Reopoliglyukin-40 - instructions for use, dose, side effects, contraindications

Plasma-substituting agent, increases the suspension stability of blood, reduces its viscosity, restores blood flow in small capillaries, normalizes arterial and venous circulation, prevents and reduces the aggregation of blood elements, exerts detoxification action.

By the osmotic mechanism it stimulates diuresis (it is filtered in the glomeruli, creates high oncotic pressure in the primary urine and prevents reabsorption of water in the tubules), which promotes (and accelerates) the excretion of poisons, toxins, degradation products of metabolism. The pronounced vollemic effect positively affects hemodynamics and is simultaneously accompanied by the washing out of metabolic products from the tissues, which together with an increase in diuresis provides an accelerated detoxification of the organism.

It causes a rapid and short-term increase in the volume of circulating blood, which increases the return of venous blood to the heart. In vascular insufficiency increases blood pressure, minute blood volume and central venous pressure. Has an average molecular weight (40 thousand Da). With a rapid introduction, the plasma volume can be increased by a factor of 2 compared with the volume of the injected drug, each gram of dextrose polymer with mol. with a mass of 35-45 thousand Da promotes the redistribution of 20-25 ml of fluid from the tissues into the bloodstream. It is pyrogen-free, non-toxic. Prevents or reduces the aggregation of red blood cells, which improves microcirculation.Reduces the adhesiveness of platelets, prevents the formation of thrombi after surgery and trauma, increases their solubility (due to a change in the structure of fibrin). When applied at a dose of up to 15 ml / kg, there is no noticeable change in bleeding time.

Pharmacokinetics:

The half-life is 6 hours. The excretion is performed by the kidneys, 60% are excreted in 6 hours, and 70% in 24 hours. 30% goes to the reticulo-endothelial system, the liver, where the enzyme is digested with acidic alpha-glucosidase to glucose, but is not a source of carbohydrate nutrition.

Indications:

To improve capillary blood flow and replenish the volume of circulating blood: paralytic intestinal obstruction, fat embolism; traumatic, burn, hemorrhagic, postoperative and toxic shock (prevention and treatment).

Substitution of plasma volume for blood loss in pediatrics.

To improve arterial and venous circulation (prevention and treatment): thrombosis, thrombophlebitis, obliterating endarteritis, Raynaud's disease, threat of gangrene development, acute stage of stroke.

For detoxification: peritonitis, pancreatitis, ulcerative-necrotic enterocolitis, food poisoning,extensive purulent-necrotic processes of soft tissues, crash syndrome, "inclusion" syndrome.

For hemodilution in the preoperative period.

Conducting therapeutic plasmapheresis to replace the removed volume of plasma.

Prevention of thrombosis on transplants (heart valves, vascular grafts); for addition to a perfusion solution in an apparatus for artificial circulation in open heart operations.

Disorders of microcirculation: traumatic or idiopathic hearing loss.

Diseases of the retina and optic nerve (complicated high degree myopathy, mesh sheath dystrophy, retinal vascular (venous) pathology, initial atrophy), inflammatory diseases of the cornea and the choroid of the eye.

Contraindications:

Hypersensitivity, bleeding, thrombocytopenia; chronic renal failure (anuria), decompensated chronic heart failure (danger of developing pulmonary edema);

Electrophoresis is contraindicated in the maceration of the skin of the eyelids, abundant mucoid-purulent discharge.

Dosing and Administration:

Individual, determined by the patient's condition, the value of blood pressure, heart rate, hematocrit.

Intravenously sprayed, drip-drip and drip. Doses and the speed of administration of the drug should be selected individually, in accordance with the indications and condition of the patient.

When using the drug is mandatory bioassays: after slow administration of the first 5 drops of the drug, the transfusion is stopped for 3 minutes, then another 30 drops are added and the infusion is stopped again for 3 minutes. In the absence of a reaction, the administration of the drug continues. The results of the bioassay are necessarily recorded in the medical history.

1. When there is a violation of capillary blood flow (various forms of shock) injected intravenously drip or drip-drop, at a dose of 0.5 to 1.5 liters, until the hemodynamic parameters stabilize at the life-supporting level. If necessary, the amount 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 dose can be increased if necessary to 15 ml / kg. It is not recommended to reduce the hematocrit value below 25%.

2. With cardiovascular and plastic operations injected intravenously drastically, immediately before surgery, for 30-60 minutes adults and children at a dose of 10 ml / kg, during surgery, adults - 500 ml, children - 15 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 once, 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 older than 14 years, the doses are the same as for adults.

3. In operations under conditions of artificial circulation the drug is added to the blood at a rate of 10-20 ml / kg of the patient's body weight 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.

4. With the aim of detoxification injected 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 and Ringer-acetate, etc.) in such quantities that normalize the water-electrolyte balance (especially important in the treatment of dehydrated patients and after surgery), the drug usually causes an increase in diuresis (a decrease in diuresis indicates for dehydration of the patient's body).

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

Side effects:

Allergic reactions (skin rash, anaphylactoid reactions - lowering of arterial pressure, collapse, oliguria), fever, chills, fever, nausea.

Can provoke bleeding, the development of acute renal failure.

Special instructions:

Together with the preparation, it is advisable to administer crystalloid solutions (0.9% sodium chloride solution, 5% dextrose solution) in such quantity as to replenish and maintain the liquid and electrolyte balance.This is especially important in the treatment of dehydrated patients and after severe surgical operations.

When used simultaneously with anticoagulants, their dose should be reduced.

Causes an increase in diuresis (if there is a decrease in diuresis with the release of viscous syrupy urine, this may indicate dehydration). In this case, it is necessary to introduce intravenous colloidal solutions to replenish and maintain the water-electrolyte balance. In the case of oliguria, it is necessary to introduce saline solutions and furosemide.

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

Dextrans are able to envelop the surface of red blood cells, preventing the determination of the blood group, so it is necessary to use washed red blood cells.

Form release / dosage:

Solution for infusions, 10%.

Packaging:

For 200, 400 ml in glass bottles for blood, transfusion and infusion preparations with a capacity of 250 and 450 ml, corked with rubber stoppers and crimped with aluminum caps. Each bottle, along with instructions for medical use, is placed in a pack of cardboard boxes.

For hospitals: 15 or 28 bottles with a capacity of 250 ml or 15 bottles with a capacity of 450 ml, together with instructions for medical use in quantities corresponding to the number of primary packages, are placed in a box of cardboard boxed with a cardboard liner or in a box of corrugated paper with gaskets and grids ("sockets" ).

Storage conditions:

Store in a place inaccessible to children, at a temperature of 5 to 25 ° C.

Non-wetting of the inner surface of bottles is not a contraindication to the use of the drug.

Shelf life:

2 years.

Do not use after the expiry date printed on the package.

Terms of leave from pharmacies:On prescription

Registration number:LSR-002642/08

Date of registration:09.04.2008 / 05.02.2013

The owner of the registration certificate:MOSFARM, OJSC MOSFARM, OJSC Russia

Manufacturer: & nbsp

MOSFARM, LLC

Representation: & nbspMOSFARM, LLCMOSFARM, LLC

Information update date: & nbsp10.01.2016

Illustrated instructions

Instructions

Reopoliglyukin-40 (Rheopolyglukin-40)