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Reopoliglucin solution d/inf 10% 400ml

Compound

Active substance: 10% solution of dextran (molecular weight from 30,000 to 40,000) in isotonic sodium chloride solution.

Indications for use

To improve capillary blood flow and replenish circulating blood volume: paralytic intestinal obstruction, fat embolism; traumatic, burn, hemorrhagic, postoperative and toxic shock (prevention and treatment). Replacement of plasma volume during blood loss.
To improve arterial and venous circulation (prevention and treatment): thrombosis, thrombophlebitis, obliterating endarteritis, Raynaud's disease, threat of gangrene, acute stage of stroke.
For detoxification: peritonitis, pancreatitis, ulcerative-necrotizing enterocolitis, foodborne toxic infections, extensive purulent-necrotic processes of soft tissues, crash syndrome, “on” syndrome.
For hemodilution in the preoperative period.
Carrying out therapeutic plasmapheresis to replace the removed plasma volume.
Prevention of thrombus formation on transplants (heart valves, vascular grafts); for addition to the perfusion solution in the heart-lung machine during open-heart surgery.
Microcirculation disorders: traumatic or idiopathic hearing loss.
Diseases of the retina and optic nerve (complicated high-grade myopathy, retinal dystrophy, vascular (venous) pathology of the retina, initial atrophy), inflammatory diseases of the cornea and choroid.

Contraindications

Thrombocytopenia.
Kidney diseases (with anuria).
Heart failure.
In cases where large amounts of liquid should not be administered.
History of allergy to dextran.

Carefully:

In case of severe disorders of the blood coagulation system (except for life-threatening conditions), dehydration.

In patients with diabetes mellitus with severe hyperglycemia and hyperosmolarity, Dextran should be used with caution.

During treatment, it is necessary to monitor the ion composition of blood serum, fluid balance and renal function.

When the drug is administered into peripheral veins, a burning sensation and pain may occur in the limb along the vein.

Directions for use and doses

Intravenous stream, stream-drip and drip.
The dose and rate of administration of the drug should be selected individually, in accordance with the indications and condition of the patient. When using the drug, it is necessary to conduct a biotest: after slowly introducing the first 5 drops of the drug, stop the transfusion for 3 minutes, then inject another 30 drops. and again stop the infusion for 3 minutes. If there is no reaction, the administration of the drug continues. The results of the bioassay must be recorded in the medical history.

1. In case of disruption of capillary blood flow (various forms of shock), it is administered intravenously or jet-drip, in a dose of 0.5 to 1.5 l, until hemodynamic parameters are stabilized at a 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 a rate of 5-10 ml/kg, the dose can be increased if necessary to 15 ml/kg. It is not recommended to reduce the hematocrit value below 25%.

2. For cardiovascular and plastic surgeries, it is administered intravenously, immediately before surgery, for 30-60 minutes to adults and children at a dose of 10 ml/kg, during surgery for adults - 500 ml, for children - 15 ml/kg. After surgery, the drug is administered intravenously (over 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 13 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. During operations under 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 concentration of dextrin in the perfusion solution should not exceed 3%. In the postoperative period, the doses of the drug are the same as for cases of capillary blood flow disturbance.

4. For the purpose of detoxification, it is administered intravenously in a single dose of 500 to 1250 ml (in children 5-10 ml/kg) for 60-90 minutes. If necessary, you can pour another 500 ml of the drug on the first day (in children, the administration of the drug on the first day can be repeated in the same doses). In the following days, the drug is administered dropwise, for adults - at a daily dose of 500 ml, for children - at a rate of 5-10 ml/kg. Together, it is advisable to administer crystalloid solutions (Ringer's and Ringer's acetate, etc.) in such quantities as to normalize the water-electrolyte balance (especially important when treating dehydrated patients and after surgical operations); the drug, as a rule, causes an increase in diuresis (a decrease in diuresis indicates to dehydrate the patient).

5. In ophthalmological practice, it is used by electrophoresis, which is carried out in a generally accepted way. The drug consumption per procedure is 10 ml. The procedure is carried out once a day, administered from both the positive and negative poles. Current density - up to 1.5 mA/sq.cm. The duration of the procedure is 15-20 minutes. The course of treatment consists of 5-10 procedures.

Storage conditions

Store in a dry place, out of reach of children, at a temperature of 10 to 20°C.

Best before date

4 years. Do not use after the expiration date stated on the package.

special instructions

Together with the drug, it is advisable to administer crystalloid solutions (0.9% sodium chloride solution, 5% dextrose solution) in such quantities as to replenish and maintain fluid and electronic balance.
This is especially important when treating dehydrated patients and after major surgical operations. When used simultaneously with anticoagulants, it is necessary to reduce their dose.

Causes an increase in diuresis (if there is a decrease in diuresis with the release of viscous, syrupy urine, this may indicate dehydration). In this case, it is necessary to administer colloidal solutions intravenously to replenish and maintain water and electrolyte balance. If oliguria occurs, saline solutions and furosemide must be administered.

In patients with reduced filtration capacity of the kidneys, it is necessary to limit the administration of sodium chloride.

Dextrans can coat the surface of red blood cells, preventing the determination of blood group, so it is necessary to use washed red blood cells.

Description

Plasma replacement agent.

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 with hemodynamic action. Helps increase plasma volume by 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 increases and remains high for a long time, and tissue swelling decreases.

Reopoliglucin can be used as a detoxification agent. When administered, blood viscosity improves and aggregation of formed elements decreases. It also stimulates diuresis through osmotic mechanisms (it is filtered in the glomeruli, creates high oncotic pressure in primary urine and prevents the reabsorption of water in the tubules), which promotes (and accelerates) the removal of poisons, toxins, and degraded metabolic products from the body.

Side effects

Allergic reactions (skin rash, anaphylactoid reactions - decreased blood pressure, collapse, oliguria), fever, chills, fever, nausea.

May provoke bleeding and the development of acute renal failure.

Use during pregnancy and breastfeeding

Prescription for health reasons is possible, if the expected benefit to the mother outweighs the potential risk to the fetus.

Interaction

Before use, it is necessary to first check for compatibility with drugs that are planned for introduction into the infusion solution.

Overdose

In case of excessive administration of the drug solution, carefully assess the patient's condition and prescribe appropriate symptomatic treatment.

Rheopolyglukin

Intravenous stream, stream-drip and drip.

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

Immediately before using dextran, with the exception of emergency conditions, a skin test is performed.

An intradermal test is carried out 24 hours before the drug infusion. To do this, 0.05 ml of the drug is injected intradermally to form a lemon peel on the inside of the forearm, shoulder or other area accessible for visual assessment of the skin test. The doctor evaluates the reaction after 24 hours.

The presence of redness at the injection site, the formation of a papule, or the appearance of symptoms of a general reaction in the form of nausea, dizziness or other manifestations 10-15 minutes after the injection indicates the patient’s increased sensitivity to the drug and the impossibility of using the drug in this patient. In the absence of any reactions, the patient is administered the required amount of the drug from the series that was used for the intradermal test. The test results are recorded in the medical history.

It should be remembered that a skin test does not reveal sensitization to dextran in 100% of patients. Therefore, in the first 5-10 minutes as the drug is administered intravenously, in each case it is necessary to carefully monitor the patient’s condition.

In case of emergency conditions when using the drug, it is necessary to conduct a biotest: after slowly introducing the first 5 drops of the drug, the administration is stopped for 3 minutes, then another 30 drops are administered and the infusion is stopped again for 3 minutes. If there is no reaction, continue administering the drug. The results of the bioassay must be recorded in the medical history.

1. In case of disruption of capillary blood flow (various forms of shock), it is administered intravenously by drip or jet-drip, in a dose of 0.5 to 1.5 l, until hemodynamic parameters are stabilized at a life-supporting level. If necessary, the amount of drug coins can be increased to 2 liters.

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

After surgery, the drug is administered intravenously (over 60 minutes) for 5-6 days at the rate of:

adults

— 10 ml/kg once;

children under 2-3 years old

— 10 ml/kg 1 time per day;

children under 8 years old

- 7-10 ml/kg 1-2 times a day;

children under 13 years old

- 5-7 ml/kg 1-2 times a day.

For children over 14 years old

doses are the same as for adults.

3. During 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 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 cases of capillary blood flow disturbance.

4. For the purpose of detoxification, it is administered intravenously in a single dose of 500 to 1250 ml (in children 5-10 ml/kg) for 60-90 minutes. If necessary, another 500 ml of the drug can be administered on the first day (in children, administration of the drug on the first day can be repeated in the same doses). In the following days, the drug is administered dropwise, for adults - at a daily dose of 500 ml, for children - at a rate of 5-10 ml/kg.