Rheoglumanum

General characteristics. Structure:

Active ingredient: 10 g of a dextran with a molecular weight from 30000 to 50000, 5 g of a mannitol.

Excipients: sodium chloride, water for injections.

Pharmacological properties:

Pharmacodynamics. Rheoglumanum – the plasma substituting hypertonic salt solution possessing multifunctional action. Drug reduces viscosity of blood due to antiagregantny action by uniform elements of blood, promotes recovery of a blood-groove in small capillaries. Rheoglumanum possesses also antishock, disintoxication and diuretic action.

Pharmacokinetics. Drug is brought out of an organism generally through kidneys: for the first days about 70%. Other amount of drug comes to retikuloendoterialny system where gradually breaks up to glucose. Each gram of the dextran which is a part promotes transition of 20-25 ml of liquid from fabric in a circulatory bed.

Indications to use:

Rheoglumanum is applied as means to improvement of a capillary blood-groove for the purpose of prevention and the treatment of the diseases which are followed by disturbance of microcirculation of both local, and general character, combined with a liquid delay in an organism:

- disturbance of a capillary blood-groove (traumatic, burn, toxic, cardiogenic shock);

- disturbance of arterial and venous circulation (thromboses, thrombophlebitises, endarteritis, Raynaud's disease);

- vascular and plastic surgery (for improvement of local circulation and reduction of a tendency to fibrinferments in a transplant);

- renal and a renal liver failure with the kept filtrational function of kidneys;

- the posttranfuzionny complications caused by incompatible blood transfusion;

- for desintoxication at burns, injuries, peritonitises, pancreatitis.

Route of administration and doses:

Rheoglumanum is entered intravenously kapelno. Jet introduction can lead to a hypervolemia due to the expressed colloid and osmotic effect of drug. Doses and rate of administering of drug should be chosen individually according to indications, assessment of a condition of the patient and his hourly and daily urine.

1. In complex therapy of shock at disturbance of a capillary blood-groove the drug is administered intravenously kapelno in a dose from 400 to 800 ml of drug under control of indicators of a hemodynamics (register arterial (ABP) and the central venous pressure (CVP), the volume of the circulating blood (VCB), an hourly and daily urine).

2. At burn shock 2-3 multiple introduction of Rheoglumanum within the first 24 hours from the injury moment are admissible. The first dose of drug of 400 ml can be entered kapelno within 2 hours, the second - in 6-12 hours with the same speed of infusions. If at burn shock also other drugs of a dextran (Poliglyukin, Reopoliglyukin) are used, then their general dose should not exceed 1600 ml/days (100-130 g of a dextran). During second day of the shock period, at stabilization of OTsK, the ABP and a diuresis, Rheoglumanum is entered on 400 ml by 1-2 times.

In the period of an acute burn toxaemia Rheoglumanum can be applied daily or every other day 400 ml intravenously kapelno as a part of an infusional set at obligatory control of a daily urine, indicators of hemoglobin of blood and a hematocrit. In the period of a septicotoxemia use of Rheoglumanum in the same doses is most reasonable when training the patient for operation of an autodermoplastika and within the first two days from the moment of its performance.

3. In cardiovascular and plastic surgery Rheoglumanum is entered just before operation (in 30-60 minutes) in a dose of 10 ml/kg, during operation of 400 ml and after operation every day within 5-6 days kapelno at the rate of 10 ml/kg of weight on single introduction.

4. At an acute renal liver failure with the kept filtering and at postgranfuzionny complications Rheoglumanum is entered once in a dose of 400-800 ml. Injection of drug can be repeated daily within 3-5 days, at the rate of 10 ml/kg of weight on introduction under control of water and electrolytic and acid-base balance and coagulant system of blood.

Features of use:

Before transfusion of Rheoglumanum the doctor has to make visual survey of drug and results of survey to write down in a case history. Drug has to be transparent, not containing a suspension, on a bottle there should not be cracks or disturbances of sealing.

At use of Rheoglumanum carrying out a bioassey is obligatory: after slow introduction of the first 5 drops of drug injection stops for 3 minutes, then 30 more drops are entered and again stop injection for 3 minutes.

In the absence of reaction administration of drug with a speed of 40 thaws a minute continues. Increase in rate of administering of Rheoglumanum over 40 drops a minute is possible only at dynamic control of indicators of the central venous daleniye and ECG.

For maintenance of water and electrolytic balance together with Rheoglumanum it is reasonable to enter the solutions containing potassium and sodium.

Side effects:

After transfusion  of Rheoglumanum of side reactions    , as a rule, it is not observed.

At certain earlier sensibilized patients emergence of allergic reactions of varying severity is possible. It must be kept in mind possibility of an acute anaphylaxis at the patients belonging to risk group, having in the anamnesis of the instruction on intolerance of intravenous injections of proteinaceous drugs, plasma substitutes including dextran drugs, and also medicines (serums, vaccines). In case of these reactions or complications it is necessary to stop immediately infusion and, without taking out a needle from a vein, to enter the symptomatic medicines applied in therapy of an acute anaphylaxis (antihistaminic, heart, corticosteroid, angiotonic and other drugs).

Tachycardia, decrease in the ABP.

Interaction with other medicines:

Let's combine with other drugs of a dextran (Polyglucinum, реополиглюкин) and crystalloid solutions.

Contraindications:

Use of Rheoglumanum is contraindicated at excessive hemodilution (a hematocrit lower than 25 units), at hemorrhagic diathesis, at a circulatory unefficiency with the expressed hypostases, at the heavy renal failure which is followed by an anury at considerable dehydration of the patient, at serious allergic conditions of not clear etiology.

Storage conditions:

In the dry place at a temperature not above 25 °C. To store in the place, unavailable to children. A period of validity - 3 years. Not to use after the expiry date specified on packaging.

Issue conditions:

According to the recipe

Packaging:

Solution for infusions. 400 ml in bottles glass for blood, infusional and transfusion drugs with a capacity of 450 ml respectively, corked by rubber bungs and pressed out by aluminum caps. 15 bottles with a capacity of 450 ml place in boxes from corrugated fibreboard with an investment of application instructions.