDITIONAL INFORMATION:
In the formulation of Oral Rehydration Salts trisodium citrate dihydrate may be replaced by 2.5 g/l of sodium hydrogen
carbonate, NaHCO3 (sodium bicarbonate). However, as the stability of the latter formulation under tropical conditions is
very poor, it is recommended only in Oral Rehydration Salts manufactured for immediate use, or where sodium hydrogen
carbonate is packaged in separate packets. These formulations would also allow the use of 14.85 g/l of glucose
monohydrate, C6H12O6.H2O, instead of anhydrous glucose.

ORAL REHYDRATION THERAPY

Oral rehydration therapy (ORT) can be delivered by village health workers and practiced in the home by mothers with some
guidance, and thus is a technology highly suited to the primary health care approach. Moreover, when given along with
advice on proper feeding practices, ORT has been found to contribute to better weight gain and thus to reduce the ill effects
of diarrhea on nutritional status.

ORT should begin at home with the use of available “home fluids” or a home-prepared “sugar and salt” solution given early
during the diarrhea episode to prevent dehydration. Once a child becomes dehydrated, however, ORT should be provided
in the form of a balanced and complete standard mixture of glucose and salts (ORS).

This ORS composition has passed extensive clinical evaluations and stability tests. The pharmacokinetics and therapeutic
values of the substances are as follows:
• glucose facilitates the absorption of sodium (and hence water) on a 1:1 molar basis in the small intestine;
• sodium and potassium are needed to replace the body losses of these essential ions during diarrhea (and
vomiting);
• citrate corrects the acidosis that occurs as a result of diarrhea and dehydration.
DOSE AND DOSING REGIMEN
Dosage
– Prevention of dehydration (WHO - Treatment plan A)
Child under 24 months: 50 to 100 ml after each loose stool (approximately 500 ml daily)
Child from 2 to 10 years: 100 to 200 ml after each loose stool (approximately 1000 ml daily)
Child over 10 years and adult: 200 to 400 ml after each loose stool (approximately 2000 ml daily)

– Treatment of moderate dehydration (WHO - Treatment plan B)

Child and adult:
Over the first four hours:
Age under 4 to 11 12 to 23 2 to 4 5 to 14 15 years
4 months months months years years and over
Weight under 5 kg 5 to 7.9 kg 8 to 10.9 kg 11 to 15.9 kg 16 to 29.9 kg 30 kg and over
ORS in ml 200 to 400 400 to 600 600 to 800 800 to 1200 1200 to 2200 2200 to 4000

After four hours:

If there are no signs of dehydration: follow Treatment plan A.
If there are signs of moderate dehydration: repeat Treatment plan B.
If there are signs of severe dehydration: start IV therapy (Treatment plan C).

– Treatment of severe dehydration (WHO - Treatment plan C)

In combination with IV therapy and only to a conscious patient:
Child and adult: 5 ml/kg per hour
After 3 hours (6 hours in infants), reassess and choose the appropriate plan A, B or C.

Duration
– As long as diarrhea and signs of dehydration persist.

EXPERIMENT 12: PREPARATION OF PRECIPITATED SULFUR USP

PRECIPITATED SULFUR USP

SYNONYM: Milk of Sulfur
DESCRIPTION: Very fine, pale yellow, amorphous or microcrystalline powder; odorless, tasteless

PREPARATION
Slake 12.5g of lime and thoroughly mix it with 125ml of water. Add 25g of flowers of sulfur, previously sifted and, after
thoroughly mixing, add 250ml of water and boil the mixture in a porcelain or glass vessel during one hour. The mixture
should be stirred frequently and the water lost by evaporation replaced. Now cover the vessel and allow it to stand until
the contents are cool and the supernatant liquid becomes clear. Carefully draw off the clear solution and filter the
remainder. To the combined liquids. Gradually add hydrochloric acid, previously diluted with an equal volume of water,
until the liquid is nearly neutralized but still retains an alkaline reaction and a yellow color. The solution should be stirred
constantly during the addition of acid. Collect the precipitate on a strainer and wash it until the washings are neutral to
litmus paper and do not give a test for calcium with ammonium oxalate TS. Dry the product rapidly.

SLAKING
• done in the preparation of calcium hydroxide, commonly known as hydrated lime
• a process done by the careful addition of a limited amount of water to lime (CaO)
• the process is characterized by the avid absorption of water by the oxide to form calcium hydroxide
accompanied by the evolution of much heat, swelling of the CaO lumps, and a final disintegration into a fine,
white powder.
• CHEMICAL EQUATION: CaO + H2O → Ca (OH)2
ADDITIONAL NOTES ON THE PREPARATION
• Most sublimed sulfur contains a small amount of arsenic as the trisulfide, and when it is digested with hot milk
of lime, calcium sulfarsenite, Ca3(AsS3)2 , is formed, which is soluble in the alkaline liquid.
• If the liquid is made acid by the addition of hydrochloric acid, the calcium sulfarsenite is decomposed into the
insoluble arsenic trisulfide which will again contaminate the precipitated sulfur.
• Sulfides of calcium are very much more readily decomposed by hydrochloric acid than is calcium thiosulfate,
the latter not being materially affected until all of the sulfides have been acted upon and only when the liquid is
decidedly acid to litmus paper.
• Any sulfur precipitated by the decomposition of calcium thiosulfate is not only much coarser than that
obtained from the sulfides but it is also insoluble in carbon disulfide; qualities that are most undesirable in
precipitated sulfur
• Precipitated sulfur is used in the preparation of Sulfur Ointment USP XVIII, at a concentration between 9.5 and
10.5%, due to its fine state of subdivision

COMMON NAME CHEMICAL NAME CHEMICAL FORMULA

Lime Calcium oxide CaO
Lime water Calcium hydroxide solution Ca(OH)2
Slaked lime Calcium hydroxide Ca(OH)2
Limestone Calcium carbonate CaCO3
Milk of Lime

OTHER FORMS OF SULFUR

• SUBLIMED SULFUR
o SYNONYM: Flowers of Sulfur
o Fine, yellow, crystalline powder having a faint odor and taste
o Obtained by condensing the sulfur vapors produced by heating any form of sulfur
• WASHED SULFUR
o Fine, yellow powder having a faint odor and taste
o when dried to constant weight over sulfuric acid, contains not less than 99.5% of sulfur

SULFUR: THERAPEUTIC USES

- Cathartic action
- Parasiticide in scabies
- Stimulant in alopecia
- Fumigation
- Keratolytic and fungicidal

EXPERIMENT 13: PREPARATION OF BORIC ACID NF

BORIC ACID NF
SYNONYM: Acidum Boricum; Boracic acid

PREPARATION
Add 50g of sodium borate (Na2B4O7.10H2O) to 120ml of distilled water and bring the solution to a boil. Filter the boiling
solution, and to the filtrate add 30ml of hydrochloric acid. Stir the mixture well and set it aside in a cool place for 24 hours
or until the next laboratory period. Collect the crystals on a wetted muslin strainer and allow them to dry completely. Wash
the crude product with a little cold water and again allow to drain. Weigh the wet mass. Dissolve it in approximately five
times its weight of boiling distilled water and set the solution aside for two or three days to crystalize. Collect the crystals
and wash them with cold water as before, spread them upon bibulous (absorbent) paper and allow them to dry in the air.
NOTES ON THE PREPARATION OF BORIC ACID
- Natural occurring deposits of boric acid:
NATURAL SOURCE CHEMICAL FORMULA
Rasorite Na2B4O7.4H2O
Borax Na2B4O7.10H2O
Borocalcite CaB4O7.4H2O
Tincal H3BO3.Na2B4O7.2CaB4O7.18H2O
Colemanite Ca2B5O11.5H2O

- Boric Acid Solution contains in each 100ml not less than 4.25g of H3BO3
- The use of HCl, a volatile acid, has superseded that of H2SO4 because residual traces of HCl will not remain on the
crystal surfaces when they are dried, whereas H2SO4, a non-volatile acid, is less easily removed.
- Upon chilling or evaporation of solvent, Boric Acid Solution tends to deposit crystals or become slightly turbid
because of the formation of minute crystals of Boric acid. These redissolve upon heating again.

PHYSICAL PROPERTIES:
- Found in the market in three forms:
o Transparent, colorless, odorless, pearly scales having a smooth feel
o Six-sided triclinic crystals
o White, odorless, rather bulky powder which is unctuous to touch (having a soapy feeling)

IDENTIFICATION TESTS

TEST POSITIVE RESULT

Litmus paper test Claret color to blue litmus paper
Turmeric paper test Brownish-red color to turmeric paper
Turmeric paper with Ammonia test Greenish black color to turmeric paper upon addition of
ammonia
Flame test (with methanol + sulfuric acid) Green-bordered flame

ADDITIONAL INFORMATION
- The name boric acid refers to what is technically known as orthoboric acid.
- Boric acid is not absorbed through the intact skin, but is highly toxic when ingested orally.
- It is absorbed when applied over large areas of broken skin.
- Toxic manifestations are first seen in the gastrointestinal tract regardless of the route of administration. Signs
and symptoms include nausea, vomiting, and diarrhea, followed by the formation of a severe rash (boiled
lobster appearance) and shedding layers of skin and mucous membranes. Other symptoms include general
weakness and headache.
- For external use, the solution may be used undiluted, except for ophthalmic use, for which purpose it may be
diluted with an equal volume of sterile distilled water. The dilution of the saturated solution, in addition to
guarding against the introduction of crystals into the eye, also renders the solution approximately isotonic, thus
minimizing any irritant effect due to a hypertonic solution

PHARMACEUTICAL AND THERAPEUTIC USES

- Vehicle for ophthalmic solutions
- Provide acidic media and buffered media for other drugs
- Used as an emollient antiseptic ointment in the treatment of diaper rash