Pharmacodynamics and pharmacokinetics
Pharmacodynamics
Plasma-substituting, anti-shock drug. Replenishes the volume of circulating blood and has a disaggregant effect . It has a high osmotic pressure (2.5 times higher than the pressure of plasma proteins), therefore it actively attracts tissue fluid and retains it in the vascular bed for a long time - the volume of circulating blood is quickly restored. Increases blood pressure platelet and erythrocyte aggregation ), improves microcirculation .
Pharmacokinetics
It is excreted from the body by the kidneys and 50% is excreted in the first day, and completely removed after 7 days. Some of the dextran accumulates in the reticuloendothelial system and is slowly metabolized to dextrose .
Poliglyukin
IV drip, for acute blood loss - IV (in a hospital setting). The volume and rate of administration is determined by the patient’s condition, blood pressure, heart rate, and hematocrit. Transfusion is carried out in the usual way in compliance with the rules for transfusion production: before transfusion, a biological test is carried out (after administering 5-10 drops, take a 3-minute break, then another 10-15 drops are transfused and after the same break in the absence of reaction symptoms (increased heart rate, decreased blood pressure, skin hyperemia, difficulty breathing) continue transfusion).
In case of developed shock or acute blood loss - intravenous injection, 0.4-2 l of the drug (5-25 ml/kg). After increasing blood pressure to 80-90 mm Hg. usually switch to drip administration at a rate of 3-3.5 ml/min (60-80 drops/min). Possible intravenous route of administration (in the same dosages). Infusions of the drug should be carried out under constant monitoring of key indicators of systemic hemodynamics. If there is a significant increase in central venous pressure, reduce the dose and rate of administration or stop completely.
In case of blood loss of more than 500-750 ml and severe anemia of the patient, the administration of the drug is combined with a transfusion of blood, red blood cells or a suspension of red blood cells necessary to eliminate tissue hypoxia, as well as fresh frozen plasma containing factors of the hemostasis system.
To prevent surgical blood loss with the drug, as well as to achieve artificial hemodilution, prevent thrombosis and reduce the tendency to develop or progress DIC syndrome, the drug is administered in doses of 5-10 ml/kg (for children - 10-15 ml/kg) for 30-60 min before surgery (in case of a significant decrease in blood pressure, switch to jet administration, if blood pressure decreases below 60 mm Hg - intravenous injection). The volume of infusions during surgery is determined by the amount of surgical blood loss (the hematocrit should not fall below 0.3).
In the postoperative period, jet-drip administration is an effective way to prevent shock.
For burn shock: in the first 24 hours, 2-3 liters are administered, in the next 24 hours - 1.5 liters. Children in the first 24 hours - 40-50 ml/kg, in the next day - 30 ml/kg.
For extensive and deep burns, it is combined with the administration of plasma, albumin, and gamma globulin; for burns of more than 30-40% of the body surface - with a blood transfusion.
To prevent possible tissue dehydration, it is recommended to combine the infusion of Polyglucin with the administration of crystalloid solutions in a 1:2 ratio.
Contraindications
- increased sensitivity;
- hemorrhagic stroke;
- intracranial hypertension;
- cardiovascular failure;
- traumatic brain injury;
- anuria;
- severe renal failure ;
- arterial hypertension;
- coagulation disorders;
- thrombocytopenia;
- tendency to allergic reactions.
Poliglyukin, instructions for use (Method and dosage)
Poliglyukin solution is administered intravenously (drip and stream), intra-arterially (in case of acute blood loss). The rate of administration and volume depend on the patient's condition and is determined by many factors ( blood pressure , hematocrit , heart rate). Before the transfusion, a test is carried out - after the first 10 drops, a break is taken, then another 15 drops are administered, if there is no reaction, the transfusion is continued.
For acute blood loss, use 5-25 ml per kg of weight. Infusions are carried out under hemodynamic control. If central venous pressure increases, the rate of administration is reduced or further administration is stopped.
For blood loss of 750 ml, a combination with blood transfusion is indicated.
For burn shock : the first day, up to 2-3 liters are administered, and then 1.5 liters. For extensive burns, a combination with the administration of albumin , plasma, and blood transfusion is indicated.
In order to prevent blood loss during major operations, 5-10 ml per kg of body weight is administered an hour before surgery. In the postoperative period, it is used to prevent shock.
Polyglucin (Polyglucinum)
IV drip, for acute blood loss - IV (in a hospital setting). The volume and rate of administration is determined by the patient’s condition, blood pressure (BP), heart rate (HR), and hematocrit.
Transfusion is carried out in the usual way in compliance with the rules for transfusion production: before transfusion, a biological test
(after administering 5-10 drops, take a 3-minute break, then pour in another 10-15 drops, and after the same break, in the absence of reaction symptoms (increased heart rate, decreased blood pressure, skin flushing, difficulty breathing), continue the transfusion).
In case of developing shock or acute blood loss
- IV stream, 0.4-2 l (5-25 ml/kg). After increasing blood pressure to 80-90 mm Hg. usually switch to drip administration at a rate of 3-3.5 ml/min (60-80 drops/min). Possible intravenous route of administration (in the same dosages). Infusions of the drug should be carried out under constant monitoring of key indicators of systemic hemodynamics. If there is a significant increase in central venous pressure, reduce the dose and rate of administration or stop completely.
In case of blood loss of more than 500-750 ml and severe anemia of the patient, the administration of the drug is combined with a transfusion of blood, red blood cells or a suspension of red blood cells necessary to eliminate tissue hypoxia, as well as fresh frozen plasma containing factors of the hemostasis system.
To prevent surgical blood loss, as well as to achieve artificial hemodilution, prevent thrombosis and reduce the tendency to develop or progress DIC syndrome
the drug is administered in doses of 5-10 ml/kg (for children - 10-15 ml/kg) 30-60 minutes before surgery (in case of a significant decrease in blood pressure, they switch to jet administration, if blood pressure decreases below 60 mm Hg - in/a). The volume of infusions during surgery is determined by the amount of surgical blood loss (the hematocrit should not fall below 0.3). In the postoperative period, jet-drip administration is an effective way to prevent shock.
For burn shock:
in the first 24 hours, 2-3 liters are administered, in the next 24 hours - 1.5 liters. Children in the first 24 hours - 40-50 ml/kg, in the next day - 30 ml/kg.
For extensive and deep burns, it is combined with the administration of plasma, albumin, and gamma globulin; for burns of more than 30-40% of the body surface - with a blood transfusion. To prevent possible tissue dehydration, it is recommended to combine the drug infusion with the administration of crystalloid solutions in a 1:2 ratio.
Analogs
Level 4 ATC code matches:
Perftoran
Gelofusin
Albumen
Stabizol
Ceruloplasmin
Refortan
Gemodez-N
Reopoliglyukin
Dextran-60-Eskom , Neorondex , Polyfer , Rondex , ReoDEX .
Reviews about Poliglyukin
Dextran solutions (a water-soluble polymer of glucose) are plasma replacement solutions and are often used in hospital settings. Rondex , Poliglyukin , Reopoliglyukin , Reogluman and others are prepared from dextran The difference between them is that Poliglyukin and Rondex are prepared on the basis of medium molecular dextran , and Reomacrodex , Reopoliglyukin , Longasteril 40 - on the basis of low molecular weight.
They also differ in their action: high-molecular dextrans , due to the large size of the molecules, are retained in the bloodstream for a long time, thereby increasing the volume of circulating fluid and normalizing hemodynamics , while low-molecular dextrans additionally improve microcirculation , reduce platelet aggregation , red blood cells and blood viscosity. However, it must be taken into account that the use of Polyglucin can cause nonspecific agglutination of red blood cells , activate fibrinolysis and cause a risk of bleeding. Therefore, the volume of administered Polyglucin should not be more than 1200 ml per day. In addition, it negatively affects the parenchyma , causing a “dextran burn” when excreted by the kidneys. Here are some patient reviews that often mention side effects of the drug.
- “... This drug was used to treat massive gynecological bleeding - 400 ml was tolerated well.”
- “... I had a feeling of heat, shortness of breath and severe sweating. They took off the drip without even finishing half of it.”
- “... I don’t tolerate Polyglyukin well - my blood pressure rises and my heart palpitates.”
- “... They dripped only once - there was a severe headache and trembling in the body. They said I can no longer take this drug.”
Another use of dextran in medicine is the reagent Polyglucin 33%, which is used in the “polyglucin test” to check the compatibility of the blood of the donor and recipient. Take 2 drops of recipient serum, a drop red blood cells and a drop of 33% Polyglucin. The test tube is tilted, shaken, and slowly rotated to spread the contents of the test tube over the walls for 3 minutes, after which 2 ml of saline is added and the test tube is inverted. If red blood cell agglutination , it means the blood is incompatible.
Polyglucin, 6%, solution for infusion, 200 ml, 28 pcs.
V/v, v/a,
drip, stream,
intravenous injection
- for acute blood loss (in a hospital setting). The dose and rate of administration is determined by the patient’s condition, blood pressure, heart rate, and hematocrit. Transfusion is carried out in the usual way in compliance with the rules for transfusion production: before transfusion, a biological test is carried out (after administering 5-10 drops, take a 3-minute break, and then transfuse another 10-15 drops and after the same break in the absence of reaction symptoms (increased heart rate, decreased blood pressure) , skin hyperemia, difficulty breathing) continue transfusion.
In case of developed shock or acute blood loss - intravenous injection, 0.4–2 l (5–25 ml/kg). After increasing blood pressure to 80–90 mm Hg. usually switch to drip administration at a rate of 3–3.5 ml/min (60–80 drops/min). Possible intravenous route of administration (in the same dosages). Infusions of the drug should be carried out under constant monitoring of key indicators of systemic hemodynamics. If there is a significant increase in central venous pressure, reduce the dose and rate of administration or stop administration.
In case of blood loss of more than 500–750 ml and severe anemia of the patient, the administration of the drug is combined with a transfusion of blood, red blood cells or a suspension of red blood cells necessary to eliminate tissue hypoxia, as well as fresh frozen plasma containing factors of the hemostasis system.
To prevent surgical blood loss, as well as to achieve artificial hemodilution, prevent thrombus formation and reduce the tendency to develop or progress DIC syndrome, the drug is administered in doses of 5-10 ml/kg (for children - 10-15 ml/kg) for 30-60 minutes before surgery (in case of a significant decrease in blood pressure, they switch to jet administration, if blood pressure decreases below 60 mm Hg - intravenous injection). The volume of infusion during surgery is determined by the amount of surgical blood loss (the hematocrit should not fall below 0.3).
In the postoperative period, to prevent shock, the drug is administered by stream-drip.
For burn shock: in the first 24 hours, 2-3 liters are administered, in the next 24 hours - 1.5 liters. Children in the first 24 hours - 40–50 ml/kg, in the next day - 30 ml/kg.
For extensive and deep burns, it is combined with the administration of plasma, albumin, and gamma globulin; for burns of more than 30–40% of the body surface - with blood transfusion.
To prevent possible tissue dehydration, it is recommended to combine the drug infusion with the administration of crystalloid solutions in a 1:2 ratio.
Poliglyukin price, where to buy
You can purchase the drug at any pharmacy. The cost of 400 ml of solution ranges from 72-95 rubles. A prescription is required to purchase Polyglucin.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Reopoliglucin solution for inf.
fl. 100 mg/ml 200 ml RUP Belmedpreparaty 108 rub. order
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PaniPharmacy
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