Reopolyglyukin

Rheopolyglucin is a liquid for perfusion procedures, as well as a blood substitute.

The drug is a plasma-replacing colloidal liquid based on dextran (glucose polymer), whose therapeutic activity is manifested as an improvement in the rheological parameters of the blood. The medicine reduces blood viscosity, restores microcirculatory blood circulation, and in addition prevents and eliminates the aggregation of some shaped components. Also, the drug stabilizes venous and arterial blood flow. [1]

Indications Reopolyglyukin

It is used in the treatment or prevention of distributive or hypovolemic shock. In addition, it is prescribed in the case of plastic and vascular operations related to transplantation .

It is used as an additional element to the perfusion that is present inside the artificial blood flow apparatus and is used during operations in the area of the heart.

Release form

The release of the therapeutic component is made in the form of an infusion liquid, inside glass bottles with a capacity of 0.2 or 0.4 liters.

Pharmacodynamics

The introduction of the drug at a high speed leads to an increase in the volume of blood plasma by an indicator that is almost twice the volume of the applied substance, because every 10 ml of it causes the redistribution of 20-25 ml of the drug into the bloodstream from the tissues. [2]

Pharmacokinetics

The half-life is 6 hours. Excretion is mainly carried out through the kidneys: about 60% in the first 6 hours; 70% excreted in 24 hours. The remainder passes into the macrophage system and liver, where it undergoes gradual degradation from α-glucosidase to glucose, while not being a carbohydrate nutritional source.

Dosing and administration

The procedures are carried out through a dropper, intravenously. Before starting the injection, you need to warm up the liquid to 35-37 ° C. Serving size and injection speed are personalized.

If there is a disorder of capillary circulation (different types of shock), an adult can be injected no more than 20 ml / kg per day, and a child - 5-10 ml / kg (if necessary, a maximum of 15 ml / kg).

During operations using artificial blood flow, the medication is added to the blood at a dosage of 10-20 ml / kg to fill the oxygenator pump; the level of dextran inside the perfusion fluid can be maximum 3%. During the postoperative period, the drug is used in portions used for capillary circulation disorders.

Reopolyglucin should not be mixed with other medications. In the presence of strict indications, the medication can be injected at high speed, even by the jet method, in a portion of 15 ml / kg.

For persons with TBI or hemorrhagic stroke, the drug can be used in a dosage of no more than 10-15 ml / kg.

• Application for children

The medication is used in pediatrics; the dosage is selected, taking into account the weight of the child.

Use Reopolyglyukin during pregnancy

It is possible to prescribe Reopolyglyukin only according to strict indications, taking into account the balance of benefits and risks from its use.

Contraindications

Among the contraindications:

• hypervolemia and hydration;
• thrombocytopenia (platelet count is less than 80 × 109 / l);
• renal lesions, in which anuria and oliguria are noted;
• insufficiency of the function of the CVS, which has a decompensated character (stages 2-3);
• DIC syndrome;
• a tendency to show signs of allergies;
• intolerance associated with dextran;
• conditions during which the introduction of a large amount of fluid is prohibited.

Dextran in combination with 0.9% NaCl is prohibited for use in case of renal disease; the combination with 5% glucose is prohibited in the case of disorders of carbohydrate metabolism (especially in the case of diabetes mellitus).

Side effects Reopolyglyukin

The main side symptoms:

• signs of allergies: fever, anaphylaxis, fever, Quincke's edema, itching, rashes, manifestations of intolerance and hyperhidrosis;
• lesions affecting the CVS: tachycardia, edema, changes in blood pressure and dyspnea;
• disorders associated with digestive function: vomiting, abdominal pain, dry mouth and nausea;
• problems with the work of the NA: tremors, headaches and dizziness;
• violations of urinary activity: often, especially in the case of hypovolemia, the medication leads to increased urine output. But sometimes its use causes a weakening of urine output; at the same time, the urine becomes viscous, from which it can be concluded that dehydration is observed inside the patient's body. In such a case, intravenous injection of crystalloid liquids is performed, which allows you to restore and maintain plasma osmosis. The introduction of 15 ml / kg of the substance leads to the appearance of hyperosmolarity, which can provoke a tubular burn with the further development of ARF. In this case, diuresis is also weakened, and the urine becomes viscous;
• lesions of the circulatory system: hyperemia, acrocyanosis and weakening of platelet activity. Also, the medicine complicates the process of identifying the blood group;
• others: swelling affecting the limbs, convulsions, systemic weakness, pain in the chest and lumbar region, as well as a feeling of lack of air.

When negative symptoms appear (taking into account the clinical picture), it is necessary to immediately stop the use of drugs, and then, without removing the needle from the vein, carry out all the urgent procedures required in such cases to help eliminate transfusion manifestations (GCS, cardiovascular substances, antihistamines, crystalloid liquids are used; in case of collapse, cardiotonics and vasopressors are used).

Overdose

With intoxication, hypocoagulation or hypervolemia may develop.

Symptomatic actions are performed.

Interactions with other drugs

The introduction together with anticoagulants requires a decrease in their dosage portion.

The presence of dextran inside the blood can alter test readings for protein and bilirubin volumes, as well as for blood typing. Because of this, such tests are required to be performed prior to drug use.

Storage conditions

Reopolyglyukin is required to be kept out of the reach of children. Temperature values - no more than 25 ° С.

Shelf life

Rheopolyglucin can be used within a 4-year period from the date of manufacture of the therapeutic agent.

Analogs

The analogs of the drug are the substances Reogluman and Polyglyukin.