Polyglyukin
Polyglyukin: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Instructions for use a: scab and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. In case of impaired renal function
- 11. Drug interactions
- 12. Analogs
- 13. Terms and conditions of storage
- 14. Terms of dispensing from pharmacies
- 15. Reviews
- 16. Price in pharmacies
Latin name: Polyglucinum
ATX code: B05AA05
Active ingredient: Dextran [average molecular weight 50000-70000] (Dextran [average mw 50000-70000])
Manufacturer: Hematologist LLC (Russia); Biochemist (Russia); Kraspharma (Russia); Maxpharm (Russia)
Description and photo update: 02.10.2019
Polyglyukin is a drug with a plasma-substituting, anti-shock effect.
Release form and composition
Available in the form of a 6% solution for infusion: transparent, colorless or with a slightly yellowish tinge (100, 200 or 400 ml in bottles (bottles) or vials for blood and blood substitutes; 100, 200, 250, 400, 500 or 1000 ml each in polyolefin bags (sachets)).
The composition of 1 ml includes:
- Dextran with a molecular weight of 50,000-70,000 - 60 mg;
- Sodium chloride - 9 mg;
- Water for injection - up to 1 ml.
Pharmacological properties
Pharmacodynamics
Polyglukin, which is a blood substitute, is a hyperosmotic solution with an osmolarity of 0.34–0.37 mmol / kg. The drug has an anti-shock, plasma-substituting, antiplatelet and replenishing effect of the circulating blood volume.
Due to the high osmotic pressure, which is 2.5 times higher than the oncotic pressure of plasma proteins, Polyglucin causes active attraction of tissue fluid (from 20 to 25 ml per 1 g of polymer) and keeps it in the vascular bed for a sufficiently long period.
The use of the drug is provided by:
- restoration of the volume of circulating blood;
- elimination of violations of systemic hemodynamics;
- increased blood pressure;
- elimination of peripheral vascular spasm;
- normalization of indicators of the acid-base state of blood, as well as its gas composition;
- an increase in the suspension stability of blood and a decrease in its viscosity characteristics;
- elimination of peripheral stasis and erythrocyte aggregation;
- pronounced antiplatelet and antiadhesive effects on platelets;
- improving the rheological properties of blood;
- activation of microcirculation and increased tissue blood flow;
- reducing the risk of developing disseminated intravascular coagulation syndrome.
Pharmacokinetics
The main dose of Polyglyukin is excreted from the body by the kidneys: during the first 24 hours, approximately 50% of the dose is eliminated, and after 3 days only trace concentrations are present in the blood. A small volume of the drug accumulates in the RES, where it is gradually degraded by dextranases to dextrose, which makes it impossible to deposit in internal organs for a long time.
Indications for use
- Surgical interventions and conservative treatment of conditions that are accompanied by thickening of blood and high viscosity syndrome (in order to improve microcirculation and hemorheology, reduce the tendency to thrombosis);
- Violations of venous and arterial blood flow (for its normalization);
- Violations of micro- and macrohemodynamics, improvement of rheological properties of blood;
- Thrombosis;
- DIC syndrome (prevention);
- Shock conditions due to acute blood loss, incl. with ectopic pregnancy, childbirth, trauma, combined lesions, intoxication and sepsis;
- Ischemic stroke;
- Shock (burn and surgery).
When using heart-lung machines, Polyglukin is added to the perfusion fluid.
Contraindications
Absolute:
- Traumatic brain injury;
- Cardiovascular and severe chronic renal failure;
- Hemorrhagic stroke;
- Increased intracranial pressure;
- Thrombocytopenia;
- Anuria;
- Clinical situations in which the introduction of large volumes of fluids is undesirable, including arterial hypertension, hyperkalemia with a hematocrit value below 0.3;
- Hypersensitivity to drug components.
Relative (Polyglyukin is prescribed with caution in the presence of the following diseases / conditions):
- Continuing internal bleeding (renal, pulmonary, etc.), except for cases of development of hemodynamic disturbances in severe course (drop in blood pressure below 60 mm Hg). The drug is administered until the blood pressure rises above the critical level. After this, the patient is transferred to a blood, plasma transfusion;
- Severe dehydration. Before the introduction of the drug, it is necessary to restore the fluid deficit;
- Metabolic acidosis;
- Severe liver dysfunction;
- Decreased blood phosphate levels;
- The risk of edema in case of functional disorders of the kidneys in cases where regular monitoring of the magnesium content in the blood is impossible;
- Urolithiasis diathesis associated with impaired metabolism of magnesium, calcium and ammonium phosphate.
Lactating and pregnant women can enter Polyglukin only after a balance of benefits with a possible risk to the health of the mother and child.
Instructions for the use of Poliglyukin: method and dosage
According to the instructions, Polyglyukin is administered in stationary conditions by intravenous drip. In acute blood loss, intra-arterial administration is indicated.
The rate and volume of solution administration are set depending on the patient's condition, pulse rate, blood pressure, respiration rate, hematocrit, skin color.
It is necessary to start the transfusion of the drug by drip. After the introduction of the first 10 and subsequent 30 drops, you need to interrupt the introduction for 3 minutes. In the absence of signs of reaction (in the form of increased heart rate, lowering blood pressure, skin hyperemia, difficulty breathing), the transfusion is continued.
When shock develops, the Polyglukin solution is injected intravenously. The average one-time volume is 400-1200 ml (an increase up to 2000 ml is possible). With an increase in blood pressure to figures close to the norm, it is advisable to continue the administration of the drug by the drip method at a rate of 3-3.5 ml / min (60-80 drops / min). Infusion should be carried out, constantly monitoring the main indicators of systemic hemodynamics. In the case of a significant increase in central venous pressure, the dose and rate of administration of Polyglucin are reduced or the therapy is completely canceled. In case of severe anemization and blood loss of more than 500 ml, it is advisable to combine it with transfusion of erythrocyte mass or suspension of erythrocytes, as well as blood, fresh frozen plasma containing factors of the hemostatic system. The use of Poliglyukin does not exclude the need for other anti-shock measures (with the use of painkillers, heart, tonic and hormonal drugs)
When carrying out operations in order to prevent operational shock, prevent thrombosis and reduce the tendency to progression or development of DIC syndrome, intravenous infusion of Polyglukin solution is performed 30-60 minutes before the operation by drip in a dose of 5-10 ml / kg, in cases of a drop in blood pressure, they are transferred for inkjet introduction. With a sharp drop in blood pressure (below 60 mm Hg), it is recommended to transfer the patient to intra-arterial administration in an average volume of up to 400 ml. Jet-drop injection of the drug is an effective means of preventing postoperative shock in the postoperative period. For children, Polyglyukin is administered in a volume of 10-15 ml / kg.
During the surgical intervention, the volume of infusions is determined by the amount of surgical blood loss (hematocrit should not drop below 0.3).
In case of burn shock, the following scheme of drug use is shown:
- The first 24 hours: adults - 2000-3000 ml, children - 40-50 ml / kg;
- Next 24 hours: adults - 1500 ml, children - 30 ml / kg.
The introduction of Polyglucin, depending on the indications, can be combined with the following substances / preparations:
- Deep and extensive burns: albumin, plasma, gamma globulin;
- Burns over 30-40% of the body surface: blood transfusion.
In order to prevent possible tissue dehydration, it is shown to combine the infusion with the introduction of crystalloid solutions (ratio - 1: 2).
Side effects
Possible side effects: increased body temperature, decreased blood pressure, increased heart rate, allergic reactions (in the form of itching, urticaria, Quincke's edema).
Overdose
In case of an overdose of the drug, an excessive increase in blood pressure may be observed. Treatment is with peripheral vasodilators.
special instructions
Rapid administration of large volumes of dextrans can provoke the development of pulmonary edema and acute left ventricular failure.
The introduction of Polyglyukin does not interfere with the determination of the blood group and the cross-test by standard methods (it is recommended to wash the erythrocytes with 0.9% NaCl solution before the study). The presence of dextran in the blood may interfere with the results of papain-based enzyme methods. When conducting studies of glucose in the blood using solutions of acetic and sulfuric acids, it is possible to obtain a glucose concentration higher than it actually is.
The Polyglukin solution reduces the transparency of the blood, and can also lead to a change in the results of measuring the concentration of protein and bilirubin (blood samples are recommended to be taken before the administration of the drug).
Drivers of vehicles and patients whose profession requires a high concentration of attention should use Polyglyukin with caution.
Application during pregnancy and lactation
There is no information on the use of the drug during this period.
With impaired renal function
It is forbidden to use the drug for anuria and oliguria against the background of organic kidney disease.
Drug interactions
Combined use of Polyglukin with other widely used transfusion agents is allowed.
Analogs
Polyglyukin's analogues are: Hemostabil, Dextran-60-Eskom, Dextran 70, Neorondeks, Polyfer, Rondex, ReoDEKS, Reopoliglyukin.
Terms and conditions of storage
Keep out of reach of children at temperatures up to 25 ° C.
The shelf life is 5 years.
The solution withstands freezing, it can be transported at temperatures down to -10 ° C. Provided that the package remains tight, the freezing of Poliglyukin is not a contraindication to its use.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Polyglyukin
Reviews of Polyglukin indicate that when using the drug, side effects can often develop.
Price for Polyglyukin in pharmacies
The price for Polyglyukin is 90–105 rubles for a 200 ml bottle and 106–130 rubles for a 400 ml bottle.
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
