Dehydration and Oral Rehydration Solutions

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Health Professional Training Guide Up to 75% less sugar and 4x more electrolytes vs. the leading sports drinks Wide range of innovate formats and great tasting flavors Lasts for 30 days in the refrigerator after opening Suitable for all ages

Fluid regulation in the body Fluids and solutes, along with nutrients and waste products, constantly shift within the body s compartments from cells to interstitial spaces, to blood vessels, and back again. Water is moved as needed to keep the amount in each area relatively constant, thus enabling the body to function optimally: When water loss is severe, the amount of water in the bloodstream decreases. The body moves water from inside the cells to outside the cells, and into the bloodstream until it can be replaced through increased fluid intake. When the body has excess water, the amount in the bloodstream increase. The body moves water from the bloodstream into and around the cells, ensuring blood volume and blood pressure can be kept relatively constant. Fluid imbalance To maintain a euhydrated state (optimal fluid balance) water intake must equal water loss. Fluid imbalance occurs when there is a: FLUID DEFICIT Active fluid loss: hemorrhage, diarrhea, excessive sweating. Inadequate fluid intake: poor thirst mechanism, mobility issues (i.e. in seniors). Regulatory mechanism failure: renal impairment, medical conditions (such as diabetic ketoacidosis), medications (such as diuretics). FLUID SURPLUS Excess fluid intake (without electrolyte replacement). Regulatory mechanism failure, medical conditions (such as congestive heart failure). Fluid imbalance can be associated with: dehydration, hyponatremia, heat cramps, heat exhaustion, heat stroke. SIGNS AND SYMPTOMS of dehydration: Increased thirst Fatigue / Lethargy Dizziness Headaches Dark yellow urine, or decreased urine output Sticky or dry mouth Loss of skin elasticity Irritability A focus on DEHYDRATION Dehydration is the significant depletion of body water and electrolytes. Dehydration results from increased fluid loss, decreased fluid intake, or both. Mild to moderate dehydration is commonly defined as 2 6% of body weight loss through fluid. Risk factors for dehydration Vomiting & diarrhea Large loss of fluid and electrolytes. FACT: Dehydration is the biggest health risk associated with vomiting and diarrhea. Heat Heat exposure raises the core body temperature and usually increases the sweat rate. Travel Travellers diarrhea. Increased physical activity and exposure to the sun (excess fluid and electrolyte loss through sweat). Long-haul flights (dry cabin conditions) can result in dehydration. Fever Fever (elevated body temperature > 37 C) is often accompanied by increased sweating which leads to fluid and electrolyte loss. Vigorous exercise / Strenuous activity Increased physical activity will increase the core body temperature and sweat rate. Work Prolonged physical work results in an increased sweat rate.

How to manage dehydration Replacing lost fluid and electrolytes with an oral rehydration solution (ORS) is the most important aspect of managing dehydration. Hydralyte is a scientifically formulated ORS based on the World Health Organization criteria for oral rehydration therapy. 1 The solutions contain the correct balance of glucose and electrolytes to allow for rapid and effective rehydration. Oral rehydration solutions (Hydralyte) The science The most important physiological features are: 1. Correct balance of sodium and glucose leads to the activation of the sodium-glucose co-transporter in the small intestinal lumen this allows for rapid absorption. Sodium and glucose bind to the transporter protein driven by high sodium concentrations in the small intestine. This dual binding causes the transport protein to change shape, delivering sodium and glucose to cell internals. At the same time, water moves into the cell internals by osmosis. Sodium and glucose are both actively transported out of the cell into the blood, along with water. Hydralyte products Powders: Easy to prepare format, compact and portable for travel and on the go. Packaged with a measuring cup to allow for accurate dosing. Solutions: Convenient pre-made drink. Extended shelf life after opening (1 month). Available in 1 Litre and 250 ml size bottles. SMALL INTESTINE CELL MEMBRANE CELL INTERNALS 2. The solution is hypotonic this allows for effective rehydration while minimizing potential side effects such as unnecessary calories or a feeling of fullness/bloating. It is important to know that water alone or sugary drinks (i.e. soda or sports drinks) do not contain the correct balance of sodium or glucose to allow for rapid hydration. 1 World Health Organization. Oral Rehydration Salts Production of the new ORS. 2006. Available at: http://whqlibdoc.who.int/hq/2006/who_ FCH_CAH_06.1.pdf Hydralyte is suitable for all ages Effervescent tablets: Compact in size to fit in luggage for travelling families, and diaper bags for moms on the go. Easy to use format dissolve 2 tablets in 200 ml of water. stirring required.

Ingredients Hydralyte electrolyte powder Sodium chloride, potassium citrate (monohydrate), citric acid (anhydrous), glucose (anhydrous), sucralose and Orange flavour: natural colour (B-carotene, 160a), natural flavour OR Berry flavour: natural and nature identical flavours, natural colour (grape anthocyanin) Hydralyte electrolyte solution Sodium chloride, potassium citrate (monohydrate), citric acid (monohydrate), glucose (monohydrate), purified water, potassium sorbate, sodium benzoate, and: Orange flavour: orange colour (110), sucralose. Berry flavour: blackcurrant colour solution (122,133) natural flavour, sucralose. Lemonade flavour: natural flavour, stevia extract. Hydralyte effervescent electrolyte tablets cose anhydrous, citric acid anhydrous, sodium bicarbonate, potassium chloride, sodium chloride, tabletting aids (maltose, mannitol, macrogol 6000) and: Orange flavour: natural colour (B-carotene 160a), natural flavour, sucralose. Berry flavour: natural colour (grape anthocyanin), nature identical flavours, sucralose. Lemonade flavour: natural flavour, stevia extract, pregelatinised starch. Contains no macrogol 6000. Hydralyte formulation Ingredient Function Hydralyte per Litre Sodium Potassium Chloride Primary sugar Osmolality Calories per Litre Helps body to retain fluid Essential for nerve and muscle function Helps body to retain fluid Assists with absorption of fluid and electrolytes WHO recommendation = 245 mosm/l Sports drink (per Litre approximate values) 45 60 mmol 12 23 mmol 20 mmol 4 9 mmol 35 45 mmol NA 16 g (glucose) 60 80 g (glucose/ fructose/ sucrose) 245 mmol Variable not standardized 80 (powder, solution) 110 (effervescent tablets) 260 320 FAQs for Health Care Professionals Is Hydralyte suitable for people with diabetes? Hydralyte products contain up to 2 g of glucose per 100 ml. For people with diabetes this amount of glucose may or may not be considered safe depending on your blood glucose control and medication use. This applies to both type 1 and type 2 diabetes. When unwell with diarrhea or vomiting it is important to replace your body s lost electrolytes, even for people with diabetes. Consult your healthcare professional and discuss monitoring and management of your glucose levels. Are there any precautions or contraindications for Hydralyte? Use with caution in patients with kidney or heart conditions, high blood pressure, conditions related to gastrointestinal function, or have any other medical conditions. Further medical advice is recommended with cases of vomiting and diarrhea lasting for longer than 24 hours, severe dehydration (including shock) and patients who are unable to drink. Does Hydralyte contain? Isomalt Saccharin Aspartame Salicylates ten Wheat Yeast Nuts Animal products Lactose or dairy products Is Hydralyte suitable to use in pregnancy and breastfeeding? Yes, however, pregnant women should seek medical advice if they experience vomiting or diarrhea. Does Hydralyte contain fructose? Hydralyte does not contain any added fructose. However, Hydralyte does contain natural flavours that may contain small quantities of fructose. If you suffer from dietary fructose intolerance (malabsorption), Hydralyte may or may not be tolerated. Should any unpleasant symptoms arise, cease taking the product. If you suffer from hereditary fructose intolerance, consult your healthcare professional before use. What is the sweetener used in Hydralyte? Hydralyte contains sucralose a modified form of table sugar in the following products: orange and berry effervescent tablets, orange and berry powders, orange and berry maintenance solutions. Hydralyte contains stevia extract in lemonade effervescent tablets and lemonade maintenance solutions. What is the source of glucose in Hydralyte? Dextrose is the name given to glucose produced from corn. Biochemically they are identical. QUESTIONS? Email us at info@hydralyte.com

Recommended instructions For dehydration due to vomiting and diarrhea For dehydration due to causes other than vomiting and diarrhea Hydralyte Electrolyte Powder 1 powder sachet = 200 ml Take up to 7 sachets per day or as directed by your healthcare professional. 1 powder sachet = 200 ml Hydralyte Electrolyte Maintenance Solution 10 13 years Take up to 4 x 200 ml for up to 3 days. Take up to 7 x 200 ml for up to 3 days. Hydralyte Effervescent Electrolyte Tablets 2 effervescent tablets = 200 ml 10 13 years Take up to 4 x 200 ml daily doses for up to 3 days or as directed by your Take up to 7 x 200 ml daily doses for up to 3 days or as directed by your For prolonged exercise (3 hours or more) or recurring dehydrating conditions, seek advice from your Dehydration due to fever 13-Adult Take up to 2 x 200 ml doses daily. For dehydration due to fever, consult a healthcare professional for use beyond 24 hours. 2 effervescent tablets = 200 ml