Gluxil

Pharmacological properties

Gluxil has an energetic, detoxification, rheological, anti-shock and alkalizing effect. The main active ingredients in the drug are glucose, xylitol and sodium acetate.

Glucose is not only the main source of energy in the body, but also a necessary component for the synthesis of a number of substances. The most important is protein metabolism. Glucose is metabolized in all cells and serves as an important source of energy, especially for the brain, red blood cells and bone marrow cells. It is important that glucose is utilized even under anaerobic conditions. The maximum rate of glucose utilization by the body is 0.5 g / h.

Xylitol is a pentatomic alcohol, which, when administered intravenously, is quickly incorporated into the general metabolism, 80% of which is absorbed by the liver and accumulates in the form of glycogen, the rest of xylitol is absorbed by tissues of other organs (kidneys, heart, pancreas, adrenal glands, brain) and excreted from urine. The product of carbohydrate metabolism - xylitol - is pentitol and is directly involved in the pentose phosphate cycle of metabolism. Xylitol, unlike fructose and sorbitol, does not cause a decrease in the level of adenine nucleotides in the liver (ATP, ADP, AMP), it is safe for administration to patients with increased sensitivity to fructose or with a deficiency of the enzyme fructose-1,6-diphosphatase. Xylitol is believed to have a more pronounced antiketogenic, nitrogen-preserving effect than glucose, and is equally well absorbed in both the pre- and postoperative period. Given that xylitol is an energy source with an insulin-independent metabolism that acts antiketogenically and lipotropically, it is recommended for use as a means of parenteral nutrition for patients, especially those who underwent surgery on the gastrointestinal tract. The maximum rate of xylitol utilization is 0.25 g / kg / h.

It was found that the combined use of glucose and xylitol does not cause an increase in the concentration of metabolites, which is noted with their separate use.

Sodium acetate is a delayed action alkalizing agent. It causes the accumulation of bases due to the metabolization of the buffered drug and is prescribed for those types of metabolic acidosis in which the accumulation of excess H⁺ occurs slowly (for example, with renal and deficient non-respiratory acidosis). In such cases, there is no need for urgent correction, the restoration of buffer bases can occur due to the metabolism of sodium acetate. When using sodium acetate, unlike sodium bicarbonate solution, the correction of metabolic acidosis is slower, as sodium acetate is included in the metabolism, without causing sharp fluctuations in pH. Oxygen consumption in the metabolism of acetate is less than in the metabolism of lactate. Sodium acetate for 1.5–2 hours is completely metabolized to an equivalent amount of sodium bicarbonate, does not cause intracellular interstitial cerebral edema, and increased platelet and red blood cell aggregation.

Due to its composition, Gluxil belongs to the group of multicomponent hyperosmolar solutions. After administration of the iv drug, the osmotic pressure of the blood rises, the evacuation of fluid from tissues to the vascular bed is enhanced, metabolic processes are intensified, detoxification function of the liver is improved, cardiac activity is enhanced, diuresis is increased.

Indications

The drug is recommended to be used as a means to compensate for the body’s calorie needs with parenteral nutrition, to reduce intoxication, to correct acid-base balance disturbances in shock conditions (taking into account the osmolarity of blood and urine), for burn disease, protracted purulent processes, liver diseases, various infectious diseases and toxic infections in the postoperative period.

Application

For adults, gluxil is administered intravenously at a rate of 40-60 drops per minute, that is, 1.7-2.5 ml / kg / h or 120-180 ml / h with a body weight of 70 kg.

The maximum dose is 1400 ml / day with a body weight of 70 kg or 1 g of xylitol / kg of body weight per day + 1.5 g of glucose / kg of body weight per day.

The maximum infusion rate is 180 ml / h with a body weight of 70 kg (60 drops per minute) or 0.125 g xylitol / kg body weight per hour + 0.187 g glucose / kg body weight per hour.

Contraindications

Hypersensitivity to the drug, diabetes and conditions accompanied by hyperglycemia, hyperosmolar coma, anuria. gluxil should not be administered in cases where fluid infusion is contraindicated (edema, hemorrhagic stroke, thromboembolism, severe cardiovascular failure in the decompensation phase, stage III ag).

Side effects

Nausea, flatulence, diarrhea, abdominal pain. gluxil, like other hypertonic and hyperosmolar solutions, with prolonged administration can cause irritation of peripheral veins at the injection site.

special instructions

The drug is used taking into account the osmolarity of blood and urine. the introduction of gluxil is carried out under the control of the level of glucose in the blood and, if necessary, insulin is used. with liver diseases, the drug is prescribed under the control of liver function indicators. since gluxil has choleretic properties, its administration in patients with gallstone disease should be carried out with caution, under the supervision of a physician. the possibility of using gluxil during pregnancy and lactation, as well as in children, has not been established.

Interactions

The drug should not be mixed with phosphate and carbonate-containing solutions. gluxil cannot be used as a carrier solution for other drugs. their addition can lead to physico-chemical changes in gluxyl.

Overdose

With the introduction of large volumes of the drug, violations of the functional state of the liver and depletion of the insular apparatus of the pancreas are possible. with a significant overdose of the drug, hyperglycemia, nausea, flatulence, diarrhea, abdominal pain can occur. in this case, the administration of the drug is immediately stopped.

Storage conditions

In a dry place at a temperature of 2-25 ° C. prevent freezing of the drug.