Pharmacokinetics
K+ and Na+ ions do not remain in the vascular bed for long and are quickly distributed throughout all tissues of the body. They are excreted mainly by the kidneys, in small quantities through the intestines, sweat, tears, etc.
In the body, acetate is activated into acetyl-Coenzyme A, then the main amount of active acetate is completely oxidized in the Krebs cycle to carbon dioxide and water. The process of acetate oxidation occurs in muscle cells, so the body's ability to metabolize it mainly depends on lean body mass. The metabolism of acetyl-CoA can also follow a minor oxidation pathway to form fatty acids, keto acids and cholesterol.
Indications for use
Acesol has a beneficial effect on metabolic processes in the body and improves the hemodynamic properties of blood. The medicine is widely used for diseases that occur with severe and moderate intoxication, such as:
- food poisoning;
- cholera;
- acute shigellosis (dysentery).
Acesol is given as a dropper to adults when the body is dehydrated and when relieving alcohol intoxication.
In emergency cases, Acesol is used as a drug to replenish blood loss.
The medication can be used for pathologies that involve metabolic disorders and blood thickening. For children, the medication is often prescribed for dehydration caused by vomiting, diarrhea, and febrile syndrome.
Contraindications
Hypersensitivity, hyperkalemia, alkalosis, chronic renal failure, the presence of contraindications to the introduction of large amounts of fluid into the body.
Carefully
Use with caution in patients with impaired renal excretory function.
Use during pregnancy and breastfeeding
It is possible if the expected effect of therapy in the mother exceeds the potential risk to the fetus and child (adequate and strictly controlled studies of the safety of use in pregnant and lactating women have not been conducted).
Mechanism of action
The drug is most often used in hospitals and intensive care units. Often, its use begins with the provision of emergency care to patients by ambulance personnel. Acesol has several effects at once, these are:
- detoxification;
- rehydrating (replenishes fluid deficiency);
- plasma-substituting;
- anti-shock;
- antiaggression;
- diuretic.
Once in the bloodstream, Acesol cleanses the blood of metabolites of pathogenic microorganisms, toxins and breakdown products of medications. Under the influence of the medicine, blood microcirculation is activated, metabolic processes are improved, and blood thickening is prevented.
At the same time, diuresis increases, which accelerates the removal of pathogenic elements from the body.
The use of Acesol against the background of hypovolemia reduces the risk of blood clots in large main vessels by 30%.
Potassium and sodium ions, which form the basis of the drug, do not remain in the systemic circulation for long. Leaving the bloodstream, they are distributed in soft tissues, then neutralized by the kidneys and excreted naturally - with urine.
special instructions
Treatment is carried out under the control of hematocrit and blood electrolyte concentrations.
If hyperkalemia develops, the drug is replaced with Disol solution until the electrolyte balance is normalized.
No studies have been conducted to assess the effect of the drug on the ability to drive vehicles and engage in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
In general, during dehydration, the introduction of special solutions orally is indicated, and only if such administration is impossible (uncontrollable vomiting, severe degree of dehydration, severity of the general condition, etc.), the drug is administered parenterally.
Overdose symptoms
Administration of the drug in too large doses or non-compliance with the infusion rate can cause overdose, which is primarily manifested by hyperkalemia. Its development is indicated by arrhythmia, weakness, muscle paralysis, and a sharp drop in blood pressure. If the above symptoms are detected, an analysis is performed and an ECG is performed. Based on the detected changes, treatment with Acesol may be discontinued.
To speed up the normalization of well-being, the patient is prescribed solutions with sodium salts, intravenous administration of Glucose and Insulin.
Hyperkalemia does not always manifest itself with pronounced symptoms, and it is in such cases that a terrible complication most often leads to death.
To prevent this, it is necessary to correctly calculate the dosage and rate of administration of the drug, monitor vital signs during therapy, and periodically repeat tests.
Directions for use and doses
The drug is used only for moderate and severe conditions when it is impossible to take oral rehydration solutions, administered intravenously (1-3 hours).
Before administration, the solution is heated to 36-38 °C. The volume of the injected solution is selected individually, in the amount necessary to restore the water-electrolyte balance (in severe forms of the disease, the solution is administered in a stream within 1 hour in an amount corresponding to 7-10% of the patient’s body weight; then the stream administration is replaced by a drip, at a speed of 40-120 drops/min (24-48 hours)), under the control of laboratory parameters.
The balance of fluid introduced and lost is determined every 6 hours. The total amount of solution administered should correspond to the volume of fluid excreted in feces, vomit, urine and sweat.
Interaction with other medications
Isotonic solutions cannot be used in conjunction with potassium-sparing diuretics, since this combination of drugs greatly increases the risk of hyperkalemia. In case of severe poisoning and when the volume of circulating blood decreases, Acesol is sometimes used in conjunction with blood substitutes - Poliglyukin, Reogluman, Reopoliglyukin.
If it is necessary to organize parenteral nutrition, Acesol is supplemented with the introduction of droppers with 5% Glucose.
When introducing other medicinal solutions into a bottle with Acesol, it is necessary to visually monitor their compatibility. That is, no sediment or flakes should appear in the liquid, and it should not become cloudy.
You should not drink alcohol-containing drinks during treatment with Acesol. In combination with the active components of the drug, ethanol often leads to angioedema of the subcutaneous tissue and mucous membranes.
Side effect
Edema, tachycardia, chills, hyperkalemia.
Overdose
Symptoms In patients with chronic kidney disease or any disease that impairs the excretion of potassium from the body, or if the drug is administered too quickly intravenously, hyperkalemia may develop, which can potentially be fatal. Early clinical manifestations of hyperkalemia (sharpening of the P wave, disappearance of the U wave, lowering of the ST segment, and prolongation of the QT interval) usually appear at serum potassium concentrations of 7 to 8 mEq/L. More severe symptoms (including muscle paralysis and cardiac arrest) develop at potassium concentrations of 9-10 mEq/L. It should be borne in mind that hyperkalemia, which can be fatal, can develop quickly and be asymptomatic.
Treatment: discontinuation of the drug; in case of hyperkalemia, the drug is replaced with Disol solution until the electrolyte balance is normalized. If necessary, hemodialysis and peritoneal dialysis are performed.
Composition and dosage form
Acesol is available in the form of a sterile solution. The drug is administered only into a vein - in a stream or drip. The solution is completely transparent, packaged in glass or polymer bottles of 200, 400 and 500 ml. Bottles of 100 and 250 ml are sold less frequently.
The main components of Acesol are:
- sodium chloride - 5 g;
- sodium acetate - 2 g;
- potassium chloride - 1 gr.
An auxiliary component is water for injection. Acesol is otherwise called a saline solution; it is isotonic with respect to plasma, and its effect is to replenish the missing fluid.
Analogues of the drug Acesol
Russian pharmaceutical companies sell Acesol at a price of 13 rubles per bottle with 200 ml of solution. The drug is considered quite effective in the treatment of poisoning, intoxication and shock. But despite the low cost and good therapeutic effect, in some cases analogues of Acesol may be required.
In terms of composition, Chlosol is a complete analogue of the described medication. It is also inexpensive - between 15-25 rubles per bottle.
In case of intolerance to Acesol and contraindications to its use, analogues with a different composition, but providing a similar therapeutic effect, are needed. There are quite a lot of them, and the most popular ones are shown in the table.
| Name | Active components | Manufacturer | Dosage form | Indications for use | average cost |
| Trisol | Sodium bicarbonate, sodium chloride, potassium chloride | Pharmaceutical companies from Belarus, Ukraine, Russia | Injection solution | Food poisoning, infectious diarrhea, viral intestinal diseases | From 30 to 70 rubles per bottle |
| Quintasol | Chlorides of magnesium, calcium, potassium, sodium | "Biosynthesis" Russia | Solution for drip administration | Hypohydration, shock, acute blood loss, acidosis. In the complex therapy of intestinal obstruction and peritonitis. | From 50 rubles for 400 ml |
| Normofundin | Dextrose, potassium chloride, magnesium chloride hexahydrate, sodium acetate and gluconate, sodium chloride | "B.braun Melsungen", Germany. | Solution for infusion | Isotonic and hypertonic dehydration. The drug is used to provide the body with electrolytes and fluid after injuries and operations. | From 100 rubles per 100 ml bottle |
| Ringer | Chlorides of calcium, potassium, sodium | Serbia, Russia | Infusion solution | Collapse, shock, frostbite, burns, electrical injuries, diarrhea, acute peritonitis, metabolic alkolosis | From 30 rubles |
| Disol | Sodium acetate, sodium chloride | Russia Ukraine | Solution for drip administration | Salmonellosis, cholera, food poisoning, infectious diarrhea, hyperglycemia, poisoning from cancer and alcohol. | From 40 rubles |
Acesol is a drug traditionally used in the treatment of intoxication and shock. The medicine acts quickly, does not have a negative effect on the functioning of internal organs, does not accumulate and is eliminated naturally. However, it is recommended to use it only for a short course, observing all the application features specified in the instructions. This will avoid adverse reactions and possible complications.
