Dextran 40 - Instructions For Use, Indications, Doses, Analogues

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Dextran 40

Instructions for use:

1. 1. Release form and composition
2. 2. Indications for use
3. 3. Contraindications
4. 4. Method of application and dosage
5. 5. Side effects
6. 6. Special instructions
7. 7. Drug interactions
8. 8. Analogs
9. 9. Terms and conditions of storage
10. 10. Terms of dispensing from pharmacies

Dextran 40 is a plasma-substituting agent that increases the suspension stability of blood; reduces its viscosity, reduces and inhibits the aggregation of blood corpuscles, normalizes blood circulation, restores peripheral blood flow, and has a detoxifying effect.

Release form and composition

Dextran 40 is available in the form of a 10% solution for infusion: colorless or yellowish transparent liquid (100, 200, 250, 400, 500 ml in polyethylene bottles; for hospitals, 1–96 bottles in a cardboard box; 200 or 400 ml in bottles glass, in a cardboard box 1 bottle; for hospitals 20, 24 or 28 bottles of 250 ml or 15 bottles of 450 ml in a cardboard box).

Composition for 1 liter of Dextran 40 solution:

• active substance: dextran (average molecular weight 35,000–45,000) - 100 g;
• auxiliary ingredients: sodium chloride, water for injection.

Indications for use

• fat embolism, paralytic intestinal obstruction, shock (burn, traumatic, hemorrhagic, toxic, postoperative) - prevention and therapy to improve capillary blood circulation and replenish the BCC (circulating blood volume);
• blood loss in pediatric practice - replacement of plasma volume;
• thrombophlebitis, thrombosis, Raynaud's disease, obliterating endarteritis, acute stage of stroke, threat of gangrene development - prevention and therapy to improve arterial and venous blood flow;
• foodborne diseases, pancreatitis, peritonitis, necrotizing enterocolitis, crash syndrome, extensive purulent-necrotic processes in soft tissues, inclusion syndrome - detoxification;
• preoperative period - hemodilution;
• therapeutic plasmapheresis - replacement of the removed plasma volume;
• thrombus formation on grafts (heart valves, vascular grafts) - prevention;
• open-heart surgery with a heart-lung machine - adding to a perfusion solution to prevent thrombus formation;
• traumatic or idiopathic hearing loss due to microcirculatory disorders;
• diseases of the retina and optic nerve (retinal dystrophy, initial atrophy, high-grade complicated myopathy, venous pathology of the retina), inflammatory diseases of the choroid and cornea of the eye.

Contraindications

• blood clotting disorders (hemophilia, thrombocytopenia);
• CRF (chronic renal failure) with anuria;
• chronic heart failure in the stage of decompensation (high probability of developing pulmonary edema);
• individual hypersensitivity to drug components.

Use of Dextran 40 for drug electrophoresis is contraindicated in case of profuse discharge of a mucopurulent nature and maceration of the eyelid skin.

During pregnancy and breastfeeding, the drug is used with caution.

Method of administration and dosage

Dextran 40 solution is intended for intravenous administration by jet or drip.

The dose is set individually depending on the patient's condition and clinical situation. The solution is injected slowly for the first 10–20 minutes, since there is a high likelihood of developing anaphylactic reactions.

Recommended dosage:

• traumatic, operational and burn shock (for therapy and prevention of capillary blood flow disorders): 400–1000 ml per day, infusion duration - 30–60 minutes;
• surgical interventions on the heart and blood vessels: before surgery - 10 ml / kg; during the operation - 400–500 ml; within 5-6 days after surgery - 10 ml / kg;
• detoxification: 5-10 ml / kg, duration of infusion - 60-90 minutes.

The total daily dose in pediatric practice should not exceed 15 ml / kg.

Recommended dosage for children with cardiovascular surgery, depending on age:

• <2-3 years - 10 ml / kg once a day, duration of infusion - 60 min;
• <8 years - 7-10 ml / kg 1-2 times a day;
• ≤ 13 years - 5–7 ml / kg 1–2 times a day;
• > 14 years - adult dose.

Side effects

Due to the use of Dextran 40 solution, the following side effects may develop: chills, fever, fever, nausea, hypersensitivity reactions (rashes on the skin; anaphylatoxic reactions - oliguria, lowering blood pressure, collapse). Development of acute renal failure and bleeding are also possible.

In case of excessive administration of a dextran solution (overdose), it is required to carefully assess the patient's condition and conduct appropriate symptomatic therapy.

special instructions

It is advisable to jointly administer crystalloid solutions (0.9% NaCl solution, 5% dextrose solution) with dextran in an amount sufficient to replenish and maintain fluid and electrolyte balance. This is especially important in the treatment of patients after severe surgery and dehydrated patients.

Simultaneous use with anticoagulants requires a reduction in their dose.

Dextran 40 increases urine output, a decrease in urine output with the release of viscous syrupy urine may indicate dehydration. In this case, intravenous administration of colloidal solutions should be performed in order to replenish and maintain the water-electrolyte balance. For oliguria, furosemide and saline solutions are administered.

Patients with reduced renal filtration capacity require restriction of sodium chloride administration.

Given the ability of dextrans to envelop the surface of erythrocytes, if it is necessary to determine the blood group, washed erythrocytes should be used for the analysis.

The drug does not have a direct effect on the speed of psychomotor reactions and concentration of attention, but such an effect can have side effects caused in susceptible patients.

Drug interactions

• aprotinin: increases the likelihood of developing unwanted side effects;
• aminocaproic acid, hydralazine, dexamethasone, streptokinase, suxamethonium iodide and suxamethonium chloride: incompatible with dextran;
• sodium heparin, apixaban, streptokinase, sodium parnaparin, calcium nadroparin: increase the risk of bleeding; It is recommended to adjust the dosage of sodium parnaparin in order to prevent a decrease in the level of blood coagulation by more than 1.5 times.

Analogs

Dextran 40 analogs are: Reopolydex, Reopolyglyukin, Reopolyglyukin-40, Hemostabil, Neorondex, Polyglyukin, ReoDEKS 40, ReoDEKS 60, etc.

Terms and conditions of storage

Keep out of the reach of children!

Transportation and storage conditions:

• polyethylene bottles: at a temperature of 10–25 ° С, in a dry place; freezing is allowed during transportation;
• glass bottles: at temperatures up to 25 ° C in a dry, dark place; freezing is allowed provided that the bottle is kept tight; non-wetting of the inner surface of the bottle walls is not a reason for refusing to use the solution.

Shelf life is 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!