Composition, form of production and packaging
Solution for infusions is transparent, colorless or slightly yellowish, odorless.
100 ml
dextran with a molecular weight of 30 000 to 40 000 10 g
dextrose (glucose) 5 g
[PRING] water d / and.
200 ml - bottles for blood substitutes (1) - packs cardboard.
200 ml - bottles for blood substitutes (28) - cardboard boxes.
400 ml - bottles for blood substitutes (1) - packs cardboard.
400 ml - bottles for blood substitutes (15) - cardboard boxes.
INSTRUCTION FOR THE SPECIALIST.
Description of the drug approved by the manufacturer for the printed edition of 2005.
PHARMACHOLOGIC EFFECT
Plasmo-replacing drug.
It 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 effect.
It stimulates diuresis on the osmotic mechanism (it is filtered in the glomeruli, creates high oncotic pressure in the primary urine and prevents the 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 excretion of metabolic products from the tissues, which together with an increase in diuresis provides an accelerated detoxification of the organism.
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 a glucose polymer with a molecular weight of 30-40 thousand Daltons contributes to the redistribution of 20-25 ml of fluid from tissues into the bloodstream.
The dextrose (glucose) included in the preparation enhances the rheological effect of the drug and serves as an additional source of energy.
PHARMACOKINETICS
Distribution and Metabolism
30% enters the RES, the liver, where the enzyme is digested with acidic alpha-glucosidase to glucose (however, dextran is not a source of carbohydrate nutrition).
Glucose in / in the introduction quickly leaves the vascular bed.
Excretion
T 1/2 - 6 hours. It is excreted in the urine: 60% in 6 hours, and 70% in 24 hours.
Glucose, entering the tissues, is phosphorylated, turning into glucose-6-phosphate.
INDICATIONS
- prevention and treatment of traumatic, burn, hemorrhagic, postoperative, cardiogenic and toxic shock (to improve capillary blood flow and replenishment of bcc);
- Substitution of plasma volume for blood loss in pediatrics;
- prevention and treatment of violations of arterial and venous circulation (including thrombosis, thrombophlebitis, obliterating endarteritis, Raynaud's disease);
- to improve microcirculation and reduce the risk of thrombus formation in the graft in vascular and plastic surgery;
- for detoxification with peritonitis, pancreatitis, ulcerative-necrotic enterocolitis, food poisoning, extensive purulent-necrotic processes of soft tissues, crash syndrome, "inclusion" syndrome;
- for hemodilution in the preoperative period;
- when performing therapeutic plasmapheresis in order to replace the removed volume of plasma;
- to be added to the perfusion fluid in the cardiopulmonary bypass in cardiac surgery;
- diseases of the retina and optic nerve (complicated high degree myopia, mesh shell degeneration, vascular / venous / retinal pathology, initial atrophy);
- inflammatory diseases of the cornea and the choroid of the eye.
DOSING MODE
The dosage regimen is determined by the patient's condition, blood pressure, heart rate, and hematocrit.
The drug is injected intravenously in a jet, drip-drop and drop. Doses and the speed of administration of the drug are determined in accordance with the indications and condition of the patient.
When capillary blood flow is disturbed (various forms of shock), the drug is injected intravenously drip or drip-dropwise at a dose of 0.5 to 1.5 l 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 different forms of shock are administered at the rate of 5-10 ml / kg of body weight, the dose can be increased if necessary to 15 ml / kg (it is not recommended to reduce the hematocrit value below 25%).
In cardiovascular and plastic surgeries, intravenously injected intravenously, directly before surgery, for 30-60 minutes to 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 injected for 5-6 days in / in the drip (within 60 minutes) at the rate: foradults and children over 14 years - 10 ml / kg once; children under the age of 2-3 years - 10 ml / kg 1 time / day; at the age of 3 to 8 years - 7-10 ml / kg 1-2 times / day; at the age of 8 to 13 years - 5-7 ml / kg 1-2 times / day.
In operations with artificial circulation, the drug is added to the blood at the rate of 10-20 ml / kg of the patient 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.
For the purpose of detoxification, the drug is administered IV drip in a single dose of 500 to 1250 ml (in children 5-10 ml / kg) for 60-90 min. 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 intravenously to adults in a daily dose of 500 ml, children - at a rate of 5-10 ml / kg.
In ophthalmic practice, it is used by electrophoresis, which is carried out in a conventional way. The drug consumption per procedure is 10 ml. The procedure is carried out 1 time / day, injected from both the positive and negative pole. The current density is up to 1.5 mA / cm 2 . The duration of the procedure is 15-20 min. The course of treatment consists of 5-10 procedures.
SIDE EFFECT
Perhaps: allergic reactions, anaphylactic reactions with the development of collapse, increased bleeding, the development of acute renal failure.
CONTRAINDICATIONS
-thrombocytopenia;
-chronic renal failure (anuria);
-chronic heart failure and other conditions, in which the introduction of large volumes of fluid is contraindicated;
-increased sensitivity to the drug.
Electrophoresis is contraindicated in the maceration of the skin of the eyelids.
Reopoliglyukin with glucose should not be administered in cases of disorders of carbohydrate metabolism, especially in diabetes mellitus.
PREGNANCY AND LACTATION
Data on the efficacy and safety of the drug during pregnancy and lactation are not provided.
APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in chronic renal failure (with anuria).
SPECIAL INSTRUCTIONS
Immediately before the use of the drug, except for urgent cases, a skin test is performed: 0.05 ml of the drug is injected into / c. The presence of redness with a diameter of more than 1.5 mm at the injection site, the formation of a papule or the appearance of symptoms of a general reaction of the body in the form of nausea, dizziness and other manifestations 10-15 min after injection indicate a hypersensitivity of the patient to the drug (risk group).
When applying the drug, a bioassay is mandatory: after a slow introduction of the first 5 drops of the drug, stop the transfusion for 3 minutes, then inject another 30 drops and stop the infusion again for 3 minutes. In the absence of a reaction, the administration of the drug continues.
Together with the preparation, it is advisable to administer crystalloid solutions (0.9% sodium chloride solution, Ringer's solution and Ringer's acetate solution) in such quantity as to normalize the water-electrolyte balance. This is especially important in the treatment of dehydrated patients and after severe surgical operations.
Administration of the drug causes an increase in diuresis (if there is a decrease in diuresis with the release of viscous syrupy urine, this may indicate dehydration of the body). In this case, it is necessary to introduce / into colloidal solutions to replenish and maintain the water-electrolyte balance.
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.
The presence of dextran in the blood affects the results of laboratory determination of the concentration of bilirubin and protein. In this regard, it is recommended to take blood samples to determine these indicators prior to the administration of the drug.
OVERDOSE
Data on the overdose of the drug Reopoliglyukin with glucose are not provided.
DRUG INTERACTION
Drug interaction of the drug is not described.
TERMS AND CONDITIONS OF STORAGE
The drug should be stored in a dry place inaccessible to children at a temperature of 10 В° to 25 В° C. Shelf life - 6 years.
Conditions of leave from pharmacies
The drug is released by prescription.
