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
Plasmo-replacing drug. Increases BCC, which leads to an increase in venous return and IOC, increased blood pressure and improved perfusion of peripheral tissues.The increase in BCC and increase in blood pressure occurs not only due to the introduced solution, but also in connection with the additional interstitial fluid entering the vascular bed. Calling osmotic diuresis, it ensures the maintenance of kidney function in shock. Reduces the viscosity of blood, improves microcirculation. Due to its colloid-osmotic properties it prevents or reduces the likelihood of developing interstitial edema. Does not violate the protein, carbohydrate and pigment functions of the liver, improves microcirculation; accelerates ESR, which normalizes on average in 20 days. The volume-substituting effect is maintained for 5 hours.
PHARMACOKINETICS
Quickly leaves the bloodstream, which is explained by the presence of a large number of low molecular weight fractions (after 2 hours in the blood there are about 20% of the injected drug). T 1/2 is 9 hours 75% of the administered substance is excreted by the kidneys, 15% - through the intestine. 10% of gelatin is cleaved in tissues through proteolysis and is included in protein metabolism. Do not cumulate.
INDICATIONS
Prevention and treatment of hypovolemia in case of traumatic, burn, hemorrhagic and toxic shock; conditions accompanied by a thickening of the blood (for the purpose of hemodilution); extracorporeal circulation; preventive maintenance of depression of a BP at a spinal or epidural anesthesia.
As a solvent when insulin is introduced (to reduce its loss due to adsorption on the walls of infusion tanks and tubes).
DOSING MODE
The dosage regimen is set individually taking into account the severity of the plasma volume deficit.
It should be administered intravenously in drip. The duration of the infusion and the volume of the administered solution are determined taking into account the dynamics of heart rate, blood pressure, diuresis, perfusion state of peripheral tissues.
With moderate blood loss and with a preventive purpose in the preoperative period or during the operation, administer a dose of 0.5-1 L for 1-3 hours.
In the treatment of severe hypovolemia - 1-2 liters.
In emergency, life-threatening situations, 500 ml is injected in the form of fast infusion (under pressure), then after an improvement in blood circulation, the infusion is performed in an amount equivalent to a volume deficit.
To maintain the BCC in shock, the infusion volume can reach 10-15 l / day.
For extracorporeal circulation requires 0.5-1.5 liters of solution (depending on the system used).
SIDE EFFECT
From the cardiovascular system: hypocoagulation caused by the effect of dilution (with a large volume of infusion).
Allergic reactions: anaphylactoid reactions.
CONTRAINDICATIONS
Hypervolaemia, severe chronic heart failure, hypersensitivity to gelatin.
With caution should be used in hyperhydration, chronic kidney failure, hemorrhagic diathesis, pulmonary edema, hypokalemia, hyponatremia.
PREGNANCY AND LACTATION
The use of the drug during pregnancy and during lactation is possible only if the intended benefit to the mother exceeds the potential risk to the fetus and the baby.
APPLICATION FOR FUNCTIONS OF THE LIVER
With caution should be used for chronic kidney failure.
APPLICATION IN ELDERLY PATIENTS
The degree of reduction of hematocrit after administration of the drug should not exceed 25% in elderly patients.
SPECIAL INSTRUCTIONS
The introduction of gelatin can change the indicators of diagnostic tests for glucose, fructose, cholesterol, fatty acids, as well as ESR, specific gravity of urine, urinary protein index (including biuret method).
If you administer more than 2-3 liters of solution during the postoperative period, you should monitor the concentration of protein in the blood serum, especially if there is tissue swelling (if necessary, the introduction of human albumin is useful for further plasma replacement therapy).
The degree of reduction of hematocrit after administration of the drug should not exceed 25% (in elderly patients, as well as in cardiovascular and pulmonary insufficiency - 30%).
In chronic heart failure, infusion is slow because of possible circulatory overload.
When used as an infusion under pressure (cuff of the tonometer, infusion pump), the solution must be heated to body temperature. When the preparation is administered under pressure, all air from the vial should be removed beforehand.
OVERDOSE
Symptoms: hemodilution.
Treatment: withdrawal of the drug, symptomatic treatment.
DRUG INTERACTION
Pharmaceutically incompatible with fat emulsions, barbiturates, muscle relaxants, antibiotics, GCS. Compatible with solutions of electrolytes, carbohydrates, whole blood preparations.
