Haemodes-N
The effect of the drug is due to the ability of low molecular weight povidone to bind toxins circulating in the blood and quickly remove them from the body. Most completely binds toxins circulating in the blood of patients with shigellosis, salmonellosis, and food intoxication. In case of burn disease, different toxins are produced at different periods of the disease. Those of them that are formed in the first 4-5 days of illness bind quite completely and are quickly eliminated from the body; toxins formed at a later date are bound much weaker.
The drug helps eliminate stasis of red blood cells in capillaries, which develops during intoxication of any origin, which leads to improved microcirculation. It increases renal blood flow, increases glomerular filtration and increases diuresis.
The drug is non-toxic and does not have pyrogenic properties.
Hemodez-N differs from Hemodez in the lower molecular weight of povidone. Reducing the molecular weight of the polymer (from 12600 Da on average in the discontinued drug “Gemodez” to 8000 Da on average in the drug “Hemodez-N”) accelerates its excretion by the kidneys from the body and improves the detoxification properties of the drug.
Potassium chloride is the main intracellular ion and plays an important role in the regulation of various body functions. Participates in maintaining intracellular osmotic pressure, in the processes of conducting and transmitting nerve impulses to innervated organs, in the contraction of skeletal muscles and in a number of biochemical processes. Reduces the excitability and conductivity of the myocardium, in high doses it inhibits automatism.
Calcium chloride replenishes the deficiency of calcium ions, which is necessary for the transmission of nerve impulses, contraction of skeletal and smooth muscles, myocardial activity, bone tissue formation, and blood clotting. Reduces the permeability of cells and the vascular wall, prevents the development of inflammatory reactions, increases the body's resistance to infections and can significantly enhance phagocytosis (phagocytosis, which decreases after taking sodium chloride, increases after taking calcium ions). Stimulates the sympathetic department of the autonomic nervous system, enhances the secretion of epinephrine by the adrenal glands, and has a moderate diuretic effect.
Magnesium chloride. Magnesium is involved in many processes occurring in the body in energy production, glucose absorption, nerve signal transmission, protein synthesis, bone tissue building; regulation of relaxation and tension of blood vessels and muscles. It has a calming effect, reducing the excitability of the nervous system and enhancing inhibition processes in the cerebral cortex, acts as an anti-allergic and anti-inflammatory factor, protects the body from infection by participating in the production of antibodies, plays a significant role in the processes of blood clotting, regulation of the intestines, bladder and prostate gland.
Sodium bicarbonate is a remedy for restoring the acid-base state of the blood and correcting metabolic acidosis. When sodium bicarbonate dissociates, a bicarbonate anion is released, which binds hydrogen ions to form a carboxylic acid; which then breaks down into water and exhaled carbon dioxide. As a result, the pH of the blood shifts to the alkaline side, and the buffer capacity of the blood increases.
Sodium chloride is a plasma-substituting agent, has a detoxifying and rehydrating effect, and normalizes the acid-base state. Replenishes sodium deficiency in various pathological conditions of the body; sodium chloride is found in blood plasma and tissue fluids of the body (concentration of about 0.9%).
Hemodez, 6%, solution for infusion, 400 ml, 1 pc.
Hemodez (solution for infusion)
Haemodesum
Pharmacotherapeutic group
Detoxifying agents. Rehydrants. Antidotes.
Composition of the drug
±2700) medical, 5.5 g of sodium chloride, 0.42 g of potassium chloride, 0.5 g of calcium chloride, 0.005 g of magnesium chloride and 0.23 g of sodium bicarbonate.
pharmachologic effect
Hemodez has a detoxifying effect due to the binding of low molecular weight polyvinylpyrrolidone to toxic substances circulating in the blood and their rapid elimination from the body. Due to increased glomerular filtration and increased renal blood flow, the drug increases diuresis.
Pharmacokinetics
Up to 80% of hemodesis, unchanged and in combination with toxins and other substances, is excreted in the urine within 4 hours (partially eliminated through the intestines). High molecular weight fractions of the drug are retained by the cells of the monocytic macrophage system.
Indications for use
Hemodez is prescribed as a detoxifying agent for toxic forms of acute gastrointestinal diseases (salmonellosis, dysentery and others), including in children; intoxication of various origins (cancer, radiation, postoperative, alcohol, intoxication due to renal and liver failure), burn disease in the intoxication stage, peritonitis, septic conditions, toxicosis of pregnant women and other pathological processes accompanied by intoxication.
Directions for use and dosage regimen
Hemodez is administered intravenously at a rate of 40-80 drops per minute. Before administration, the solution is heated to +35 - +37 0C. Adults are given a single dose of up to 300-400 ml (sometimes up to 500 ml) of the drug. Children are administered once: in infancy - at a dose of 4-5 ml/kg body weight (maximum volume - 40 ml), from 2 to 5 years - 70 ml, from 5 to 10 years - 100 ml, from 10 to 15 years - 150 ml. Repeated infusions of hemodez are carried out no earlier than 10-12 hours after the end of the previous infusion. The number of injections and the total amount of injected solution depend on the nature and course of the pathological process. For acute gastrointestinal diseases and intoxications, for burn disease in the intoxication phase (1-5 days of illness) and in the intoxication phase of acute radiation sickness, 1-2 infusions are usually given, for hemolytic disease and toxemia of newborns - from 2 to 8 infusions (daily or 2 times a day).
The administration of the drug, especially in severe conditions of patients, requires medical supervision.
Side effect
When administered slowly, hemodez is usually well tolerated. When infused at an increased rate, hypotension, tachycardia, and difficulty breathing are possible, which requires stopping the administration of hemodez and prescribing calcium chloride (intravenously), mezaton, cardiac drugs, and polyglucin.
Contraindications
The drug is contraindicated in cases of severe cardiopulmonary decompensation, cerebral hemorrhage, bronchial asthma, acute and chronic kidney diseases, severe allergies, and immunosuppressive conditions.
Interaction with other drugs
Hemodez can be used in combination with other detoxification and plasma replacement agents, most often with polyglucin, saline solutions, albumin, red blood cells, and also in combination with osmotic diuretics (mannitol).
Precautionary measures
If the drug is used for sepsis, due to a possible decrease in blood pressure, careful monitoring of the patient's condition is necessary.
Release form
Solution for infusion in bottles of 200 and 400 ml.
Medical Internet conferences
The use of drugs Remaxol and Gemodez-N and a repolarizing mixture during antitumor chemotherapy
Meldina Yu. N.
Scientific supervisor: candidate of medical sciences, associate professor Averyanova S.V.
GBOU VPO Saratov State Medical University named after. IN AND. Razumovsky Ministry of Health of the Russian Federation
Department of Faculty Surgery and Oncology named after. S.R. Mirotvortseva
Relevance: A severe side effect of antitumor chemotherapy is toxic reactions, the incidence of which reaches 90%, so the actual problem of treatment is detoxification therapy.
Purpose: to compare the effectiveness of using Remaxol, Hemodez and a repolarizing mixture as a means of detoxification in patients receiving antitumor chemotherapy.
Materials and methods: The study involved 55 patients undergoing treatment for malignant neoplasms in the antitumor chemotherapy department of a road clinical hospital, of which 41 (74%) were women, 14 (26%) were men. The age of the patients ranged from 24 to 73 years.
The first group consisted of 24 patients who received Remaxol as a means of detoxification, the second - 13 patients receiving Hemodez, the third - 18 patients receiving a repolarizing mixture. The quality of life of patients was assessed using the MOS SF-36 questionnaire, as well as biochemical blood parameters (alkaline phosphatase, AST and ALT).
Results: Based on the survey results, the following data were obtained. The average indicator of physical functioning in the first group was 42.40 ±17.8; in the second – 38.37±20.6; in the third – 36.40±15.9. The differences between the first and third groups are significant. The average indicator of emotional functioning in the first group was 44.64 ±17.3; in the second – 43.58±19.6; in the third – 42.05±19.2. No significant differences were found between the groups.
In the first group, alkaline phosphatase levels exceed the norm in 5% of patients, in the second – in 16.7%, in the third – in 17.6%. AST indicators exceed the norm in the first group - in 0% of patients, in the second - in 16.7%, in the third - in 33.3%; ALT values in the first group – in 4.7% of patients, in the second – in 50%, in the third – in 27.8%. No correlation was found between biochemical parameters and quality of life indicators.
Conclusions:
1. Remaxol and Hemodez are more effective means of detoxification than the repolarizing mixture.
2. No significant differences were found between the effectiveness of Remaxol and Hemodez.
3. Further research is required to deepen and clarify the data.
Gemodez-N Solution, 1 piece, 400 ml, for injection
Pharmacological properties
The effect of the drug is due to the ability of low molecular weight povidone to bind toxins circulating in the blood and quickly remove them from the body.
Most completely binds toxins circulating in the blood of patients with shigellosis, salmonellosis and food intoxication.
In case of burn disease, different toxins are produced at different periods of the disease. Those of them that are formed in the first 4-5 days of the disease are quite completely bound and quickly eliminated from the body; toxins formed at a later date bind much weaker.
The drug helps eliminate the stasis of red blood cells in the capillaries that develops during intoxication of any origin, which leads to improved microcirculation. It increases renal blood flow, increases glomerular filtration and increases diuresis.
The drug is non-toxic and does not have pyrogenic properties.
Gemodez-N differs from Gemodez in the lower molecular weight of polyvinylpyrrolidone.
Reducing the molecular weight of the polymer accelerates its excretion from the body by the kidneys and improves the detoxification properties of the drug.
Potassium chloride is the main intracellular ion and plays an important role in the regulation of various body functions. Participates in maintaining intracellular osmotic pressure in the processes of conducting and transmitting nerve impulses to innervated organs in the contraction of skeletal muscles and in a number of biochemical processes. Reduces the excitability and conductivity of the myocardium in high doses - inhibits automatism.
Calcium chloride replenishes the deficiency of calcium ions necessary for the process of transmission of nerve impulses, contraction of skeletal and smooth muscles, activity of the myocardium, formation of bone tissue, blood coagulation. Reduces the permeability of cells and the vascular wall, prevents the development of inflammatory reactions, increases the body's resistance to infections and can significantly enhance phagocytosis (phagocytosis, which decreases after taking sodium chloride, increases after taking calcium ions). Stimulates the sympathetic department of the autonomic nervous system, enhances the release of epinephrine by the adrenal glands and has a moderate diuretic effect.
Magnesium chloride. Magnesium is involved in many processes occurring in the body - energy production, glucose absorption, nerve signal transmission, protein synthesis, bone tissue building; regulation of relaxation and tension of blood vessels and muscles. It has a calming effect, reducing the excitability of the nervous system and enhancing inhibition processes in the cerebral cortex, acts as an anti-allergic and anti-inflammatory factor, protects the body from infection, participates in the production of antibodies, plays a significant role in the processes of blood clotting, and regulates the functioning of the intestines of the bladder and prostate gland.
Sodium bicarbonate is a remedy for restoring the acid-base state of the blood and correcting metabolic acidosis. When sodium bicarbonate dissociates, a bicarbonate anion is released, binding hydrogen ions to form a carboxylic acid, which then breaks down into water and exhaled carbon dioxide. As a result, the pH of the blood shifts to the alkaline side, and the buffer capacity of the blood increases.
Sodium chloride is a plasma-substituting agent that has a detoxifying and rehydrating effect; normalizes the acid-base state. Replenishes sodium deficiency in various pathological conditions of the body; sodium chloride is contained in the blood plasma and tissue fluids of the body (concentration of about 09%).
Pharmacokinetics:
Povidone does not undergo metabolic transformations in the body. It is quickly excreted by the kidneys within 4 hours, 80% is excreted and after 12-24 hours - completely.
Potassium chloride after administration is easily and in almost any quantity passively absorbed (70%) because its concentration released from the dosage form is higher in the lumen of the small intestine than in the blood. In the ileum and colon, potassium is released into the intestinal lumen according to the principle of coupled exchange with sodium and is excreted with bile (10%). T1/2 in the absorption phase is 131 hours.
Calcium chloride is excreted from the body through the intestines and kidneys. Calcium absorption occurs in the small intestine, mainly in the duodenum. Here, bile acids form complex compounds with calcium salts, which then pass through the wall of the villi.
Magnesium chloride is normally excreted 80% in 24 hours. In the kidneys, it is filtered in the glomeruli and then reabsorbed in the thick section of the ascending limb of the nephron loop. Reabsorption of magnesium is associated with the kinetics of calcium and sodium: with intensification of natriuresis and calciumuresis, the excretion of magnesium also increases. Therefore, any infusion of solutions containing these cations increases the excretion of magnesium in the urine.
Sodium bicarbonate increases the excretion of sodium and chlorine ions from the body, increases osmotic diuresis, alkalinizes urine, preventing the precipitation of uric acid salts in the urinary system. The bicarbonate anion does not penetrate inside the cells.
Sodium chloride, being the most important inorganic component that maintains the appropriate osmotic pressure of blood plasma and extracellular fluid, is quickly removed from the vascular bed, only temporarily increasing the volume of circulating blood (effectiveness in case of blood loss and shock is insufficient).
