Hartman

Instruction manual

For medical use of the drug

Hartmans solution

(hartman’s solution)

Structure:

Active ingredients: sodium chloride, potassium chloride, sodium lactate, calcium chloride dihydrate, magnesium chloride hexahydrate;

100 ml of the solution contain: sodium chloride - 0.6 g; potassium chloride - 0.04 g; sodium lactate - 0.303 g; calcium chloride dihydrate - 0.02013 g; magnesium chloride hexahydrate - 0.02 g;

ionic composition per 1000 ml of solution: Na⁺- 129.7 mmol; TO⁺- 5.36 mmol; Sa⁺⁺1.37 mmol;

Mg⁺⁺- 0.98 mmol; Cl^¯- 112.74 mmol; lactate - 27.03 mmol;

excipient: water for injection.

Dosage form.

Solution for infusion.

Basic physical and chemical properties: transparent, colorless liquid; theoretical osmolarity 277.18 mosmol / l; pH 5.5–7.5.

Pharmacotherapeutic group.

Blood substitutes and perfusion solutions. solutions used to correct electrolyte imbalance. electrolytes.

Code ATX B05V B01.

Pharmacological properties.

Pharmacodynamics

A saline solution with a balanced electrolyte content. Replenishes the deficit of circulating blood volume. Corrects the water-alkaline balance, has a detoxifying effect. Lactate, which is part of the drug, due to metabolic processes turns into bicarbonate anions, which help restore the acid-base balance of the blood. The solution is close to isotonic.

Pharmacokinetics

With intravenous administration of the drug for a short period of time, the osmolarity of blood increases. The drug does not remain in the blood for a long time and after about half an hour passes into the tissue. The components of the drug are excreted in the urine.

Clinical characteristics.

Indications.

Hypovolemia and isotonic dehydration in combination with metabolic acidosis. for pre-, intra- and postoperative fluid balance maintenance. rehydration of the interstitial space after colloidal replacement of the circulating blood volume.

Contraindications

Hypervolemia, hypernatremia (including due to the use of corticosteroids), hyperkalemia, hypermagnesemia, hyperchloremia, hypercalcemia, extracellular hyperhydration, hypertonic dehydration, alkalosis, lactic acidosis, arterial hypertension, cardiovascular insufficiency and / or. renal failure), liver failure (due to a decrease in the formation of bicarbonate from lactate), pulmonary edema, thrombophlebitis, conditions with increased blood coagulation, decompensated heart defects; oliguria and anuria, cerebral edema.

Interaction with other drugs and other types of interactions.

When using potassium-sparing diuretics, angiotensin-converting enzyme inhibitors (APFs) and potassium preparations, the risk of developing hyperkalemia is increased. with the simultaneous use of the solution and cardiac glycosides, the toxic effect of the latter is enhanced due to the presence of Ca ++ ions in the solution.

The drug is incompatible with cefamandol, amphotericin, ethyl alcohol, thiopental, aminocaproic acid, metaraminol, ampicillin, vibramycin and monocycline.

It is possible to increase sodium retention in the body while using such drugs: non-steroidal anti-inflammatory drugs, androgens, anabolic hormones, estrogens, corticotropin, mineralocorticoids, vasodilators or ganglion blockers.

Due to the presence of lactate, which alkalizes the pH, the drug should be used with caution while the use of drugs whose renal elimination depends on pH. Renal clearance of salicylates, barbiturates, lithium may decrease, and sympathomimetics and stimulants (such as dexamphetamine sulfate, fenfluramine hydrochloride) may increase.

Features of the application.

Blood should be monitored for electrolyte, fluid, pH and pso2 values. use the drug with caution in patients with respiratory failure, acute dehydration, as well as in patients who are simultaneously undergoing corticosteroid therapy.

Due to the content of sodium ions, the drug should be used with caution in patients with congestive heart failure, especially in the postoperative period, elderly patients, as well as patients with clinical conditions that are accompanied by sodium retention and edema, patients with hypoxia and liver failure.

Since the drug contains sodium lactate, it should be used with extreme caution in patients prone to hypernatremia (for example, with adrenocortical insufficiency, diabetes insipidus or massive tissue damage), and in patients with heart diseases.

Solutions that contain sodium should be used with caution in patients who receive corticosteroids or corticotropin.

The use of intravenous solutions can cause overloading with a liquid and / or solution, hyperhydration, congestion and pulmonary edema. The risk of dilution develops inversely with the concentration of electrolytes. The risk of developing an overload with a solution that causes congestion with peripheral edema and pulmonary edema is directly proportional to the concentration of electrolytes.

In the event of any manifestations of a hypersensitivity reaction, you should immediately stop the introduction of the solution and carry out appropriate treatment.

Potassium content requires caution when applying the solution to patients with heart diseases and clinical conditions that are accompanied by a delay in potassium in the body.

In patients with reduced renal excretory function, the use of a solution can lead to a delay in sodium or potassium.

The use of calcium should be carried out, controlling cardiac activity using an ECG, especially in patients who receive digitalis. Serum calcium levels do not always reflect tissue calcium levels.

Due to the presence of calcium ions in the drug, caution is required in case of simultaneous administration with blood products, since there is a risk of developing coagulation.

Lactate is a substrate for gluconeogenesis, therefore, blood glucose levels should be carefully monitored for patients with type II diabetes mellitus.

Use during pregnancy or lactation.

The drug should be used during pregnancy only if the expected benefit of the treatment prevails over the possible risk to the fetus. There are no clinical data on the use of the drug during lactation.

The ability to influence the reaction rate when driving vehicles or other mechanisms.

data on the effect of the drug on the reaction rate when driving or working with other mechanisms are not available, since it should be used exclusively in a hospital.

Dosage and administration.

Assign intravenously. administered intravenously. the dose is determined by the doctor depending on the condition of the patient. the maximum rate of administration is 5 ml / kg / h, i.e. 350 ml / h with a body weight of 70 kg. the maximum daily dose for adults is 40 ml / kg / day (an average of 2500–3000 ml at a rate of 60 drops / min). the duration of treatment depends on the condition of the patient. during the first 24 hours, it is necessary to ensure the daily need and half of the fluid deficiency, during the next 2 days - ¼ of the fluid deficiency daily. thus, total fluid deficiency is resumed within 72 hours. when renewing previously lost fluid, it is necessary to take into account the loss that continues and to resume it.

Children.

there is no experience with the use of the drug in pediatric practice.

Overdose.

In the event of an overdose or too rapid administration of the solution, a violation of the balance of water and electrolytes, cardiopulmonary decompensation (including acute circulatory failure, pulmonary edema) is possible. in this case, you should stop the administration of the drug and conduct symptomatic therapy.

Excessive administration of lactate can lead to the development of metabolic alkalosis, which, in turn, may be accompanied by hypokalemia. Symptoms: mood swings, fatigue, shortness of breath, muscle weakness, polydipsia, polyuria, impaired thinking, arrhythmia. Muscle hypertonicity, twitching, and tetanic cramps can develop in patients with hypocalcemia.

Adverse Reactions

Disorders of water-electrolyte and acid-base balance: violation of electrolyte metabolism (including hypernatremia, hyperkalemia, hyperchloremia), hypervolemia, hyperhydration, metabolic alkalosis, chloride acidosis.

General reactions of the body: allergic or anaphylactic reactions (fever, itching, coughing, sneezing, shortness of breath, local or generalized urticaria, angioedema).

Changes in the place of infusion: inflammation, swelling, rash, itching, erythema, pain, burning, numbness at the site of infusion, thrombophlebitis.

Mental disorders: panic attack.

In case of adverse reactions, the administration of the solution should be discontinued, the patients condition assessed and appropriate assistance provided.

Shelf life.

5 years.

Storage conditions.

Store at a temperature not exceeding 25 ° C. Keep out of the reach of children.

Incompatibility.

"Hartmans solution" is not recommended as a means for diluting antibiotics during their infusion, as well as for diluting anti-inflammatory drugs, sodium thiopental, ethyl alcohol, aminocaproic acid due to their chemical incompatibility.

Packaging.

200 ml or 250 ml, or 400 ml, or 500 ml in bottles.

Vacation category.

On prescription.

Manufacturer.

Private joint-stock company "infusion".

The location of the manufacturer and his address of the place of business.

Ukraine, 23219, Vinnitsa region., Vinnytsia district, s. Vinnytsia farms, st. Nemirovskoe highway, 84a.