Universal reference book for medicines
Product name: HEMOHES (HEMOHES)

Active substance: pentastarch

Type: Plasma Substitute

Manufacturer: B.BRAUN MELSUNGEN (Germany)
Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
Plasmasubstitution, hydroxyethylated starch (HES).
HES is a high molecular weight compound consisting of polymerized glucose residues, which is obtained by hydroxyethylation of amylopectin, a natural polysaccharide contained in potato starch and wax ripen corn. Amylopectin is rapidly hydrolyzed in the blood, the time of its presence in the bloodstream is about 20 minutes. To increase stability and increase the duration of action, amylopectin is hydroxyethylated. The depth of this process is characterized by the degree of substitution.
The intensity and duration of the substitution activity of HES preparations are determined by the molecular weight and the degree of substitution of the HES substance.
The higher the degree of substitution, the longer the HES persists in the circulating blood. With a C 2 / C 6 ratio of more than 8, HES is metabolized much more slowly in the body than at a ratio of less than 8.
The penta starch has a molecular weight of about 200,000 daltons and a degree of substitution of about 0.5;
the C 2 / C 6 ratio, which determines the features of substitution, is 6.
Improves the rheological properties of the blood by reducing the hematocrit, reduces the viscosity of the plasma, reduces the aggregation of erythrocytes, promotes the restoration of impaired microcirculation.

It is deposited in RES cells, which has no clinical significance.

PHARMACOKINETICS
After intravenous infusion, penta starch is subjected to intensive metabolism, splitting (under the action of serum amylase) to low-molecular fragments.
Metabolism products with a molecular weight of less than 50,000 daltons are rapidly excreted by the kidneys. About 70% of the dose is excreted in the urine within 24 hours and about 80% - within a week.
INDICATIONS
As a plasma substitute for hypovolemia and shock associated with surgical interventions, wounds, infectious diseases and burns;
disorders of microcirculation;therapeutic hemodilution.
DOSING MODE
Established individually, depending on age, indications, clinical situation.
Enter as an IV infusion.
SIDE EFFECT
Allergic reactions: hives are possible, anaphylactic reactions;
rarely - stubborn, but reversible itching.
CONTRAINDICATIONS
Hyperhydration, hypervolemia, decompensated heart failure, renal insufficiency with oliguria or anuria, cardiogenic pulmonary edema, intracranial bleeding, severe bleeding disorders, hypersensitivity to HES.

PREGNANCY AND LACTATION
Pentacral is contraindicated for use in the first trimester of pregnancy.

In experimental studies , it has been established that penta starch does not exert embryotoxic and teratogenic effects.

APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in renal failure with oliguria or anuria.

SPECIAL INSTRUCTIONS
With caution apply for hemorrhagic diathesis, dehydration (requires a preliminary corrective therapy).

It should be borne in mind that too fast IV administration, as well as the use of HES in large doses, can cause acute volume overload of the circulatory system.

During the treatment it is necessary to monitor the ionogram of the blood plasma, bcc, kidney function, monitor the introduction of sufficient fluid.

With the development of reactions of hypersensitivity, the administration of HES should be stopped immediately and the necessary emergency measures taken.

When using HES, an increase in serum amylase activity is possible, which is not associated with clinical manifestations of pancreatitis.

Penta starch can be used for leukapheresis.

Penta-starch does not have a mutagenic effect.

DRUG INTERACTION
Penta-starch is incompatible with solutions of other drugs.

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