Reopoliglyukin-40 (Rheopolyglukin-40)

Composition Pharmacodynamics Indications Carefully Contraindications Dosing and Administration Side effects Form release / dosage
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Active substanceDextranDextran
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  • Reopoliglyukin-40
    solution d / infusion 
    KRASFARMA, JSC     Russia
    • Dosage form: & nbspsolution for infusions
    Composition:

    Active substance: dextran 40000 100 g;

    Excipients: sodium chloride 9 grams, water for injection up to 1 liter.

    Theoretical osmolarity is 308 mOsm / l.

    Description:

    Transparent, colorless or slightly yellowish liquid.

    Pharmacotherapeutic group:plasma-substituting agent
    ATX: & nbsp

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

    Pharmacodynamics:

    Reopoliglyukin 40 - plasma-substituting agent, improves 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 effect.

    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 blood, thereby increasing the return of venous blood to the heart. In vascular insufficiency increases blood pressure, minute blood volume and central venous pressure. With a rapid injection, the volume of plasma can increase 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. It is excreted by the kidneys: in 6 hours 60% are excreted, and for 24 hours - 70% of the injected volume of the drug. 30% enters the reticulo-endothelial system, the liver, where the enzyme is digested with acidic alpha-glucosidase to glucose, but it 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). Replacing the volume of plasma with blood loss.

    - 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 toxic infections, obesitywinflammatory 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 with muco-purulent discharge.

    Carefully:

    With severe violations of the blood coagulation system (other than life-threatening conditions), dehydration.

    In patients with diabetes mellitus with severe hyperglycemia and hyperosmolarity, Dextran 40 should be used with caution.

    In the process of treatment, it is necessary to control the ion composition of blood serum, the balance of fluid and the function of the kidneys.

    When the drug is injected into the peripheral veins, a burning sensation and tenderness may appear in the limb along the vein.

    Pregnancy and lactation:

    It is possible to appoint a vital indication if the intended benefit to the mother exceeds the potential risk to the fetus.

    Dosing and Administration:

    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, it is necessary to carry out a bioassay: after a slow administration of the first 5 drops of the drug, stop the transfusion for 3 minutes, then inject another 30 drops. and again stop the infusion 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 the capillary blood flow is disturbed (various forms of shock) are administered 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 dextrin 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.

    Overdose:

    In case of excessive administration of the drug solution, the condition of the patient is carefully assessed and appropriate symptomatic treatment is prescribed.

    Interaction:

    Before use, it is necessary to first check for compatibility with the drugs that are planned for introduction into the infusion solution.

    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 electronic 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 a 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:

    200 ml, 400 ml in bottles of glass with a capacity of 250 ml, 450 ml.

    1 bottle with instructions for use in a pack of cardboard.

    For hospitals:

    - 24 bottles of 200 ml, 12 bottles of 400 ml with an equal number of instructions for use in a box of corrugated cardboard;

    - from 1 to 24 bottles of 200 ml, from 1 to 12 bottles of 400 ml with an equal number of instructions for use in a box of corrugated cardboard.

    Storage conditions:

    At a temperature of no higher than 25 ° C.

    Keep out of the reach of children.

    Shelf life:

    2 years.

    Do not use after the expiration date.

    Terms of leave from pharmacies:On prescription
    Registration number:LSR-007071/08
    Date of registration:04.09.2008 / 11.06.2013
    The owner of the registration certificate:KRASFARMA, JSC KRASFARMA, JSC Russia
    Manufacturer: & nbsp
    Information update date: & nbsp10.01.2016
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