Hemodez-N - instructions for use, doses, side effects, contraindications

Povidone-8 thousand (polyvinylpyrrolidone low molecular weight medical 8000 ± 2000), in terms of anhydrous - 60.0 g,sodium chloride - 5.5 g, potassium chloride - 0.42 g, calcium chloride hexahydrate - 0.5 g, magnesium chloride hexahydrate - 0.005 g, sodium bicarbonate - 0.23 g.

Excipient: water for injection - up to 1.0 liter.

Ionic composition per 1 liter:

Sodium ion	96.85 mmol / l
Potassium ion	5.63 mmol / l
Calcium ion	2.28 mmol / l
Magnesium ion	0.025 mmol / l
Chlor-ion	104.35 mmol / l
Hydrocarbonate ion	2.74 mmol / l

Theoretical osmolarity - 219.37 mOsm / l

Description:Pa transparent liquid of light yellow or yellow color.

Pharmacotherapeutic group:Electrolytes in combination with other drugs

ATX: & nbsp

B.05.A.A Blood plasma preparations and plasma-substituting drugs

Pharmacodynamics:

The effect of the drug is due to the ability of low molecular weight povidone to bind toxins that circulate in the blood and quickly remove them from the body. The most fully binds toxins circulating in the blood of patients with shigellosis, salmonellosis, food intoxication. At a burn disease at different periods of the disease, different toxins are produced. Those of them that are formed in the first 4-5 days of the disease are quite fully bound and quickly removed from the body; toxins formed at a later date are significantly weaker.

The drug contributes to the elimination of stasis of erythrocytes in capillaries, developing with intoxication of any origin, which leads to an improvement in microcirculation. It increases renal blood flow, increases glomerular filtration and increases diuresis.

The drug is non-toxic, does not have pyrogenic properties.

Hemodez-H differs from Hemodesis by a lower molecular weight povidone. Decrease in the molecular weight of the polymer (from 12600 Da on average in the discontinued preparation "Gemodez" to 8000 Da on average in the preparation "Gemodez-N") accelerates the excretion of its kidney from the body and improves the detoxification properties of the drug.

Potassium chloride - the main intracellular ion, plays an important role in the regulation of various functions of the body. It participates in the maintenance of intracellular osmotic pressure, in the processes of transmission and transmission to the innervated organs of the nerve impulse, in the reduction of skeletal muscles and in a number of biochemical processes. Reduces the excitability and conductance of the myocardium, in high doses - oppressing automatism.

Calcium chloride replenishes the deficiency of calcium ions necessary for the process of transmission of nerve impulses, the reduction of skeletal and smooth muscles, myocardial activity, the formation of bone tissue, and the coagulation of blood.Reduces the permeability of the cells and the vascular wall, it prevents the development of inflammatory reactions, increases resistance to infection and can significantly enhance phagocytosis (phagocytosis, declining after receiving the sodium chloride is increased after ingestion of calcium ions). Stimulates the sympathetic department of the autonomic nervous system, enhances the secretion of epinephrine by the adrenal glands, and has a moderate diuretic effect.

Magnesium chloride. Magnesium participates in many processes occurring in the body in energy production, glucose assimilation, nerve signal transmission, protein synthesis, bone tissue building; regulation of relaxation and tension of blood vessels and muscles. It has a soothing effect, reducing the excitability of the nervous system and increasing the braking process in the cerebral cortex, acts as an anti-allergic and anti-inflammatory factor, it protects the body against infection, participating in the production of antibodies plays a significant role in the processes of blood coagulation, regulation of the intestines, bladder and prostate cancer.

Sodium bicarbonate - a means for restoring the acid-base state of blood and correcting metabolic acidosis. With the dissociation of sodium bicarbonate, a bicarbonate anion, which binds hydrogen ions to form a carboxylic acid, is released; which then decomposes into water and exhaled carbon dioxide. As a result, the pH of the blood shifts to the alkaline side, the buffer capacity of the blood increases.

Sodium chloride - plasma-substituting agent, has detoxification and rehydration effect, normalizes acid-base state. Replenishes sodium deficiency with various pathological conditions of the body, sodium chloride is contained in the blood plasma and body fluids (concentration about 0.9%).

Pharmacokinetics:

When administered intravenously, the effect of the drug manifests itself as it enters the blood. The effect persists for 3-12 hours, which depends on the functional state of the kidneys and the rate of circulation.

Povidone not metabolized in the body. Quickly excreted by the kidneys, within 4 hours 80% are output, and after 12-24 hours - completely.

Potassium chloride - after administration, it is passively absorbed (70%) easily and practically in any quantity, becauseits concentration, released from the dosage form, is higher in the lumen of the small intestine than in the blood. In the ileum and large intestine, potassium is released into the lumen of the gut by the principle of conjugated metabolism with sodium and is secreted with bile (10%), the main part is excreted by the kidneys. The half-life (T_1/2) in the absorption phase is 1.31 hours.

Calcium chloride. In the blood, calcium is in the ionized and bound state. In plasma about 45% of calcium is in a complex with proteins. Ionized calcium has physiological activity. It is deposited in bone tissue. About 20% of the drug is excreted by the kidneys, the rest (80%) is the intestine. 95% of calcium emitted by glomerular filtration undergoes a resection in the ascending segment of the Henle loop, as well as in the proximal and distal renal tubules.

Magnesium chloride - Normally 80% is output in 24 hours. In the kidneys it is filteredis in a ballkah, and then reabsorbed in the thick section of the ascending knee of the nephron loop. Magnesium reabsorption is associated with the kinetics of calcium and sodium: with the intensification of natriuresis and calcium sulphide, excretion and magnesium increase.Therefore, any infusion of solutions containing these cations increases the excretion in urine and magnesium.

Sodium bicarbonate is a source of sodium ions and hydrocarbonate buffer. It is included in the general system for providing acid-base and electrolyte balance.

Sodium chloride, being the most important inorganic component supporting the corresponding osmotic pressure of blood plasma and extracellular fluid, is rapidly excreted from the vascular bed, only temporarily increasing the volume of circulating blood (effectiveness with blood loss and shock is insufficient).

Indications:

Detoxification therapy with:

- toxic forms of acute infectious intestinal diseases (shigellosis, salmonellosis);

- peritonitis (in the pre- and postoperative period);

- liver diseases accompanied by the development of hepatic insufficiency;

- Burn disease in the phase of intoxication (2-5th day);

- acute radiation sickness in the phase of intoxication;

- sepsis.

Contraindications:

Hypersensitivity to the components of the drug, intracranial hypertension, hemorrhagic stroke, condition after traumatic brain injury, chronic heart failure II-IV functional class for NYHA, respiratory failure, severe allergic reactions, thromboembolism, oliguria, anuria, acute nephritis, bronchial asthma, phlebothrombosis, the period of breastfeeding.

Carefully:

Pregnancy.

Pregnancy and lactation:

During pregnancy, the drug is used if the benefit to the mother exceeds the possible risk to the fetus.

During the use of the drug, breastfeeding should be discontinued.

Dosing and Administration:

Hemodez-H is injected through a system with a filter intravenously drip (40-80 cap / min).

The dose of the drug, depending on the age of the patient and the intensity of intoxication is different.

Single dose for adults and children over 15 years of age - 200-500 ml.

Infants inject no more than 14-16 drops per minute; course - 5-7 days. The initial dose for infants is 2.5 ml / kg.

The maximum single dose, depending on the age of the patient is presented in the table:

Patient's age	Maximum single dose
Up to 1 year	50 ml
2-5 years	70 ml
6-9 lay down	100 ml
10-15 years	200 ml
adults	400 ml

The therapeutic effect is manifested at a dose of 1.5 ml / kg.

The drug is administered once or twice within 1-10 days, depending on the severity of intoxication.

In acute infectious intestinal diseases, burn and radiation diseases are administered 1-2 times a day.

Before administration, the solution should be heated to 35-37 ° C.

Repeated infusions of Hemodesis-H are performed according to indications, but not earlier than 10-12 hours after its previous administration.

The introduction of the drug, especially in severe conditions of patients, it is necessary to exercise under the supervision of a doctor.

Side effects:

From the immune system: hypersensitivity reactions, anaphylactic shock, angioedema.

From the skin and subcutaneous tissue: pallor of the skin, skin rash, hives, hyperemia, maculopapular and petechial rash, itching.

From the side of the cardiovascular system: tachycardia, pain in the heart, arterial hypotension.

From the respiratory system: shortness of breath, bronchospasm.

From the nervous system: headache, dizziness.

From the side of the digestive tract: nausea, vomiting.

From the body as a whole: general weakness, sweating, fever, chills, changes in the injection site.

Overdose:

Symptoms: hyperhydration, arterial hypotension.

Treatment: stopping the introduction of the drug, symptomatic therapy, if necessary - the introduction of means to maintain cardiac activity, calcium chloride,rheopolyglucin.

Interaction:

Drug interaction of the drug is not established.

Do not add any medications to the Hemodez-H solution.

Special instructions:

Patients with impaired renal excretory function should be administered with caution.

Treatment for severe intoxication should be carried out under the supervision of a doctor.

Before administration, the solution is warmed to body temperature. Before the start of the infusion, it is necessary to check the shelf life of the drug.

With extensive burns combined with the introduction of plasma, albumin, gamma globulin.

The preparation should be transparent, should not contain a suspension, a deposit and a mold. Pressing the container with the preparation is checked for its tightness and the integrity of the package. The results of visual inspection are recorded in the medical history.

During the treatment, it is necessary to monitor blood pressure and the patient's condition.

Effect on the ability to drive transp. cf. and fur:

During treatment should refrain from driving or working with other mechanisms, as the drug can cause such side effects as dizziness, headache.

Form release / dosage:

Solution for infusion.

Packaging:

200, 250, 400 or 500 ml into a single-use container made from polyethylene or polypropylene granules with or without a ring. Each container is ukuporen polyethylene or polypropylene cap with foil or ring of the first autopsy.

One container, together with the instruction for use, is placed in a cardboard package (bundle).

Without carton packs: 30, 24, 15 or 12 containers of 200 ml volume, 250 ml, 400 ml, 500 ml with the appropriate number of instructions for use are placed in boxes of corrugated cardboard with baffles or lattices (for hospitals).

Storage conditions:

In the dark place at a temperature of no higher than 25 ° C.

Keep out of the reach of children.

Shelf life:

3 years.

Do not use after the expiration date.

Terms of leave from pharmacies:On prescription

Registration number:LP-003953

Date of registration:09.11.2016

Expiration Date:09.11.2021

The owner of the registration certificate:ATOLL, LLC ATOLL, LLC Russia

Manufacturer: & nbsp

OZON PHARM, LLC Russia

Representation: & nbspOZON PHARM, LLCOZON PHARM, LLC

Information update date: & nbsp11.12.2016

Illustrated instructions

Instructions

Hemodez-H (Haemodes-N)