Reopoliglyukin instructions for use injections. Rheopolyglukin

A drug Reopoliglyukin- a plasma substitute for a group of dextrans with a pronounced plasma-substituting and antiplatelet effect.
Plasma-replacing colloidal solution of dextran (glucose polymer), the pharmacological effect of which is manifested in improving the rheological properties of blood, reducing its viscosity, restoring microcirculatory blood flow, preventing and eliminating the aggregation of formed elements, normalizing arterial and venous circulation. With the rapid introduction of Rheopolyglucin, the blood plasma volume can increase by almost 2 times the volume of the injected drug, since every 10 ml of the drug promotes the redistribution of 20-25 ml of fluid from the tissues into the bloodstream.

Pharmacokinetics

.
The half-life is 6:00.
It is excreted mainly by the kidneys: in the first 6:00 - about 60%, in 24 hours - 70%.
The rest of the amount enters the reticuloendothelial system and the liver, where alpha-glucosidase is gradually broken down to glucose, but is not a source of carbohydrate nutrition.

Indications for use

Indications for the use of the drug Reopoliglyukinare:
- Prevention and treatment of hypovolemic, distributive shock.
- Transplant vascular and plastic surgery.
- Application to perfusion fluid in heart-lung machines for cardiac surgery.

Mode of application

A drug Reopoliglyukinintravenous drip is prescribed.
Before administration, the solution should be heated to 35-37 ° C. Doses and the rate of administration of the drug are determined individually.
In case of impaired capillary blood flow (various forms of shock), the maximum daily dose for adults is 20 ml / kg, for children - 5-10 ml / kg (if necessary - up to 15 ml / kg).
In operations with artificial circulation, add to the blood at the rate of 10-20 ml / kg to fill the oxygenator pump; the concentration of dextran in the perfusion solution should not exceed 3%. In the postoperative period, the drug should be used in the same doses in case of impaired capillary blood flow.
The drug should be administered without mixing with other drugs. For health reasons, the drug should be administered quickly, even in a jet at the rate of 15 ml / kg.
For patients with hemorrhagic stroke, craniocerebral trauma, the drug should be administered at the rate of 10-15 ml / kg and no more!

Side effects

Allergic reactions. Anaphylactic shock, angioedema, rash, itching, fever, fever, increased sweating, hypersensitivity reactions.
On the part of the cardiovascular system. Fluctuations in blood pressure, tachycardia, shortness of breath, swelling.
From the digestive tract. Nausea, vomiting, dry mouth, abdominal pain.
From the nervous system. Headache, dizziness, tremors.
From the urinary system. As a rule, especially with hypovolemia, the drug causes an increase in urine output.
However, sometimes with the use of Reopolyglucin, a decrease in diuresis is observed, the urine becomes viscous, which indicates dehydration of the patient's body. In this case, it is necessary to inject intravenous crystalloid solutions to restore and maintain plasma osmosis.
When using the drug at a rate of more than 15 ml / kg, hyperosmolarity occurs, which can cause burns of the tubules with the subsequent development of acute renal failure. Accordingly, there is a decrease in urine output, urine becomes viscous.
From the side of the blood. Acrocyanosis, hyperemia, decreased platelet function. The drug makes it difficult to determine the blood group.
Others. General weakness, swelling of the limbs, back pain, chest pain, feeling short of breath, cramps.
In case of adverse reactions (depending on the clinical situation), the administration of the drug should be stopped immediately and, without removing the needle from the vein, all emergency measures provided for by the appropriate instructions should be started to eliminate the transfusion reaction (administration of cardiovascular drugs, corticosteroids, antihistamines, crystalloid solutions, in case of collapse - vasopressors and cardiotonics).

Contraindications

Hyperhydration, hypervolemia, thrombocytopenia (platelet count 80 x 10 9 / L and below), kidney disease accompanied by oliguria, anuria, decompensated cardiovascular failure stage II-III, disseminated intravascular coagulation syndrome, tendency to severe allergic reactions, hypersensitivity to dextran.
Reopoliglyukinwith 0.9% sodium chloride solution should not be administered in case of pathological changes in the kidneys, and with 5% glucose solution - in violation of carbohydrate metabolism, especially in diabetes mellitus.
Conditions in which large volumes of liquid cannot be injected.

Pregnancy

A drug Reopoliglyukinuse for health reasons and taking into account the ratio of risk to the mother / benefit to the fetus.

Interaction with other medicinal products

With simultaneous use Reopoliglyukinawith anticoagulants, it is necessary to reduce their doses. The presence of dextran in the blood can affect the results of determining the amount of bilirubin, protein, blood group, therefore, these studies should be carried out before the administration of the drug.

Overdose

The occurrence of hypervolemia, hypocoagulation is possible.

Storage conditions

Store at a temperature not exceeding 25 ° С out of reach of children.

Release form

Reopolyglyukin -solution for infusion.
Packaging: glass bottles of 200 ml or 400 ml.

Composition

:
1 ml solution Reopoliglyukincontain dextran 40 100.0 mg, sodium chloride 9.0 mg.
Excipients: water for injection.

Additionally

Children. A drug Reopoliglyukincan be used for children; the dose is determined taking into account body weight.
Use only under medical supervision.
Reopolyglyukin can be administered only after preliminary intradermal test, except in cases of emergency (urgent) care in case of shock. In such cases, you need to have the necessary drugs to eliminate all possible allergic reactions.
Intradermal test to determine individual sensitivity to Reopolyglucin is carried out 24 hours before drug administration. To do this, take 0.2-0.3 ml of Reopolyglyukin with a syringe from the bottle with the drug, observing the rules of asepsis. After replacing the needle with a syringe with a sterile injection needle, intradermally inject 0.05 ml of the drug on average one third of the inner surface of the forearm.
The correctness of the drug administration is monitored visually (obtaining a "lemon peel"). The doctor evaluates the reaction after 24 hours.
The presence of a local reaction in the form of redness (a spot with a diameter of more than 1.5 cm), the appearance of papules or symptoms of a general reaction of the body (nausea, vomiting, dizziness, pain, shortness of breath, fever) indicate an increased sensitivity of the body to Rheopolyglucin and the impossibility of using the drug for this patient.
In the absence of any reactions, the patient should enter the required amount of the drug of the series that was used for the intradermal test. The results of the sample are recorded in the medical history.
Intradermal test does not reveal sensitization to Rheopolyglucin in 100% of patients. Therefore, the first 5-10 minutes during the intravenous administration of the drug, it is necessary to closely monitor the patient's condition.
If it is necessary to urgently administer Reopolyglucin in order to provide emergency care, after the slow introduction of the first 10 drops, stop the administration for 3-5 minutes, then introduce another 30 drops and stop the administration again for 3-5 minutes. If there is no reaction, continue the administration of the drug. The test results are recorded in the medical history.
Use with caution in the administration to patients with impaired renal excretory function, if necessary, to limit the administration of sodium chloride, prescribe Reopolyglucin with 5% glucose solution. In case of disorders of carbohydrate metabolism and other conditions in which the introduction of carbohydrates is contraindicated, Reopolyglucin should be used with 0.9% sodium chloride solution. Use with caution for administration to patients with hypertensive disease due to the possibility of increased blood pressure and patients with cardiac dysfunction.
The contents of the vial can only be used for one patient. After breaking the tightness of the bottle, the unused part of its contents should be disposed of in accordance with current requirements.
The ability to influence the reaction rate when driving motor transport or other mechanisms
Has not been investigated. But you should consider the likelihood of side effects such as general weakness and dizziness.

Main settings

Name:	REOPOLIGLUKIN
ATX code:	B05AA05 -

200 ml - polymeric containers (1) - cardboard packs.

Description of the dosage form

Solution for infusion 10% transparent, colorless or slightly yellow in color.

pharmachologic effect

Solutions of high molecular weight dextran with sodium chloride, glucose or mannitol are polyfunctional plasma-substituting solutions. They normalize hemodynamics, increase the volume of fluid in the bloodstream. Solutions of low molecular weight dextran, in addition, help to improve microcirculation, reduce the aggregation of blood corpuscles, blood viscosity. Dextran solutions containing mannitol also have an osmo-diuretic effect.

Clinical pharmacology

Plasma-substituting drug.

Indications for use Reopolyglyukin

High molecular weight dextran solutions: severe post-hemorrhagic hypovolemia, hypovolemic shock due to trauma, blood loss during childbirth, as a result of ectopic pregnancy, etc. Hypovolemia due to plasma loss (burns, compression syndrome). Preoperative and postoperative prevention of embolism.

Low molecular weight dextran solutions: microcirculation disorders, traumatic shock, burn shock, compression syndrome. Septic shock. Plasma volume replacement in pediatric blood loss. For filling heart-lung machines (in certain proportions with blood).

Dextran with a molecular weight of 1000: prevention of severe allergic reactions to intravenous administration of dextran solutions.

Contraindications to the use of Reopolyglucin

Skull trauma with increased intracranial pressure, cerebral hemorrhage and other cases when the administration of a large amount of fluid is not indicated. Oliguria and anuria due to organic kidney disease, heart failure, coagulation and hemostasis disorders, a tendency to allergic reactions. For solutions with glucose - diabetes mellitus and other disorders of carbohydrate metabolism.

Reopolyglyukin Use during pregnancy and children

Application is possible under the strict supervision of a physician.

Reopoliglyukin Side effects

Possibly: allergic reactions.

Rarely: arterial hypotension.

Dosage of Reopolyglucin

High-molecular dextran solutions are injected intravenously at a rate of 60-80 drops / min in an amount of up to 2-2.5 liters (with significant blood loss - with additional blood injection).

Low molecular weight dextran solutions, when used as a blood substitute, are usually administered in the same doses. In other cases, the daily dose should not exceed 20 ml / kg. The rate of intravenous infusion is determined by the indications and the severity of the patient's condition.

Dextran with a molecular weight of 1000 is injected intravenously in a jet for adults at a dose of 3 g (20 ml), for children at a dose of 45 mg / kg (0.3 ml / kg) - 1-2 minutes before the intravenous infusion of a dextran solution. The interval between the introduction of dextran with a molecular weight of 1000 and the infusion of dextran solution should not exceed 15 minutes. If more than 15 minutes have elapsed, then dextran with a molecular weight of 1000 should be re-introduced. It can be administered before each infusion of dextran solution, especially if more than 48 hours have elapsed since the previous infusion.

Precautionary measures

Due to possible allergic reactions, the first 10-20 ml of infusion solution is recommended to be administered slowly, observing the patient's condition. Given the possibility of developing arterial hypertension, it should be borne in mind that appropriate funds for intensive care may be required.

Dextran with a molecular weight of 1000 must not be diluted or mixed with dextran solutions for infusion. Dextran with a molecular weight of 1000 can be injected intravenously through the Y-shaped branch or rubber tube of the infusion system, provided that there is no significant dilution of the drug during the injection.

Reopoliglyukin

International non-proprietaryname

Dextran

Dosage form

solution for infusion 10%.

Composition

100 ml of solution contains

active substance-: dextran (M from 30,000 to 40,000) - 10 g

excipients:sodium chloride - 0.9 g;

water for injection - up to 100 ml.

Theoretical osmolarity ~ 311 mOsm / L.

Description

Transparent colorless or slightly yellowish liquid, odorless

Pharmacotherapeutic group

Plasma substitution and perfusion solutions. Blood plasma preparations and plasma-substituting drugs.

ATX code B05AA05

Pharmacological properties

Pharmacokinetics

Dextran, which is part of rheopolyglucin, is excreted from the body mainly by the kidneys: in the first day, approximately 70% is excreted unchanged. A certain part of dextran enters the reticuloendothelial system, where it is gradually degraded to glucose. Does not participate in carbohydrate metabolism. Very small amounts of dextran can enter the gastrointestinal tract and be excreted in the faeces.

Pharmacodynamics

Reopolyglucin is a 10% colloidal solution of glucose polymer (dextran) (C6H10O5) with a molecular weight of 30,000-40,000. It is used as a plasma-substituting, anti-shock drug of hemodynamic action. Promotes an increase in plasma volume almost 2 times compared to the volume of the administered drug, since each gram of glucose polymer with a molecular weight of 30,000-40,000 causes the movement of 20-25 ml of fluid from the tissues into the bloodstream. Due to the high oncotic pressure, rheopolyglucin passes very slowly through the vascular wall and circulates in the vascular bed for a long time, normalizing hemodynamics due to the flow of fluid along the concentration gradient - from tissues to vessels. As a result, blood pressure quickly rises and remains at a high level for a long time, and tissue edema decreases.

Reopolyglukin can be used as a detoxifying agent. With its introduction, the viscosity of the blood improves, the aggregation of the formed elements decreases. It also stimulates diuresis by osmotic mechanisms (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 removal of poisons, toxins, and degradative metabolic products from the body.

Indications for use

Impaired capillary blood flow

Prevention and treatment of traumatic, operational and burn shock

Septic shock

Arterial and venous circulation disorders

Treatment and prevention of thrombosis and thrombophlebitis, endarteritis and Raynaud's disease

Heart-lung operations performed using a heart-lung machine (to be added to the perfusion fluid)

In vascular and plastic surgery to improve local circulation (reduce the tendency to thrombosis in the graft)

Detoxification for burns, peritonitis, pancreatitis, etc.

Diseases of the retina and optic nerve (complicated myopia, retinal dystrophy, etc.)

Inflammatory processes of the cornea and choroid

Renal and renal-hepatic failure with preservation of renal filtration function.

Method of administration and dosage

Intravenous jet, jet and drip.

Doses and rate of administration of the drug should be selected individually in accordance with the indications and condition of the patient, the value of blood pressure, heart rate, hematocrit.

When using the drug, it is necessary to conduct a bioassay: after the slow introduction of the first 5 drops of the drug, the transfusion is stopped for 3 minutes, then another 30 drops are injected and the infusion is stopped again for 3 minutes. In the absence of a reaction, the administration of the drug continues. The results of the bioassay must be recorded in the medical history.

1. In case of impaired capillary blood flow (various forms of shock), intravenous drip or jet-drip is injected in 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.

In children with various forms of shock, it is administered at the rate of 5-10 ml / kg, the dose can be increased, if necessary, up to 15 ml / kg. It is not recommended to reduce the hematocrit value below 25%.

2. In case of cardiovascular and plastic surgeries, it is administered intravenously by drop infusion, immediately before surgery, for 30 - 60 minutes for adults and children at a dose of 10 ml / kg, for adults - 500 ml, for children - 15 ml / kg.

After the operation, the drug is administered by intravenous drip (within 60 minutes) for 5-6 days at the rate of: adults - 10 ml / kg once,

children under 2 - 3 years old - 10 ml / kg once a day,

children under 8 years old - 7-10 ml / kg 1 - 2 times a day,

children under 14 years old - 5 - 7 ml / kg 1 - 2 times a day.

For children over 14 years of age, the doses are the same as for adults.

3. In operations with artificial circulation, the drug is added to the blood at the rate of 10-20 ml / kg of the patient's body weight to fill the oxygenator pump. The dextran concentration in the perfusion solution should not exceed 3%. In the postoperative period, the doses of the drug are the same as in the case of impaired capillary blood flow.

4. For the purpose of detoxification, it is administered intravenously in a single dose from 500 to 1250 ml (in children, 5-10 ml / kg) for 60 - 90 minutes. If necessary, another 500 ml of the drug can be poured on the first day (in children, the administration of the drug on the first day can be repeated in the same doses). On the following days, the drug is administered by drip, for adults - in a daily dose of 500 ml, for children - at the rate of 5-10 ml / kg. It is expedient to jointly inject crystalloid solutions (Ringer's and Ringer's acetate, etc.) in such an amount to normalize the water-electrolyte balance (especially important in the treatment of dehydrated patients and after surgery), the drug, as a rule, causes an increase in urine output (a decrease in urine output indicates for dehydration of the patient's body).

5. In ophthalmic practice, it is used by electrophoresis, which is carried out in a conventional manner. The consumption of the drug for one procedure is 10 ml. The procedure is carried out once a day, injected from both the positive and negative poles. Current density - up to 1.5 mA / cm 2. The duration of the procedure is 15-20 minutes. The course of treatment consists of 5-10 procedures.

Side effect

Allergic and anaphylactoid reactions (pruritus, rashes, Quincke's edema, decreased blood pressure, collapse, oliguria)

Violation of blood circulation and breathing

Acute renal failure

Nausea, chills, fever.

Contraindications

Hypersensitivity

Decompensated cardiovascular failure

Traumatic brain injury with increased intracranial pressure - hemorrhagic stroke

Internal bleeding

Hypocoagulation

Thrombocytopenia

Severe renal dysfunction, accompanied by oligo and anuria

Hypervolemia, overhydration and other situations in which the administration of massive doses of fluids is contraindicated

High blood pressure.

Drug interactions

It is necessary to pre-check for compatibility of dextran with medications that are planned to be introduced into the infusion solution. Can be used in conjunction with other traditional transfusion agents.

special instructions

Together with the drug, it is advisable to inject crystalloid solutions (0.9% sodium chloride solution, 5% dextrose solution) in such an amount to replenish and maintain the fluid and electrolyte balance. This is especially important when treating dehydrated patients and after major surgery. With simultaneous use with anticoagulants, it is necessary to reduce their dose. Causes an increase in urine output (if there is a decrease in urine output with the release of viscous syrupy urine, this may indicate dehydration). In this case, it is necessary to inject intravenous colloidal solutions to replenish and maintain the water-electrolyte balance. In the event of oliguria, saline solutions and furosemide must be administered. In patients with reduced renal filtration capacity, it is necessary to limit the administration of sodium chloride. Dextrans are capable of enveloping the surface of erythrocytes, interfering with the determination of the blood group, therefore it is necessary to use washed erythrocytes.

Application in children

There are no data on the safety and efficacy of Reopolyglucin in children and adolescents under 18 years of age, so it should be prescribed only in cases where the intended benefit outweighs the potential risk.

Pregnancy and lactation

The use of the drug during pregnancy is possible only if the intended benefit to the mother outweighs the potential risk to the fetus.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous machinery.

During the period of treatment, a decrease in the speed of mental and motor reactions is possible, therefore, it is necessary to refrain from driving vehicles and engaging in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.

WITH caution Reopolyglukin with 0.9% sodium chloride solution should not be administered in cases of pathological changes in the kidneys

Overdose

Symptoms:feeling of tightness in the chest, difficulty breathing, back pain, the onset of chills, cyanosis, impaired blood circulation and breathing.

Treatment:10% calcium chloride solution (10 ml), 20 ml of 40% glucose solution are injected into the vein, cardiac drugs, antihistamines are used.

The formrelease and packaging

200 or 400 ml glass bottles for blood, infusion and transfusion preparations with a capacity of 250 or 450 ml, respectively, sealed with rubber stoppers and crimped with aluminum caps.

Each bottle with instructions for use is placed in a cardboard box.

(molecular weight from 30,000 to 40,000), which is in saline sodium chloride solution.

Release form

Available in the form of a solution for infusion.

pharmachologic effect

Plasma-substituting drug .

Pharmacodynamics and pharmacokinetics

The action of the drug is aimed at restoring blood flow in small-caliber capillaries, increasing the suspension stability of blood, providing detoxification effect , reduction and prevention aggregations blood cells, normalization of venous and arterial circulation , decrease blood viscosity .

As a result of the pronounced volemic effect, hemodynamics improves and the leaching of metabolic products of their organs and tissues is accelerated, which, simultaneously with an increase in diuresis, leads to accelerated detoxification of the human body. The drug briefly and rapidly increases the volume of circulating blood, which makes it possible to increase the return of venous blood to the heart.

In patients with vascular insufficiency, the central venous pressure and the minute volume of blood increase. The drug has an average molecular weight. Rapid administration leads to an increase in the volume of plasma in two times compared to the volume of the injected solution.

Reopolyglucin is pyrogen-free , non-toxic. Thanks to its action, the aggregation of erythrocytes is reduced and prevented, which has a positive effect on microcirculation.

The drug prevents the formation of blood clots after injuries and surgical interventions, reduces the adhesiveness, increases the solubility of blood clots by changing the structural structure of fibrin.

With the introduction of the drug up to 15 ml / kg, there is a noticeable deviation in the bleeding time.

Indications for use

Reopolyglucin is prescribed to replenish the circulating blood volume, improve capillary blood flow in fat embolism , paralytic intestinal obstruction, with toxic shock, postoperative shock, cardiogenic, hemorrhagic, burn and traumatic shocks.

The drug allows you to replace the volume of plasma in pediatric practice.

The drug is prescribed to improve venous and arterial circulation in thrombosis, raynaud's disease , obliterating endarteritis, acute, .

For the purpose, rheopologlyukin is prescribed for peritonitis, food toxicoinfections, crash syndrome, extensive purulent and necrotic lesions of soft tissues, with ulcerative, necrotizing enterocolitis , "Inclusion syndrome".

In the preoperative period, Reopolglukin is prescribed for hemodilution .

With the help of the drug, therapeutic plasmapheresis is performed to replace the removed plasma volume.

The drug is added to the perfusion solution during open-heart surgery in the heart-lung machine, for the prevention of thrombus formation on the heart valves, vascular grafts.

The drug is effective for impaired microcirculation with idiopathic or traumatic hearing loss.

The drug is prescribed for diseases of the optic nerve, retinal pathology, inflammatory processes in the cornea, pathology of the choroid.

Contraindications

Reopolyglyukin is contraindicated in thrombocytopenia , bleeding, intolerance to the components of the drug, pathology of the renal system (oliguria).

With abundant mucopurulent sections, maceration of the eyelid skin, electrophoresis is strictly contraindicated.

Side effects

Nausea, febrile syndrome, chills, fever, anaphylactoid reactions , collapse, drop in blood pressure, skin rash and other allergic reactions.

The drug can cause the development of acute renal failure, provoke bleeding.

Reopoliglyukin, application instruction (Way and dosage)

Taking into account the hematocrit, indicators of blood pressure, pulse, the patient's condition and his individual characteristics, the dosage of the drug is calculated.

Reopolglyukin is administered intravenously, drip, jet and jet-drop administration is permissible.

Mandatory before the introduction of the drug, with the exception of urgent, life-threatening conditions, carry out skin test : the injection site is treated with alcohol in the middle part on the inner surface of the forearm, then 0.05 ml is injected intradermally, a lemon crust should form.

With the development of nausea, dizziness, the appearance of redness at the injection site, the formation of papules speak of the patient's intolerance to this drug.

Mandatory holding biological sample : after the introduction of the first five drops of rheopolyglucin, the infusion is stopped for three minutes, after which another 30 drops are injected, and stop again. In the absence of a reaction, the infusion is continued according to the calculated scheme. Registration of the bioassay results in the medical history is required.

In patients with impaired capillary blood flow, the administration of the drug Reopolyglyukin is carried out by jet-drip, drops of 0.5-1.5 liters until the hemodynamic parameters are completely stabilized at the level of life support. In severe cases, the amount of the injected solution is increased to two liters.

In case of shocks in children, the volume of the drug is calculated according to the scheme: 5-10 ml / kg, an increase up to 15 ml / kg is possible. It is not recommended to reduce the hematocrit value below 25%.

For plastic surgeries, cardiovascular surgeries, Reopolyglucin is administered immediately before surgical treatment within an hour at a dose of 10 ml / kg.

After surgery, the drug is administered intravenously for an hour.

In surgical interventions with artificial circulation, the drug is added to the blood according to the scheme: 10-20 ml / kg in order to fill the oxygenator pump.

According to the instructions for use of Reopolyglyukin, for detoxification, the drug is administered intravenously by drop infusion at a dosage of 500-1250 ml for 1-1.5 hours.

Overdose

Possible hypovolemia, hypocoagulation.

Symptom therapy is administered.

Interaction

Together with anticoagulants, their dosage must be reduced.

The medicine can affect the accurate determination of the amount of bilirubin, protein, blood group.

Terms of sale

Prescription only.

Storage conditions

Store in a dry place, out of the reach of children, at a temperature not exceeding 25 degrees Celsius.

Shelf life

No more than two years.

special instructions

Rheopolglucin can be administered with crystalloid solutions to maintain and replenish electrolyte, fluid balance ... Such infusions must be carried out after severe surgical interventions, in dehydrated patients.

In case of simultaneous administration anticoagulants a reduction in dosage is highly recommended.

Reopolyglucin is able to increase urine output. With a decrease in urine output, excretion of syrupy, viscous urine, they talk about dehydration and intravenously inject colloidal solutions in order to maintain and replenish water-electrolyte balance .

With oliguria, saline solutions are also administered.

Patients with reduced filtration function of the renal system are limited to sodium chloride.

interfere with the determination of the blood group, envelop the surface of erythrocytes, which requires the use of washed erythrocytes.

INN: Reopoliglyukina Dextran.

Analogs

Matching ATX level 4 code:

Medicines can be called analogs: Polydextran , Promit infusion .

Reopolyglyukin is an anti-shock drug of hemodynamic action. With its help, you can quickly increase blood pressure indicators, reduce swelling and eliminate blood clots.

You can buy this drug at almost any pharmacy, but only with a doctor's prescription. The price of the medication is small, which allows even patients with limited financial resources to be treated with it.

Release form and composition

Manufacturers of Reopolyglyukin (INN Dextran) produce only one dosage form of this medication - an infusion solution. It is a transparent liquid that is colored in a light yellow tint. You can buy the solution in bottles from 100 ml to 1 liter. Such containers are packed in cardboard boxes and delivered to pharmacies.

The composition of the drug is distinguished by the presence of one active substance and several auxiliary ones. 1 liter of the solution should contain the following chemical compounds:

• dextran - 100 g;
• sodium chloride;
• special liquid for injection.

Indications

In order for the medication to have the most effective effect on the patient's body, it is necessary to use it correctly. It is recommended to use Reopolyglucin for the treatment of such pathologies:

• prevention and treatment of surgical, burn or traumatic shock;
• heart surgery, which is performed using a heart-lung machine;
• raynaud's disease, thrombosis, thrombophlebitis;
• violation of capillary, venous and arterial circulation;
• pancreatitis, peritonitis;
• burns of varying severity;
• plastic and vascular surgery;
• inflammation of the choroid or cornea;
• diseases of the optic nerve.

Contraindications

Reopolyglucin, like any other drug, has several contraindications. They cannot be neglected, as they can cause serious complications and deterioration of the patient's health.

It is forbidden to use Reopolyglucin in the following diseases and conditions:

• acute heart failure;
• pulmonary edema;
• thrombocytopenia;
• internal bleeding;
• renal failure;
• hypocoagulation;
• increased intracranial pressure, which was the result of the injury;
• hemorrhagic stroke;
• hypervolemia and hyperhydration;
• individual intolerance to one of the auxiliary components of the drug;
• hypersensitivity of the body to the active substance;
• an allergic reaction to one of the analogs of Reopolyglucin.

In some situations, the use of a Reopoliglyukin dropper is allowed. At the same time, it is important to regularly monitor changes in health status and follow all the prescriptions of doctors.

If any abnormalities are found, you should immediately stop using Reopolyglucin and seek help from your doctor. He will conduct additional examination of the patient, adjust the dosage or cancel the infusion.

The medicine should be used with caution in such situations:

• dehydration;
• poor blood clotting;
• diabetes;
• hyperosmolarity and hyperkalemia;
• negative changes in water and electrolyte balance;
• all trimesters of pregnancy;
• period of breastfeeding the baby.

Instructions for use

In order to achieve maximum results and quickly get rid of the existing disease, it is necessary to correctly administer the drug.

The drug can be injected into the patient's body only intravenously. This can be done by jet, drip, and also use the combined option. The dosage of Reopolyglucin and the rate of its administration depends on the following factors:

• heart rate;
• the value of the blood pressure indicator;
• concentration of red blood cells in the blood.

A skin test should be done 24 hours before the first infusion. With its help, you can identify drug intolerance, as well as the degree of its effect on the patient's body.

If after a day the patient does not have any side effects, the drug can be safely used in therapy.

The dosage of the medicine for each specific case:

1. Various forms of shock. It is recommended to make daily infusions of 0.4-1 liters of the drug. In severe form, it is allowed to use up to 1.5 liters of solution per day. In childhood, the dosage depends on the patient's body weight and is determined at the rate of 10 ml / kg. In all cases, the duration of the infusion should not exceed 1 hour.
2. Plastic and cardiovascular surgery. The drug is administered before the start of the operation in an amount of 10 ml per kilogram of weight. In addition, Reopolyglyukin can be used during surgery, as well as after its completion. The maximum duration of therapy can be 1 week.
3. Operations performed with a heart-lung machine. The medicine is added to the blood (up to 20 ml / kg), and is also used during rehabilitation therapy. In this case, the dosage is calculated based on the current state of the patient.
4. Detoxification. The best option is an hour and a half infusion in the amount of 0.4-1 liters for adults and 10 ml / kg for children. If necessary, you can enter another daily dose of the drug, but this opportunity should be used only as a last resort.
5. Ophthalmic diseases. The drug Reopolyglyukin is used during the electrophoresis procedure. It is injected into the patient's body in a volume of up to 10 ml. The maximum allowable duration of such therapy is 10 days.

Side effects

If you use the medicine incorrectly and do not follow the prescribed dosages, you may encounter one of the side effects. Because of them, not only the duration of the healing process will increase, but also the cost of treatment.

Possible side effects:

• a rash on the surface of the skin, accompanied by severe itching;
• lowering blood pressure to a critical level;
• fever;
• nausea;
• impaired renal function;
• increased likelihood of bleeding (external and internal);
• arrhythmia, heart failure;
• pulmonary hypertension.

special instructions

During clinical studies, some of the features of Reopolyglucin were discovered. All of them are included in the instructions for use of the drug and must be taken into account before starting therapy.

So, the following features of the drug should be taken into account:

• The medicine retains all its properties at low temperatures, so it can be frozen for transportation.
• The process of administering the medication can cause slight painful sensations and a burning sensation.
• Patients suffering from various kidney diseases should use the minimum amount of the drug. In the absence of any deviations, you can gradually increase the dosage.
• During therapy with Rheopolyglucin, the process of determining the blood group may be difficult. Because of this, you should perform this procedure before starting treatment.
• The active substance of the drug does not combine well with alcohol, therefore, its consumption should be limited during therapy.

Drug interactions

When using Reopolyglucin, one should take into account not only its characteristics, but also interactions with other drugs. Some drug combinations can increase or decrease the effectiveness of the action, as well as develop side effects.

The main combinations and their consequences for patients:

• The simultaneous use of Reopolyglucin with anticoagulants increases their effect on the patient's body.
• The combination of the drug with other transfusion solutions will not adversely affect the patient.
• Dextran (active ingredient of the drug) in combination with antiplatelet agents can enhance their effectiveness.

Cost and analogues

Reopolyglyukin is included in the register of medicines, therefore, it is allowed throughout Russia. The price for Reopoliglyukin in Moscow starts from 100 rubles. In other regions, it may differ slightly from the capital.

Pharmaceutical companies produce a large number of Reopolyglucin analogues. They are all very similar in composition, but slightly differ in characteristics and methods of application.

The most popular and frequently purchased of them are the following medicines:

• Hemostabil;
• Neorondex;
• Polydextran;
• Polyglyukin;
• Dextran 40.

Reopolyglyukin can be replaced with them only after consultation with your doctor. Otherwise, self-medication can cause deterioration in health and the development of complications.

Reopolyglyukin is an effective drug of hemodynamic action. With its correct use and following all the recommendations of doctors, you can significantly speed up the healing process and avoid any adverse reactions.