Isotonic Hypertonic Hypotonic and Relate Them to a Clinical Implication Application Research Paper

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¶ … Isotonic, Hypertonic, Hypotonic and Relate Them to a Clinical Implication (application)

Hypotonic, hypertonic and isotonic solutions

In biology the concentration of solutions is very important as it determines the water content of the cells. Water movement in and out of the cell is highly influenced by the concentration of the solutions within and out of the cell membrane. Osmosis; the movement of water from a relatively lower concentration of solute to a higher region of solute concentration, is highly determined by the concentration gradient, thus if cells are kept in either concentrated or less concentrated environment the volume of their content will be interfered with.

In medical scenarios and clinical applications of medicine, the three terms -- isotonic, hypotonic and hypertonic are commonly used when referring to the type of solutions. In the field of cancer chemotherapy, the choice of drugs solution is particularly important to achieve the desired effects of treatment. The three solutions are explored often with both low and high molecular chemotherapy molecules. The ideal carrier solution for patients must be appropriately used according to their blood type and blood serum. The ideal carrier solution of the three should be able to provide the following: slow clearance from the peritoneal membrane as well as an enhanced exposure of the peritoneal surface.

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The right solution is important in a clinical situation especially in the setting of early postoperative intraperitoneal chemotherapy where a high level of chemotherapy solutions over a prolonged time period is important to improve the distribution of the drug and the overall effectiveness of the treatment Biology, Press and Central ()

Research Paper on Isotonic Hypertonic Hypotonic and Relate Them to a Clinical Implication Application Assignment

. The three solutions -- isotonic, hypotonic and hypertonic are more so studied significantly so in oncological research and medical practices, as they exude a high potential for affecting the management of patients more so in the future. Their study may concurrently reflect some ongoing controversies in medicine and each and every effort is needed for clear direction of medical practitioners. Solutions used in the pre-hospital care environment are classified as hypotonic, isotonic or hypertonic.

The tonicity of these 3 solutions is compared to the tonicity of human plasma as explained in the table below: tonicity is the ability of a group of particles or molecules (solute) to cause the movement of water from one side of a membrane to another.

Intravenous fluids


Lactated Ringer's


0.9% saline


3% saline


5% dextrose in water (D5W)


The table explains the concepts of osmolarity and tonicity that can be understood by considering how red blood cells react when placed in different osmolarity solutions De Vita ()


The term isotonic generally refers to equal amount of strengths in term of solute concentration. This is when the concentration of the liquid within a membrane is equal to the strength of external solutions Biology, Press and Central (; Michael and Sircar)

. In clinical medicine the term isotonic exclusively refers to when a muscle contracts due to some form of relative equal tension while the muscle length also changes. It can also refer to when serum found in blood exudes similar tonicity as to some form of solution such as a physiological one. Isotonic can also mean fully challenging a person's muscles against a series of motion movements that cause body resistance like pulling of elastic cables, springs or strands.

Galvagno has successfully showed that an isotonic high molecular weight dextrose solution will prolong the intraperitoneal retention of the artificial ascites. It should be noted that when red blood cells are placed in a solution that has the same osmolarity (isotonic) as the cells, the cell volume does not change. Therefore they neither swell, nor shrink in size, due to the lack of water movement in and out of the cells Biology, Press and Central (; Michael and Sircar)

The term isotonic in medicine means that isotonic solutions actually have tonicity that is equal to a human being's body plasma. When a normally hydrated patient is administered to an isotonic solution, the body does not cause a significant shift of water between the red blood cells and the body plasma.


Hypotonic solutions generally refer to solutions that are of a lower concentration as compared to others. In clinical medicine, hypotonic solutions have a lower tonicity than the body plasma Michael and Sircar ()

. When hypotonic solutions are administered, they cause a shift in the intra-vascular space and to the extra vascular space of the tissue cells. An IV solution when administered mostly is hypotonic. It then creates a situation where the extra vascular spaces appear to have more concentrations Biology, Press and Central ()

. Clinically, it should be noted that hemolysis occurs when normal blood is mixed with descending leveled concentrations of hypotonic salt solutions and thus red blood cells undergo hemolysis.

Clarification of the safety and efficacy of hypotonic carrier solutions is required before their use can be recommended. This is because, if red blood cells are placed in a solution that has a higher osmolarity than the red blood cells, then the red blood cells are bound to shrink because the osmotic differences causes water to move form cells into the solution to equalize concentration; the cells are hypotonic or hypo-osmotic Galvagno ()

Some studies of in vitro animal studies especially in man have suggested a pharmacokinetic advantage of hypotonic carrier solutions in different settings. There were no significant differences spotted in absorption and intra-tumoral oxaplatin but there were very high incidences of unexplained post op bleedings (50%) and unusually severe thrombocytopenia in patients treated with hypotonic carrier solutions Biology, Press and Central

( ADDIN EN.CITE; De Vita; Stoker)


This generally refers to solutions with relatively higher solute concentration. In a hypertonic solution, when red blood cells are placed in it, the red blood cells rupture since water enters the cells, causing them to swell. The cells swell because they are hyper osmotic or hypertonic as compared to the solution. Water movement into the cell causes the rupture due to pressure created within the cell membrane thus causing the death of the cells Stoker ()

Hypertonic solutions are thus more and more concentrated. This does occur in medicine and healthcare when the amount of salts in any given solution exceeds that of blood. Most hypertonic solutions are used and administered clinically in the case of cerebral dehydration and renal protection to protect the body against renal failure as a result of osmotic dieresis Michael and Sircar ()


An IV administrator was asked by the hospital doctor to administer an IV fluid to a 32-year-old woman who was severely dehydrated after running a marathon in hot and humid weather. The IV administrator found 3 solutions in the medical supply area -- isotonic solutions, hypertonic solutions and hypotonic solutions as well as refrigerator of colloid solutions.

From his clinical knowledge, the IV administrator knows that the patient requires IV fluid to do 2 functions -- increase the blood volume and rehydrate the red blood cells Biology, Press and Central ()

. The IV administrator then decides upon the 1000 mm bag of 0.9% saline solution. This is because; the colloid solutions and the hypertonic solutions would only increase the volume of the blood by pulling water into the blood vessels from the red blood cells. The red blood cells would continually become more and more dehydrated following the increase of the blood's volume De Vita ()

. The low concentration of solutes in a hypotonic solution would cause water to shift from the blood vessels to the red blood cells. This might be advantageous, but the blood volume would not at all be increased. The patient feels much better after being administered to with the isotonic solution Michael and Sircar ()


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