Clinical and pharmacological group: & nbsp

Substitutes for plasma and other blood components

Included in the formulation
  • Rheopolyglucin with glucose
    solution locally d / infusion 
  • Pharmacodynamics:

    1 gram of dextran [cf. Mol. mass 30000-40000] transfers 20-25 ml of fluid from the tissue into the bloodstream, due to which the normalization of arterial and venous circulation (volemic) takes place, prevention and reduction of aggregation of blood elements: restoration of blood flow in small capillaries; increasing the suspension resistance of blood, reducing its viscosity, contributes to the creation of high oncotic pressure in the primary urine and prevents the reabsorption of water in the renal tubules (diuretic effect). Promotes elimination of toxins, metabolic products and poisons. Reduces the aggregation of blood cells.

    Pharmacokinetics:

    Metabolised by the liver (30%) to glucose. The half-life is 6 hours, is eliminated by the kidneys, a small amount is excreted through the gastrointestinal tract.

    Indications:

    The drug is used to replenish the volume of circulating blood and capillary blood flow in the prevention and treatment of postoperative, toxic, cardiogenic, burn, traumatic and hemorrhagic shock.To replace the volume of plasma with blood loss, thrombosis, for detoxification, hemodilution, in diseases of the retina and optic nerve, for perfusion in heart operations.

    IV.E70-E90.E86   Reduction of the volume of the liquid

    XVIII.R50-R69.R57.0   Cardiogenic shock

    XVIII.R50-R69.R57.1   Hypovolemic shock

    XVIII.R50-R69.R57.8   Other types of shock

    XIX.T79.T79.4   Traumatic shock

    Contraindications:

    Chronic diseases of the heart and / or kidney, hypersensitivity, thrombocytopenia, chronic circulatory insufficiency and other conditions in which the introduction of large volumes of fluid is contraindicated. Diabetes mellitus and other disorders of carbohydrate metabolism. Electrophoresis is contraindicated in case of abundant mucous-purulent discharge and maceration of the eyelids.

    Carefully:

    At the first administration it is necessary to monitor the patient to provide first aid in case of allergic reactions.

    Pregnancy and lactation:

    Category Food and Drug Administration (US Food and Drug Administration) not determined. Adequate and well-controlled studies in humans and animals have not been conducted. There is no information on the penetration into breast milk.

    Dosing and Administration:

    Intravenous spray, drip-drop or drop introduction, electrophoresis. Dosage is selected individually in accordance with the diagnosis and physiological parameters of the patient.

    When there is a violation of capillary blood flow (various forms of shock) intravenously drip or drip-drop injected at a dose of 0.5 to 1.5 liters to stabilize hemodynamic parameters at the life-supporting level. If necessary, the volume of the drug can be increased to 2 liters.

    Children with various forms of shock are administered at the rate of 5-10 ml / kg, the need - up to 15 ml / kg. It is not recommended to reduce the hematocrit value below 25%.

    In cardiovascular and plastic surgery, intravenously drip, immediately before surgery, for 30-60 minutes to adults and children at a dose of 10 ml / kg; during surgery, adults - 500 ml, children - 1.5 ml / kg. After the operation, the drug is administered intravenously drip (within 60 minutes) for 5-6 days at the rate of: adults - 10 ml / kg, children up to 2-3 years - 10 ml / kg 1 time per day, children under 8 years - 7 -10 ml / kg 1-2 times a day, children under 13 years - 5-7 ml / kg 1-2 times a day; for children over 14 years of age, the doses are the same as for adults.

    In operations with artificial circulation, the drug is added to the blood at a rate of 10-20 ml / kg to fill the oxygenator pump.The concentration of dextran in the perfusion solution should not exceed 3%. In the postoperative period, the doses of the drug are the same as for a violation of capillary blood flow.

    For the purpose of detoxification, intravenously drip in a single dose of 500 to 1250 ml (in children 5-10 ml / kg) for 60-90 minutes. If necessary, you can pour another 500 ml of the drug in the first day (in children the administration of the drug in the first day can be repeated in the same doses). In the following days, the drug is administered drip, adults in a daily dose of 500 ml, children - at a rate of 5-10 ml / kg. It is jointly advisable to introduce crystalloid solutions (Ringer, Ringer-acetate, etc.) in such quantities as to normalize the water-electrolyte balance (especially important in the treatment of dehydrated patients and after surgical operations); the drug, as a rule, causes an increase in diuresis (a decrease in diuresis indicates dehydration of the body).

    In ophthalmic practice, it is used by electrophoresis, which is carried out in a conventional way. The consumption of the drug per 1 procedure is 10 ml. The procedure is carried out once a day, injected both from the positive and from the negative pole. Current density - up to 1.5 mA / cm2. The duration of the procedure is 15-20 minutes. The course of treatment - 5-10 procedures.

    Side effects:

    Hypersensitivity, acute renal failure, bleeding.

    Overdose:

    Glucosuria, hyperglycemia, hyperhydration, hyperglycemic hyperosmolar coma, disturbance of water-electrolyte balance.

    Interaction:

    Pharmacodynamic and / or pharmaceutical incompatibility is possible when combined with other drugs.

    Special instructions:

    Dextrans are able to envelop red blood cells and make it difficult to determine the blood group. When taking the drug, monitoring of blood coagulability, kidney function and blood pressure is necessary.

    In patients with reduced filtration capacity of the kidneys, it is necessary to limit the administration of sodium chloride.

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