Universal reference book for medicines
Name of the drug: HEMOLACTOL (HEMOLACTOL)

Active substance: comb.
drug
Type: Haemofiltration solution

Manufacturer: GAMBRO DASCO (Italy) manufactured by GAMBRO LUNDIA (Italy)
Composition, form of production and packaging
Solution for hemodialysis
1 liter

dextrose 1.1 g

potassium chloride 149 mg

calcium chloride 257 mg

magnesium chloride 152 mg

sodium lactate 4.483 g

Sodium Chloride 5.844 g

Auxiliary substances: water d / and.

5 l - plastic bags Ljur-Lok (1) - boxes cardboard.

INSTRUCTION FOR THE SPECIALIST.

Description of the drug approved by the manufacturer for the printed edition of 2010.

PHARMACHOLOGIC EFFECT

Hemolactol is a solution of electrolytes containing potassium ions in two concentrations (2 mmol / L, 4 mmol / L), dextrose (glucose) and lactate buffer, free of bacterial endotoxins.
The solution is pharmacologically inactive. During hemodialysis, haemofiltration and haemodiafiltration, plasma fluid and substances dissolved in it, including toxins, are removed through a semipermeable hemofiltration membrane (dialyzer). Since large volumes of liquid are removed during these procedures, pre-or post-dilution of a sterile solution that replenishes the volume of blood circulating in the outline of the hemodialysis apparatus is required.
Hemolactol contains sodium, calcium, magnesium, chlorine and glucose ions in physiological concentrations, which makes it possible to use it as a replenishing solution.
Lactate is metabolized in the Corey cycle (the stage of gluconeogenesis) with the formation of an equimolar amount of glucose, which allows you to correct metabolic acidosis.
INDICATIONS

- for the treatment of acute renal failure of various genesis by hemodialysis, hemofiltration and hemodiafiltration;

- in case of poisoning by filtering or dialyzing drugs and substances with normokaliemia for the prevention of hyperkalemia.

DOSING MODE

Hemolactol is injected into the extracorporeal circuit to the hemofiltration (predilution) or after the hemofiltration (post-dilution).
The volume of the replenishing solution depends on the intensity of the therapy and the required replacement volume and is in the competence of the attending physician. With continuous hemofiltration procedures or with hemodialysis, the clearance of removed substances depends on the blood flow rate, the rate of administration of hemolactol, the area and characteristics of the haemofilter membrane.
As a rule, the rate of intake of the replenishing solution in the hemodialysis apparatus during hemofiltration and hemodiafiltration is:

For adults, 500-1500 ml / h;

For children 20 ml / kg / h.

As a rule, the rate of dialysis solution entering the contour of the hemodialysis apparatus with continuous hemodialysis is:

For adults, 500-2000 ml / h;

For children 20 ml / kg / h.

The procedure continues for as long as it is clinically necessary.

Solutions with different potassium concentrations are used depending on the initial level of potassium in the blood.

SIDE EFFECT

During hemodialysis, hemofiltration and hemodiafiltration procedures, nausea and vomiting can occur due to increased blood pressure, chills, and hypotension.

Possible electrolyte imbalance: the development of hypokalemia with the long uncontrolled administration of hemolactol with a concentration of potassium 2 mmol / l in the extracorporeal contour of the hemodialysis apparatus.

CONTRAINDICATIONS

Absolute contraindications to application are not revealed.

Do not use when:

- pronounced decompensated metabolic acidosis;

- marked violation of lactate metabolism.

PREGNANCY AND LACTATION

Studies of the effect of the solution for hemodialysis on reproductive function and on the fetus when used in pregnant women and during lactation were not conducted.
The hemodialysis solution should be used during pregnancy and lactation only after evaluating the potential benefit to the mother and the risk of the fetus (child).
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS

Particular attention is needed in patients with severe hepatic insufficiency.

SPECIAL INSTRUCTIONS

You should carefully monitor the condition of hemodynamics, water balance, acid-base and electrolyte balance throughout the procedure.
Particular attention should be paid to the timely correction of the level of potassium. The pronounced decompensated metabolic acidosis should be corrected by infusion of the sodium bicarbonate solution into the extracorporeal circuit of the apparatus prior to the application of hemolactol. It is permissible to use only devices for continuous renal replacement therapy. It is necessary to carefully monitor the level of glycemia, especially in diabetes mellitus. Particular attention is needed for patients with severe hepatic insufficiency, heart failure with a lactate replenishment solution.
It is necessary to carefully follow the rules of asepsis, both when connecting, and when detaching the packet from the solution from the mains.
Do not use the solution in case of damage to the package, violation of the transparency of the solution. Empty unused solution immediately after use. The temperature of the solutions (37 ° C) should be closely monitored during the procedure.
Do not mix with solutions containing bicarbonate, to avoid the formation and precipitation of calcium and magnesium carbonates.

Do not reuse partially used bags with solution.

Guidelines for use:

Remove the outer sheath of the plastic bag made of PVC with the mortar, making sure in its integrity, absence of foreign inclusions, clouding of the solution and its leakage.
In any of these cases, do not use the solution.
Hang a plastic bag of PVC with a solution on the hooks of the scales built into the unit.
Strictly observe the rules of asepsis, connect the hemodialysis solution line to the bag.
During the procedure, the solution is consumed from a plastic bag.
If it is completely emptied, replace the empty bag with a full one, strictly follow the above instructions.
OVERDOSE

Symptoms: Overdose can cause hypervolemia in patients with renal insufficiency.

Treatment: Continuation of the procedure will remove excess fluid.

DRUG INTERACTION

It should be remembered that the medications taken can be passed into the dialysate and, together with it, can be excreted from the body, therefore a dosage correction of these preparations may be required.

The potassium level should be monitored especially carefully with concomitant therapy with cardiac glycosides, as the sensitivity to these drugs increases with hypokalemia.

Changes in the concentration of electrolytes can lead to overdose events with cardiac glycosides.

TERMS OF RELEASE FROM PHARMACY

For hospitals.

TERMS AND CONDITIONS OF STORAGE

At a temperature not lower than + 4 ° С.
Keep out of the reach of children. Shelf life - 2 years.
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