Potassium chloride + Calcium chloride + Magnesium chloride + Sodium bicarbonate + Sodium chloride + Povidone-8 thousand - instructions for use, dose, side effects, contraindications

Binding and elimination of toxins circulating in the blood (polyvinylpyrrolidone). Hemodilution.Elimination of stasis of erythrocytes in capillaries. Increase in bicarbonate in the plasma. Buffer action - binding of hydrogen ions, increasing pH. Strengthening of renal blood flow. Increase glomerular filtration.

Pharmacokinetics:

Calcium and magnesium ions penetrate the placental barrier and into breast milk. Povidone not metabolized in the body. Elimination by the kidneys is fast, within 4 hours - 80%, after 12-24 hours - complete. Excretion by the kidneys (potassium ions - in the distal tubules in exchange for sodium or hydrogen ions), a small amount is excreted with sweat. 25-30% of magnesium binds to plasma proteins. Sodium bicarbonate - kidney elimination formed by CO₂ is displayed by the lungs.

Indications:

Shock (post-traumatic, postoperative, burn, hemorrhagic).

Toxic diseases of the gastrointestinal tract, acute gastrointestinal infections (shigellosis, dyspepsia, salmonellosis), burn, radiation sickness.

Peritonitis, intestinal obstruction, thyrotoxicosis, liver disease, sepsis, pneumonia.

Acute myocardial infarction (large-focal).

Hemolytic disease, toxemia of newborns.

ICD-10

I.A00-A09.A01 Typhus and paratyphoid

I.A00-A09.A02 Other salmonella infections

I.A00-A09.A03.8 Other shigellosis

I.A00-A09.A04 Other bacterial intestinal infections

I.A30-A49.A40 Streptococcal septicemia

I.A30-A49.A41 Other septicemia

IV.E00-E07.E05 Thyrotoxicosis [hyperthyroidism]

X.J10-J18.J15 Bacterial pneumonia, not elsewhere classified

XI.K65-K67.K65.0 Acute peritonitis

XI.K70-K77.K72 Hepatic failure, not elsewhere classified

XVI.P35-P39.P36 Bacterial sepsis of newborn

XVI.P50-P61.P55 Hemolytic disease of the fetus and newborn

XVIII.R50-R69.R57.1 Hypovolemic shock

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

XIX.T20-T32 Thermal and chemical burns

XIX.T79.T79.4 Traumatic shock

Contraindications:

Hypersensitivity, severe allergic reactions, chronic heart failure IIb-III stage.

Bronchial asthma, respiratory failure; hemorrhagic stroke.

Intracranial hypertension, conditions after head trauma; oliguria, anuria, acute nephritis.

Phlebotrombosis, thromboembolism.

Carefully:No data.

Pregnancy and lactation:

Adequate and well-controlled studies in humans and animals have not been conducted. There is no information on the penetration into breast milk.

The category of FDA recommendations is not defined.

Dosing and Administration:

Shock, toxic diseases of the gastrointestinal tract, acute gastrointestinal infections, burn, radiation sickness: intravenously 1-2 times a day.

Peritonitis, intestinal obstruction, thyrotoxicosis, liver disease, sepsis, pneumonia, acute myocardial infarction: intravenously on the first day of 200 ml once, on the second day for complications - an additional 200 ml.

Hemolytic disease, toxemia of newborns: intravenously 2-8 times a day (daily or every other day).

Gestosis: intravenously drip 40-80 drops per minute through a device with a filter and a polymer needle to connect to the container. Single dose of 200-500 ml.

Dose and duration of the course - depending on the age and severity of intoxication (once or up to 2 times a day for 1-10 days).

Side effects:

Allergic reactions of varying severity (up to the development of anaphylactic shock).

Reduced blood pressure, tachycardia, difficulty breathing (with rapid administration).

Infection, thrombosis or phlebitis at the site of infusion.

Sodium chloride - side effects are associated with electrolyte imbalance due to excess sodium or with the effects of the sodium and chlorine ions themselves,accumulation of extracellular fluid to maintain normal plasma osmolality: hypernatremia (thirst, decreased salivation, tear, fever, sweating, tachycardia, hypo- or hypertension, headache, dizziness, restlessness, irritability, weakness, muscle twitching or stiffness, dehydration of the brain, drowsiness, confusion and convulsions, coma, respiratory failure, death), risk of pulmonary edema and peripheral edema; risk of loss of bicarbonate with subsequent acidifying effect.

Sodium bicarbonate: with excessive parenteral administration - hypokalemia (dry mouth, thirst, irregular heartbeat, disturbed mood or psyche, muscle cramps or pains, weak pulse); when administered in large doses - swelling of the feet or legs.

Potassium chloride: hyperkalemia, especially in renal failure (paresthesia of limbs, muscle weakness, paralysis, cardiac arrhythmias, blockade, cardiac arrest, confusion).

Calcium chloride: hypercalcemia (anorexia, nausea, vomiting, constipation, abdominal pain, muscle weakness, impaired thinking, thirst, polyuria, nephrocalcinosis, cardiac arrhythmias,coma), calcification of soft tissues, especially with kidney failure and simultaneous reception of colcalciferol.

Magnesium chloride: hypersensitivity, hypermagnesia (loss of deep tendon reflexes, respiratory depression due to neuromuscular blockade, nausea, vomiting, redness of the skin, thirst, hypotension due to peripheral vasodilation, drowsiness, confusion, confused speech, double vision, muscle weakness, bradycardia, coma, cardiac arrest).

Overdose:

In case of an overdose, the drug should be withdrawn and symptomatic therapy should be performed.

Interaction:

Aminoglycosides - an increase in the neuromuscular blocking effect with the simultaneous administration of magnesium sulfate.

Potassium-sparing diuretics - the development of hyperkalemia.

Competitive and depolarizing neuromuscular blockers - potentiation of their effect with the simultaneous administration of magnesium sulfate intravenously.

Non-steroidal anti-inflammatory drugs, androgens, estrogens, anabolic hormones, corticotropin, mineralocorticoids, vasodilators or ganglion blockers - an increase in the delay Na⁺.

Nifedipine - an increase in the hypotensive effect with the simultaneous administration of magnesium sulfate.

Osmotic diuretics - strengthening their action.

Povidone - interactions are possible due to adsorbing properties.

Cardiac glycosides - increased risk of their toxic effects in combination with Ca^2+.

Special instructions:

Common for all drugs containing povidone.

A cross-over hypersensitivity to the drugs of this group is possible.

Povidone is a linear polymer of 1-ethenyl-pyrrolidin-2-one. Different types of povidone differ in viscosity in solution. Povidone easily soluble in water, alcohol, slightly soluble in acetone. A 5% aqueous solution has a pH of 3.0-7.0 depending on the viscosity.

Povidone as a filler is contained in some preparations for parenteral administration; cases of povidone deposition in various tissues with subsequent damage and morbidity are noted. There have been cases of liver damage.

Povidone was previously used as a plasma-substituting agent, but currently other drugs are preferred.

Monitoring: blood pressure, kidney function.

Distinctive characteristics

The effect is due to the ability of low molecular weight polyvinylpyrrolidone to bind and excrete toxins circulating in the blood. The decrease in the molecular weight of the polymer accelerates the excretion of it by the kidneys from the body and improves the detoxification properties of the preparation. Most fully bind toxins in shigellosis, salmonellosis, food intoxication. In case of burn disease, the toxins formed in the first 4-5 days of the disease are inactivated almost completely; toxins formed at a later date are much less neutralized. Toxins formed in the body of patients with acute radiation sickness do not bind, although it is possible to accelerate their excretion from the body.

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

With extensive burns combine with the introduction of plasma, albumin, γ-globulin.

Instructions

Potassium Chloride + Calcium Chloride + Magnesium Chloride + Sodium Hydrocarbonate + Sodium Chloride + Povidone-8 Thousand. (Kalii chloridum + Calcii chloridum + Magnii chloridum + Natrii hydrocarbonas + Natrii chloridum + Povidonum 8000)