Resocal

Calcium polystyrene sulphonate.

Each Resocal Powder sachet contains Calcium polystyrene sulphonate 5 g.
Resocal containing Calcium polystyrene sulphonate as active ingredient is available in 5 g powder.
Molecular formula: C₈H₇CaO₃S⁺.
Molecular weight: 223.3.
Chemical name: calcium 2-ethenylbenzenesulfonate.

Pharmacology: Calcium polystyrene sulphonate contains ion Ca²⁺ in radical group of sulphonate resin which is a copolymer styrene divinylbenzene. By action as ion resin exchange. Calcium polystyrene sulphonate release ion Ca²⁺ and bind K⁺ by adsorption.
In oral administration, this medicine will cause process of ion exchange in gastrointestinal tract and then excreted in feces. Calcium polystyrene sulphonate does not effect to spontaneous motoric activity. Calcium polystyrene sulphonate cause elimination of ion K⁺ in renal failure patient.

Hyperkalemia conditions because of acute and chronic of renal failure.

Adult: The usual dose is 15 gram, divide in 3 or 4 times daily. Dosage can be adjusted as severity level of the illness. Suspended in 30-50 ml of water.

Hyperthyroid.
Multiple myeloma.
Sarcoidosis or carcinoma metastases with renal failure and hypercalcemia.
Serum potassium levels less than 5 mmol/L.
History of hypersensitivity to polystyrene sulphonate resins.

In administration of Calcium polystyrene sulphonate, have to monitor serum calcium and potassium level regularly during therapy.
The possibility of severe potassium depletion should be considered and adequate clinical and biochemical digoxin. Administration of the resin should be stopped when the serum potassium falls to 5 mmol/L.
Serum calcium levels should be monitored at weekly intervals to detect the early development of hypercalcemia and hypocalcemia are prevented. Hypomagnesemia may also occur and serum magnesium levels should be monitored.
In the event of clinically significant constipation, treatment should be discontinued until normal bowel movement has resumed. Magnesium containing laxatives should not be used.
With oral administration, care should be taken to avoid aspiration, which may lead to bronchopulmonary complications.
The use of sorbitol with polystyrene sulphonate both orally and in enemas has been implicated in cases of colonic necrosis. Although no cause and effect relationship has been established, it is prudent not to use sorbitol with calcium polystyrene sulphonate.
Since effective lowering of serum potassium with calcium resonium may take hours to days, treatment with this drug alone may be insufficient to rapidly improve severe hyperkalemia, often associated with states or rapid tissue breakdown e.g. burn or trauma. In such cases, dialysis is recommended. Where there is hyperkalemia crisis leading to an emergency state, immediate treatment with intravenous glucose and insulin or intravenous sodium bicarbonate may be required to lower the serum potassium level rapidly & briefly while other long-term potassium lowering therapy is prepared.

Gastrointestinal tract: May occur constipation and rarely nausea, vomiting, anorexia and dyspepsia.
Electrolyte: Hypokalemia sometimes occurs, serum potassium level should be monitored and if necessary the dose could be decreased or stopped.
Hypercalcemia may occur.

Depletion of potassium serum level may increase probability of digitalis intoxication.
Co-administration of drugs or liquids containing cations may reduce the effectiveness of calcium resin binding to potassium.
Aluminium hydroxide, intestinal obstruction due to co-administration of aluminium hydroxide has been reported when taken in combination with resin.
Digoxin: The toxic effects of digoxin to the heart, especially ventricular arrhythmias and AV nodal depression, can be exaggerated by hypokalemia and/or hypercalcemia.

Store below 30°C.
After reconstitution, store maximum 6 hours at temperature below 30°C. It is recommended to drink it immediately after reconstitution.

Antidotes & Detoxifying Agents

V03AE01 - polystyrene sulfonate ; Belongs to the class of drugs used in the treatment of hyperkalemia and hyperphosphatemia.

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