Sodium fumaric acid (Natrii fumaras)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Antihypoxants and antioxidants

Included in the formulation
  • Confumin®
    solution in / in 
    Russian Research Institute of Hematology and Transfusiology of the Federal Medical Biological Agency, FGU     Russia
    • АТХ:

    B.05.C.B   Saline solutions

    Pharmacodynamics:

    Saline infusion solution, the main pharmacologically active component of which is sodium fumarate-antihypoxant, activates the adaptation of the cell to a lack of oxygen. Its effect is due to participation in the reactions of reversible oxidation and reduction in the Krebs cycle. In the course of these reactions, ATP synthesis occurs in an amount sufficient to maintain the functions of the body cells during hypoxia.

    At metabolic acidosis shows alkalizing effect, its osmolarity is 400-410 mOsm / l, with hypovolemic conditions quickly replenishes the volume of circulating blood, prevents dehydration of tissues.

    Reduces the viscosity of blood and improves its rheological properties, increases diuresis, promotes the activation of detoxification processes; reduces the concentration in the blood of intermediate and final products of lipid peroxidation (antioxidant properties).

    Pharmacokinetics:

    Elimination by the kidneys, formed carbon dioxide - by the lungs.

    Indications:

    Hypovolemic and hypoxic conditions (blood loss, shock, trauma, intoxication); acute disorders of cerebral circulation in adults,flowing through ischemic and hemorrhagic type; as a component of the perfusion mixture for filling the contour of the device of artificial circulation in cardiosurgical operations in adults and children.

    ICD-10

    XX.Y40-Y59.Y48.1   Parenteral pain medication

    XVIII.R50-R69.R57.1   Hypovolemic shock

    XIX.T79.T79.4   Traumatic shock

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

    XVIII.R50-R69.R57.0   Cardiogenic shock

    XV.O00-O08.O08.3   Shock caused by abortion, ectopic and molar pregnancy

    IX.I60-I69.I63   Cerebral infarction

    Contraindications:

    Hypersensitivity;

    Craniocerebral injury, accompanied by increased intracranial pressure.

    Conditions in which intravenous injection of large volumes of liquid is contraindicated (including arterial hypertension and chronic heart failure).

    Carefully:

    Children under 18 years of age, pregnancy, breast-feeding. Elderly age, renal and hepatic insufficiency. Edema, arterial hypertension (the condition may worsen), anuria or oliguria (increased risk of excessive sodium retention).

    Pregnancy and lactation:

    The category of FDA recommendations is not defined.

    It is necessary to relate the risk and benefit.There is no information on the penetration into breast milk. Complications in humans are not recorded.

    Dosing and Administration:

    Intravenously struino and drip, less often - intraarterially. Doses and the speed of administration are chosen in accordance with the indications and the condition of the patient.

    In the case of shock (hemorrhagic, burn, traumatic, operating) of mild and moderate severity, adults are given a dose of 2-3 liters, initially - jet, and with the normalization of hemodynamic indicators - drip; in children - in a dose of 20-25 ml / kg.

    In severe shock in adults, it is recommended to use in combination with erythrocyte-containing media, as well as colloid blood substitutes for hemodynamic action. The dose in this case is set individually, but not less than 1 liter; Children are injected at least 15 ml / kg.

    In severe intoxications in adults (peritonitis, sepsis, intestinal obstruction), up to 2-3 liters per day are administered in combination with other detoxification drugs; Children - 30-35 ml / kg per day.

    As a hemodiluent when refilling the device of artificial circulation can be up to 50-70% of the perfusion solution introduced into the device.

    In cases of blood loss not exceeding 15% of the volume of circulating blood in adults and children, it can be used as the only infusion medium.

    It can be used in place of other polycomponent saline infusion solutions, in contrast to acetate and lactate-containing salt infusion media, it is possible to prescribe patients with extremely severe hypovolemia and hypoxia with phenomena of pronounced metabolic acidosis.

    Side effects:

    Allergic reactions, cerebral edema, pulmonary edema, respiratory arrest (obliquity of the medulla oblongata).

    Overdose:

    Too fast administration with the use of large doses can lead to the development of acute left ventricular failure.

    Interaction:

    Can be used in combination with colloidal solutions (dextran preparations and others); is also compatible with donor blood, erythromass, plasma and other blood products.

    Do not interfere with the appointment of commonly used anti-shock drugs, including drugs for neuroleptanalgesia (fentanyl, droperidol), benzodiazepines (diazepam), as well as muscle relaxants (suxamethonium), proteolysis inhibitors (aprotinin) and alpha-adrenostimulants (dopamine, epinephrine).

    Special instructions:

    In chronic renal failure may worsen the state due to a shift in the acid-base state to the alkaline side.

    In diseases of the heart and / or kidneys, excess sodium ions causes edema and heart failure.

    Instructions
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