REOPOLIGLYUKIN

General characteristics. Structure:

Active ingredients: 1 l of drug contains a dextran 40 (in terms of dry matter) 100 g; sodium of chloride of 9 g; 
 
excipient: water for injections.
 
Main physical and chemical properties: transparent, colourless or yellowish liquid.

Pharmacological properties:

Pharmacodynamics. Reopoliglyukin is 10% colloidal solution of a dextran (Dextrosums/glucose polymer) with a molecular weight of 35 000 - 45 000 with addition of 0,9% of solution of sodium of chloride. It is the plasma substituting solution improving rheological properties of blood, reduces its viscosity, promotes recovery of a blood-groove in small capillaries, prevents and reduces aggregation of uniform elements of blood, shows disintoxication action. At bystry administration of drug the volume of a blood plasma can increase almost twice compared with the volume of the administered drug.
 
Pharmacokinetics. Out of an organism it is brought, generally by kidneys with urine (in 1 days - about 70%). The rest of 30% comes to reticuloendothelial system where gradually breaks up to glucose. Half-life – 6 hours.

Indications to use:

Drug is used for:
 
- improvements of a capillary blood-groove for prevention and treatment of traumatic, operational, toxic and burn shock;

- improvements of arterial and venous circulation for prevention and treatment of thromboses, thrombophlebitises, an endarteritis, a Raynaud's disease;

- additions to perfused liquid in cardiopulmonary bypasses at heart operations;

- improvements of microcirculation and decrease in a tendency to thrombosis in a transplant at vascular and plastic surgeries;
 
- desintoxication at the peritonitis, pancreatitis, ulcer and necrotic colitis, food toxicoinfections widespread it is purulent - necrotic processes of soft tissues.

Route of administration and doses:

- at disturbance of a capillary blood-groove (various forms of shock) enter intravenously, kapelno 400-1000 ml (to 1500 ml) within 30 – 60 min., to children in a dose of 5-10 ml/kg (if necessary to 15 ml/kg). It is not recommended to reduce hematocrit size to 25%;
 
- at cardiovascular and plastic surgeries enter intravenously, kapelno, just before operation, to adults and children within 30 – 60 min. in a dose of 10 ml/kg during operation – adult 500 ml (to children - 15 ml/kg), after operation within 5-6 days - intravenously, kapelno (within 60 min.) from calculation: adult 10 ml/kg on single introduction (to children aged up to 2-3 years - to 10 ml/kg of 1 times a day; from 3 to 8 years – 7-10 ml/kg of 1 - 2 time a day; from 8 to 13 years – 5-7 ml/kg of 1 - 2 time a day; 14 years – a dose for adults are more senior);
 
- at operations with artificial circulation add to blood  at the rate of 10-20 ml/kg for filling of the pump of the oxygenator; concentration of a dextran in perfused solution should not exceed 3%. During the postoperative period drug is used in the same doses, as at disturbance of a capillary blood-groove;
 
- for the purpose of desintoxication enter intravenously, kapelno in a single dose from 500 to 1250 ml (children have 5-10 ml/kg) within 60 – 90 min. If necessary it is possible to enter in the first days 500 more ml of drug (at children administration of drug in the first days can be repeated in the same doses). In the next days the drug is administered kapelno, the adult – in a daily dose of 500 ml, to children – at the rate of 5-10 ml/kg. It is jointly reasonable to enter crystalloid solutions in such quantity to normalize water and electrolytic balance (especially important at treatment of the dehydrated patients and after surgeries), drug, as a rule, causes increase in a diuresis (reduction of a diuresis indicates dehydration of an organism of the patient).

Features of use:

Apply only under control of the doctor.
 
Reopoliglyukin it is possible to enter only after preliminary carrying out an intracutaneous test, except for cases of rendering the acute (urgentny) management at a depressed case. In such cases it is necessary to have necessary drugs for elimination of all possible allergic reactions.
 
The intracutaneous test for definition of individual sensitivity to Reopoliglyukin is carried out in 24 hours prior to administration of drug. For this purpose from a bottle with drug, following rules of an asepsis, the syringe select 0,2-0,3 ml of Reopoliglyukin. After replacement of a needle on the syringe on a sterile injection cannula vnutrikozhno enter 0,05 ml of drug into an average third of an internal surface of a forearm.
 
Correctness of administration of drug is controlled visually (receiving "a lemon crust"). The doctor carries out reaction assessment in 24 hours.
 
Existence of local reaction in the form of reddening (a spot which diameter more than 1,5 cm), emergence of a papule or symptoms of the general reaction of an organism (nausea, vomiting, dizziness, pain, a zadyshka, increase to temperature) testify to hypersensitivity of an organism to Reopoliglyukin and impossibility of use of drug for this patient.
 
In the absence of any reactions to the patient administer necessary amount of the drug of that series which was used for carrying out an intracutaneous test. Results of test are registered in the history of a disease.

The intracutaneous test does not allow to reveal a sensitization to Reopoliglyukin at 100% of patients. Therefore the first 5-10 min. during intravenous administration of drug it is necessary to watch closely a condition of the patient.
 
In need of urgent introduction of Reopoliglyukin for the purpose of rendering acute management after slow introduction of the first 10 drops stop introduction for 3-5 minutes, then enter 30 more drops and again stop introduction for 3-5 minutes. In the absence of reaction continue administration of drug. Results probyregistrirut in the history of a disease.
 
Apply with care to introduction by the patient with the broken secretory function of kidneys, in need of restriction of administration of sodium of chloride appoint Reopoliglyukin from 5% glucose solution. At disturbances of carbohydrate metabolism and other states at which administration of carbohydrates is contraindicated Reopoliglyukin apply from 0,9% chloride sodium solution. With care apply to introduction by the patient with an idiopathic hypertensia in connection with a possibility of increase in arterial pressure and the patient with disturbances of cordial activity.

Side effects:

As a rule, drug causes increase in a diuresis. However sometimes at Reopoliglyukin's use reduction of a diuresis is observed, urine becomes knitting that indicates dehydration of an organism of the patient. In this case it is necessary to enter intravenously crystalloid solutions for completion and maintenance of water and electrolytic balance. Fluctuations of arterial pressure, allergic reactions are possible: acute anaphylaxis, Quincke's disease, skin rashes, itch.

Interaction with other medicines:

At simultaneous use with anticoagulants it is necessary to lower their doses. Existence of a dextran in blood can affect results of determination of amount of bilirubin, protein, a blood group. Therefore the specified researches should be conducted before administration of drug.

Contraindications:

Hypersensitivity to drug. Thrombocytopenia, diseases of kidneys which are followed by an anury, heart failure, states at which it is impossible to enter liquid in large volumes. Reopoliglyukin from 0,9% solution of sodium of chloride it is not necessary to enter at pathological changes in kidneys, and from 5% glucose solution - at disturbance of carbohydrate metabolism, especially at a diabetes mellitus.

Overdose:

Symptoms. Emergence of a hypervolemia, hypocoagulation is possible. Treatment. Therapy is symptomatic.

Storage conditions:

To store in the dry place at a temperature from 15 °C to 25 °C. Freezing of drug during the transporting and storage is not allowed. To store in the place, unavailable to children.

Issue conditions:

According to the recipe

Packaging:

On 200 ml in bottles. On one bottle in a cardboard pack or without cardboard pack (in coordination with the consumer).