Electrolyte solutions: Milliequivalents,

millimoles and milliosmoles

Dr. Osama A. A. Ahmed

Milliequivalents, millimoles and milliosmoles

Milliequivalent (mEq) is used in the United states, while in the international system
Molar concentrations (mmol/L or mol/L) are used throughout the world.

Under normal conditions blood plasma contains 154 mEq of cations and an equal
number of anions

Milliequivalent is the amount, in milligram, of a solute equal to 1/1000 of its gram

equivalent weight

mg Valence
mEq
Atomic, molecular or formula weight
mEq Atomic, molecular or formula weight
mg
Valence
Dr. Osama A. A. Ahmed

Milliequivalents, millimoles and milliosmoles

What is the concentration, in mg/ml, of a solution containing 2 mEq of

potassium chloride (KCl) per milliliter?

M.Wt. of KCl = 74.5

Equivalent weight of KCl = 74.5

1 mEq of KCl

1
74.5 g 0.0745 g 74.5 mg
1000

2 mEq of KCl = 74.5 X 2 = 149 mg/ml

OR

mEq Atomic, molecular or formula weight

mg
Valence

mg / ml
Dr. Osama A. A. Ahmed

2 (mEq / ml ) 74.5
149 mg / ml
1
3

Milliequivalents, millimoles and milliosmoles

What is the concentration, in g/ml, of a solution containing 4 mEq of calcium

chloride (CaCl2.2H2O) per milliliter?

M.Wt. of CaCl2.2H2O = 147

Equivalent weight of CaCl2.2H2O = 147/2 = 73.5

1 mEq of CaCl 2 .2H 2 O

1
73.5 g 0.0735 g
1000

4 mEq of CaCl2.2H2O = 0.0735 g X 4 = 0.294 g/ml

OR

mEq Atomic, molecular or formula weight

mg
Valence
mg / ml

4 (mEq / ml ) 147
294
294 mg / ml
0.294 g / ml
2
1000

Dr. Osama A. A. Ahmed

Milliequivalents, millimoles and milliosmoles

Millimoles (mmol) used by SI to express electrolyte concentrations in millimoles per

liter (mmol/L).

For monovalent species, the numeric values of the milliequivalent and millimole are
identical

Millimole is the amount, in milligram, of a solute equal to 1/1000 of its gram

molecular weight. A mole is the molecular weight of a substance in grams.

Example
How many millimoles of monobasic sodium phosphate (m.w. 138) are present in 100 g
of the substance?

1 mole = 138 g

1 mole

138 g

X mole

100 g

How many milligrams would 1 mmol of monobasic sodium phosphate weigh?

1 mole = 138 g

so

Dr. Osama A. A. Ahmed

X = 0.725 mole = 725 mmol

1 mmol = 138 mg
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Milliequivalents, millimoles and milliosmoles

Osmolarity

U.S. Pharmacopeia states the knowledge of osmolar concentration of parenteral fluids

is essential.

This information indicates to the practitioner whether this solution is hypo-osmotic,

iso-osmotic or hyper-osmotic with regard to biologic fluids and membranes.

The unit used to measure osmotic concentration is the milliosmole (mOsmol)

Osmotic pressure is proportional to the total number of particles in solution.

For nonelectrolytes (e.g. dextrose), a 1 mmol represents 1 mOsmol

For electrolytes, the total number of particles in solution depends on the degree of
dissociation of the substance
1 mmol of NaCl (Na+ + Cl-) represnts 2 mOsmol, 1 mmol CaCl2 represents 3 mOsmol,
and 1 mmol of sodium citrate (Na3 C6H5O7) represents 4 mOsmol (3 Na + C6H5O7) of
total particles.

mOsmol / L

Weight of subs tan ce g / L

Number of species 1000
Molecular Weight

Dr. Osama A. A. Ahmed

Milliequivalents, millimoles and milliosmoles

Example

Calculate the ideal osmolarity of 0.9 % NaCl injection?

9g/L
mOsmol / L
2 1000 308 mOsmol / L
58.5 g

Because of bonding forces, however, n is slightly less than 2 for solutions of sodium
chloride at this concentration, and the actual measured osmolarity is about 286
mOsml/L

A distinction should be madebetween the terms osmolarity and osmolality

Osmolarity is the milliosmoles of solute per liter of solution.

Osmolality is the milliosmoles of solute per kilogram of solvent.

Normal serum osmolality is considered within the range of 275 to 300 mOsmol/kg.

Osmometers are commercially available for use in the laboratory to measure

osmolality
Abnormal blood osmolality can occur with shock, trauma, burns, electrolyte
imbalance, hyperglycemia or renal failure

Dr. Osama A. A. Ahmed

Milliequivalents, millimoles and milliosmoles

Example: How many a) millimoles, b) milliequivalents, and c) milliosmols of

calcium chloride (CaCl2. 2H2O m.w. 147) are represented in 147 ml of a 10 % w/v
calcium chloride solution?

10 g

100 ml

147

1 mmol = molecular weight in grams / 1000 = 147/1000 = 0.147 g = 147 mg

1 mmol

147 mg

X mmol

14700 mg

OR

mEq

mmol

X = 147 x 10/100= 14.7 g = 14700 mg

mg
molecular weight

mg Valence
Atomic, molecular or formula weight

mOsmol / L

X = 14700/147 = 100 mmol

mmol= 14700/147 = 100 mmol
= 14700 x 2/ 147 = 200

Weight of subs tan ce g / L

Number of species 1000
Molecular Weight g

mOsmol

Weight of subs tan ce mg

Number of species
Molecular Weight

Dr. Osama A. A. Ahmed

14700 X 3/147 = 300

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Clinical considerations of water and electrolyte balance

Water provides the environment in which cells live and is the primary medium for the
ingestion of nutrients and the excretion of metabolic waste products.

Maintaining body water and electrolyte balance is an essential component of good

health.

Fluid and electrolyte therapy (oral or parenteral) is provided either for maintenance
requirements or to replace serious losses or deficits.

Example, a patient taking diuretics may simply require a daily oral potassium
supplement along with adequate intake of water. Hospitalized patients commonly receive
parenteral therapy of fluids and electrolytes to support ordinary metabolic functions.

In adult males, total body water ranges between 55% and 65% of body weight depending
on the proportion of body fat. Adult women are about 10% less than adult men. New
born infants have approximately 75% body water.

About 66.7 % (2/3) of adults body water is intracellular and about 33.3 % (1/3) is
extracellular

1500 ml of water per square meter may be used to calculate the daily requirements for
adults.

On weight basis, 32 ml/kg for adults and 100-150 ml/kg for infants
Dr. Osama A. A. Ahmed

Clinical considerations of water and electrolyte balance

Body fluids are extracellular (intravascular or interstitial) and intracellular (within

cells)

Osmolality of intracellular fluid and extracellular fluids is about equal (cell

membrane) this value is about 290 mOsm/kg water.

The plasma osmolality is approximated by the formula

plasma osmolality mOsm / kg 2 Na K plasma

BUN Glu cos e

2.8

18

Where Na and K are in mEq/L, and blood urea nitrogen (BUN) and glucose
concentrations are in mg/100 ml (mg/dl)

Example, Estimate the plasma osmolality from the following data: sodium 135
mEq/L; blood urea nitrogen, 14 mg/dL; and glucose, 90 mg/dL

plasma osmolality mOsm / kg 2 135 4.5

14 90

2.8 18

= 2 (139.5) + 5 + 5 = 289

Dr. Osama A. A. Ahmed

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