Poliglyukin solution: instructions for use, price and reviews

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Plasma-substituting, anti-shock drug. Replenishes the volume of circulating blood and has a disaggregant effect . It has a high osmotic pressure (2.5 times higher than the pressure of plasma proteins), therefore it actively attracts tissue fluid and retains it in the vascular bed for a long time - the volume of circulating blood is quickly restored. Increases blood pressure platelet and erythrocyte aggregation ), improves microcirculation .

Pharmacokinetics

It is excreted from the body by the kidneys and 50% is excreted in the first day, and completely removed after 7 days. Some of the dextran accumulates in the reticuloendothelial system and is slowly metabolized to dextrose .

Directions for use and dosage

Polyglucin is used intravenously by drip or stream, or intra-arterially (for acute blood loss in a hospital setting). The rate and volume of administration are set taking into account the patient’s condition, heart rate, blood pressure (BP), and hematocrit values.

Before the transfusion, a biological test is carried out: after slowly introducing 5-10 drops of the solution, take a three-minute break, then pour in another 10-15 drops and again take the same break, in the absence of reaction symptoms (difficulty breathing, increased heart rate, skin flushing, decreased blood pressure) the procedure continues.

In case of acute blood loss or developed shock, Poliglyukin is administered intravenously in a stream in a volume of 0.4-2.0 l (5-25 ml/kg), moving after an increase in blood pressure to 80-90 mm Hg. for drip infusion at a rate of 60-80 drops/min (3-3.5 ml/min). In the same doses, it is permissible to administer the solution intra-arterially. Infusions must be carried out with constant monitoring of the main indicators of systemic hemodynamics. In case of a significant increase in central venous pressure, reduce the rate of administration and dose, or stop the infusion.

In case of severe anemia of the patient and blood loss exceeding 500-750 ml, combine the use of the drug with a transfusion of a suspension of red blood cells, red blood cells or blood, as well as fresh frozen plasma, which includes coagulation factors.

In order to prevent surgical blood loss, as well as to achieve artificial hemodilution, prevent thrombus formation and reduce the tendency to the occurrence or aggravation of disseminated intravascular coagulation syndrome, Poliglyukin is prescribed 0.5-1 hour before the start of surgery at a dose of 5-10 ml/kg (for children - 10-15 ml/kg).

With a pronounced decrease in blood pressure, they switch to jet injection, and if it drops sharply (systolic pressure below 60 mm Hg), intra-arterial injections are advisable. The volume of infusion during surgery is determined by the amount of surgical blood loss. To prevent shock in the postoperative period, jet-drop administration is effective.

In case of burn shock, on the first day adults are given 2-3 liters of solution, children - 40-50 ml/kg, on the next day adults - 1.5 liters, children - 30 ml/kg. It is recommended to combine the use of the drug for deep and extensive burns with the administration of gamma globulin, plasma, and albumin. In case of burns covering more than 30-40% of the body surface, a blood transfusion is prescribed.

To prevent possible tissue dehydration, infusion of the solution should be carried out simultaneously with the introduction of crystalloid solutions in a ratio of 1:2.

Contraindications

increased sensitivity;
hemorrhagic stroke;
intracranial hypertension;
cardiovascular failure;
traumatic brain injury;
anuria;
severe renal failure ;
arterial hypertension;
coagulation disorders;
thrombocytopenia;
tendency to allergic reactions.

Side effects

During therapy with Polyglucin, the development of angioedema, itching or hyperemia of the skin, and anaphylactic reactions may occur (very rarely).

If such effects are observed, you should immediately stop administering the solution and (if necessary), without removing the needle from the vein, take measures to eliminate the transfusion reaction using cardiovascular and antihistamines, glucocorticosteroids, and respiratory analeptics.

With rapid administration of the drug in high doses, the risk of developing pulmonary edema and acute left ventricular failure increases. In case of cyanosis, chills, breathing and circulatory disorders, as well as complaints of lower back pain, chest tightness, difficulty breathing, it is necessary to interrupt the transfusion and administer intravenously 20 ml of a 40% dextrose solution, 10 ml of a 10% calcium chloride solution, antihistamines drugs, glucocorticosteroids and carry out symptomatic therapy.

Poliglyukin, instructions for use (Method and dosage)

Poliglyukin solution is administered intravenously (drip and stream), intra-arterially (in case of acute blood loss). The rate of administration and volume depend on the patient's condition and is determined by many factors ( blood pressure , hematocrit , heart rate). Before the transfusion, a test is carried out - after the first 10 drops, a break is taken, then another 15 drops are administered, if there is no reaction, the transfusion is continued.

For acute blood loss, use 5-25 ml per kg of weight. Infusions are carried out under hemodynamic control. If central venous pressure increases, the rate of administration is reduced or further administration is stopped.

For blood loss of 750 ml, a combination with blood transfusion is indicated.

For burn shock : the first day, up to 2-3 liters are administered, and then 1.5 liters. For extensive burns, a combination with the administration of albumin , plasma, and blood transfusion is indicated.

In order to prevent blood loss during major operations, 5-10 ml per kg of body weight is administered an hour before surgery. In the postoperative period, it is used to prevent shock.

Polyglucin, 6%, solution for infusion, 200 ml, 28 pcs.

V/v, v/a,

drip, stream,
intravenous injection
- for acute blood loss (in a hospital setting). The dose and rate of administration is determined by the patient’s condition, blood pressure, heart rate, and hematocrit. Transfusion is carried out in the usual way in compliance with the rules for transfusion production: before transfusion, a biological test is carried out (after administering 5-10 drops, take a 3-minute break, and then transfuse another 10-15 drops and after the same break in the absence of reaction symptoms (increased heart rate, decreased blood pressure) , skin hyperemia, difficulty breathing) continue transfusion.

In case of developed shock or acute blood loss - intravenous injection, 0.4–2 l (5–25 ml/kg). After increasing blood pressure to 80–90 mm Hg. usually switch to drip administration at a rate of 3–3.5 ml/min (60–80 drops/min). Possible intravenous route of administration (in the same dosages). Infusions of the drug should be carried out under constant monitoring of key indicators of systemic hemodynamics. If there is a significant increase in central venous pressure, reduce the dose and rate of administration or stop administration.

In case of blood loss of more than 500–750 ml and severe anemia of the patient, the administration of the drug is combined with a transfusion of blood, red blood cells or a suspension of red blood cells necessary to eliminate tissue hypoxia, as well as fresh frozen plasma containing factors of the hemostasis system.

To prevent surgical blood loss, as well as to achieve artificial hemodilution, prevent thrombus formation and reduce the tendency to develop or progress DIC syndrome, the drug is administered in doses of 5-10 ml/kg (for children - 10-15 ml/kg) for 30-60 minutes before surgery (in case of a significant decrease in blood pressure, they switch to jet administration, if blood pressure decreases below 60 mm Hg - intravenous injection). The volume of infusion during surgery is determined by the amount of surgical blood loss (the hematocrit should not fall below 0.3).

In the postoperative period, to prevent shock, the drug is administered by stream-drip.

For burn shock: in the first 24 hours, 2-3 liters are administered, in the next 24 hours - 1.5 liters. Children in the first 24 hours - 40–50 ml/kg, in the next day - 30 ml/kg.

For extensive and deep burns, it is combined with the administration of plasma, albumin, and gamma globulin; for burns of more than 30–40% of the body surface - with blood transfusion.

To prevent possible tissue dehydration, it is recommended to combine the drug infusion with the administration of crystalloid solutions in a 1:2 ratio.

Analogs

Level 4 ATC code matches:
Perftoran

Gelofusin

Albumen

Stabizol

Ceruloplasmin

Refortan

Gemodez-N

Reopoliglyukin

Dextran-60-Eskom , Neorondex , Polyfer , Rondex , ReoDEX .

special instructions

As long as the packaging remains sealed, freezing the Poliglucin solution is not a contraindication to its use.

Non-wetting of the bottle surface on the inside is not a contraindication to the use of the product.

In the presence of severe dehydration, the fluid deficit should be restored before using the drug. The rate of administration should not be more than 500 ml/hour. Use of the drug in recommended doses has virtually no effect on the hemostatic system.

Administration of doses higher than recommended may prolong bleeding time.

Hemodilution caused by dextrans can cause a decrease in plasma proteins, including hemoglobin. The volume of the drug used should be calculated so that the hemoglobin concentration does not fall below 90 g/l (hematocrit 27%) for a long time.

The use of dextrans is not an obstacle to determining the blood group and conducting a cross-test using standard methods (it is recommended to wash the red blood cells with a 0.9% NaCl solution before the study).

The presence of Polyglucin in the blood can affect the results of enzymatic methods based on papain.

When determining the level of glucose in the blood using solutions of acetic and sulfuric acids (capable of hydrolyzing dextran), it is possible to obtain glucose concentrations that exceed those actually available.

The presence of dextran in the blood reduces its transparency and can affect the results of measuring bilirubin and protein levels; therefore, it is recommended to determine the concentration of the latter before using the drug.

Reviews about Poliglyukin

Dextran solutions (a water-soluble polymer of glucose) are plasma replacement solutions and are often used in hospital settings. Rondex , Poliglyukin , Reopoliglyukin , Reogluman and others are prepared from dextran The difference between them is that Poliglyukin and Rondex are prepared on the basis of medium molecular dextran , and Reomacrodex , Reopoliglyukin , Longasteril 40 - on the basis of low molecular weight.

They also differ in their action: high-molecular dextrans , due to the large size of the molecules, are retained in the bloodstream for a long time, thereby increasing the volume of circulating fluid and normalizing hemodynamics , while low-molecular dextrans additionally improve microcirculation , reduce platelet aggregation , red blood cells and blood viscosity. However, it must be taken into account that the use of Polyglucin can cause nonspecific agglutination of red blood cells , activate fibrinolysis and cause a risk of bleeding. Therefore, the volume of administered Polyglucin should not be more than 1200 ml per day. In addition, it negatively affects the parenchyma , causing a “dextran burn” when excreted by the kidneys. Here are some patient reviews that often mention side effects of the drug.

“... This drug was used to treat massive gynecological bleeding - 400 ml was tolerated well.”
“... I had a feeling of heat, shortness of breath and severe sweating. They took off the drip without even finishing half of it.”
“... I don’t tolerate Polyglyukin well - my blood pressure rises and my heart palpitates.”
“... They dripped only once - there was a severe headache and trembling in the body. They said I can no longer take this drug.”

Another use of dextran in medicine is the reagent Polyglucin 33%, which is used in the “polyglucin test” to check the compatibility of the blood of the donor and recipient. Take 2 drops of recipient serum, a drop red blood cells and a drop of 33% Polyglucin. The test tube is tilted, shaken, and slowly rotated to spread the contents of the test tube over the walls for 3 minutes, after which 2 ml of saline is added and the test tube is inverted. If red blood cell agglutination , it means the blood is incompatible.

Polyglucin (Polyglucinum)

IV drip, for acute blood loss - IV (in a hospital setting). The volume and rate of administration is determined by the patient’s condition, blood pressure (BP), heart rate (HR), and hematocrit.

Transfusion is carried out in the usual way in compliance with the rules for transfusion production: before transfusion, a biological test is carried out (after administering 5-10 drops, take a 3-minute break, then another 10-15 drops are transfused and after the same break in the absence of reaction symptoms (increased heart rate, decreased blood pressure, skin hyperemia, difficulty breathing) continue transfusion).

In case of developed shock or acute blood loss - intravenous injection, 0.4-2 l (5-25 ml/kg). After increasing blood pressure to 80-90 mm Hg. usually switch to drip administration at a rate of 3-3.5 ml/min (60-80 drops/min). Possible intravenous route of administration (in the same dosages). Infusions of the drug should be carried out under constant monitoring of key indicators of systemic hemodynamics. If there is a significant increase in central venous pressure, reduce the dose and rate of administration or stop completely.

In case of blood loss of more than 500-750 ml and severe anemia of the patient, the administration of the drug is combined with a transfusion of blood, red blood cells or a suspension of red blood cells necessary to eliminate tissue hypoxia, as well as fresh frozen plasma containing factors of the hemostasis system.

To prevent surgical blood loss, as well as to achieve artificial hemodilution, prevent thrombus formation and reduce the tendency to develop or progress DIC syndrome, the drug is administered in doses of 5-10 ml/kg (for children - 10-15 ml/kg) for 30-60 minutes before surgical intervention (in case of a significant decrease in blood pressure, switch to jet administration, if blood pressure decreases below 60 mm Hg - intravenous injection). The volume of infusions during surgery is determined by the amount of surgical blood loss (the hematocrit should not fall below 0.3). In the postoperative period, jet-drip administration is an effective way to prevent shock.

For burn shock: in the first 24 hours, 2-3 liters are administered, in the next 24 hours - 1.5 liters. Children in the first 24 hours - 40-50 ml/kg, in the next day - 30 ml/kg.

For extensive and deep burns, it is combined with the administration of plasma, albumin, and gamma globulin; for burns of more than 30-40% of the body surface - with a blood transfusion. To prevent possible tissue dehydration, it is recommended to combine the drug infusion with the administration of crystalloid solutions in a 1:2 ratio.

Poliglyukin price, where to buy

You can purchase the drug at any pharmacy. The cost of 400 ml of solution ranges from 72-95 rubles. A prescription is required to purchase Polyglucin.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

ZdravCity

Reopoliglucin solution for inf.
fl. 100 mg/ml 200 ml RUP Belmedpreparaty 109 rub. order

Pharmacy Dialogue

Reopoliglyukin (bottle 200 ml (ind. pack.)) Belmedpreparaty
109 rub. order

Pharmacy24

Reopolyglucin 200 ml solution for infusion ZAT"Infusion", Ukraine
92 UAH.order
Reopolyglucin 400 ml solution for infusion Novofarm-Biosintez TOV, Novograd-Volinsky, Ukraine
85 UAH order
Reopolyglucin 200 ml solution for infusion TOV "Yuriya-Pharm", Ukraine
101 UAH order
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PaniPharmacy

Reopoliglyukin infusion Reopoliglyukin solution inf. 400ml Ukraine, Novofarm-Biosintez LLC
92 UAH order
Reopoliglyukin infusion Reopoliglyukin solution inf. 400ml Ukraine, Yuria-Pharm LLC
149 UAH order
Reopoliglyukin infusion Reopoliglyukin solution inf. 200ml Ukraine, Yuria-Pharm LLC
75 UAH order
Reopoliglyukin infusion Reopoliglyukin solution inf. 200ml Ukraine, Novofarm-Biosintez LLC
55 UAH order
Reopoliglyukin solution inf. 400ml Ukraine, Infusion
107 UAH order

Release form and composition

Polyglucin is available in the form of a solution for infusion: a colorless or pale yellow transparent liquid (200 or 400 ml in glass bottles for blood, infusion and transfusion drugs, with a capacity of 250 and 450 ml, respectively, sealed with rubber stoppers and crimped with aluminum caps; bottles with a capacity of 250 ml - 1 in a cardboard pack, 24 or 28 in a corrugated cardboard box; bottles with a capacity of 450 ml - 1 in a cardboard box, 12 or 15 in a corrugated cardboard box).

Composition of 1 liter of the drug:

Dextran (with molecular weight from 50,000 to 70,000) – 60 g;
Sodium chloride – 9 g;
Water for injections – up to 1 liter.

Poliglyukin

IV drip, for acute blood loss - IV (in a hospital setting). The volume and rate of administration is determined by the patient’s condition, blood pressure, heart rate, and hematocrit. Transfusion is carried out in the usual way in compliance with the rules for transfusion production: before transfusion, a biological test is carried out (after administering 5-10 drops, take a 3-minute break, then another 10-15 drops are transfused and after the same break in the absence of reaction symptoms (increased heart rate, decreased blood pressure, skin hyperemia, difficulty breathing) continue transfusion).

In case of developed shock or acute blood loss - intravenous injection, 0.4-2 l of the drug (5-25 ml/kg). After increasing blood pressure to 80-90 mm Hg. usually switch to drip administration at a rate of 3-3.5 ml/min (60-80 drops/min). Possible intravenous route of administration (in the same dosages). Infusions of the drug should be carried out under constant monitoring of key indicators of systemic hemodynamics. If there is a significant increase in central venous pressure, reduce the dose and rate of administration or stop completely.

To prevent surgical blood loss with the drug, as well as to achieve artificial hemodilution, prevent thrombosis and reduce the tendency to develop or progress DIC syndrome, the drug is administered in doses of 5-10 ml/kg (for children - 10-15 ml/kg) for 30-60 min before surgery (in case of a significant decrease in blood pressure, switch to jet administration, if blood pressure decreases below 60 mm Hg - intravenous injection). The volume of infusions during surgery is determined by the amount of surgical blood loss (the hematocrit should not fall below 0.3).

In the postoperative period, jet-drip administration is an effective way to prevent shock.

For burn shock: in the first 24 hours, 2-3 liters are administered, in the next 24 hours - 1.5 liters. Children in the first 24 hours - 40-50 ml/kg, in the next day - 30 ml/kg.

For extensive and deep burns, it is combined with the administration of plasma, albumin, and gamma globulin; for burns of more than 30-40% of the body surface - with a blood transfusion.

To prevent possible tissue dehydration, it is recommended to combine the infusion of Polyglucin with the administration of crystalloid solutions in a 1:2 ratio.