Plasma Substitute Solution

Pharmacological properties

Pharmacodynamics

The main active ingredients of the drug are xylitol and sodium acetate.

Xylitol is a pentatomic alcohol, which, when given intravenously, is quickly included in the general metabolism, 80% is absorbed in the liver and accumulates in the form of glycogen.

It has a pronounced antiketogenic effect, is an energy source with an insulin-independent metabolism.

Xylitol is a natural intermediate product of human carbohydrate metabolism, therefore it has low toxicity and good tolerance. Unlike fructose, it does not cause a decrease in the level of nucleotides in the liver (ATP, ADP, AMP), and is also safe for administration to patients who do not tolerate fructose or have a deficiency of the enzyme fructose-1,6-diphosphatase.

Sodium acetate is a delayed-action alkalizing agent. It causes the accumulation of bases due to the metabolism of the buffered drug and is indicated for those types of metabolic acidosis in which the accumulation of excess N⁺ occurs slowly (for example, with renal and deficient non-respiratory acidosis). When using sodium acetate, unlike sodium bicarbonate solution, the correction of metabolic acidosis is slower, therefore, does not cause sharp pH fluctuations.

Pharmacokinetics 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. It is important that the oxygen consumption in the metabolism of acetate is significantly less than in the metabolism of lactate, which is important for the treatment of severe shock of various origins.

Due to its composition, Xylate belongs to the group of multicomponent multifunctional hyperosmolar solutions and, thus, has an antiketogenic, hemodynamic, detoxification, rheological, energetic, alkalizing and osmodiuretic effect.

Indications

To reduce intoxication, improve microcirculation, partially cover the need for carbohydrates, which occurs in diabetes mellitus and other disorders of glucose utilization, in traumatic, surgical, hemolytic and burn shock (taking into account the osmolarity of blood and urine), in preoperative preparation and in the postoperative period, with acute blood loss, as well as with burn disease, with prolonged purulent processes, with various infectious diseases and chronic toxic hepatitis.

Application

Adults are injected intravenously at a rate of 50–70 drops / min, that is, 2.1–3.0 ml / kg / h or 150–210 ml / h.

Maximum dose: adults - 2100 ml / day or 1.5 g xylitol / kg body weight per day. The maximum infusion rate is 210 ml / h (70 drops per minute) = 0.15 g xylitol / kg body weight per hour.

In chronic and toxic hepatitis - for adults, 400 ml (5-6 ml / kg), iv / drop, repeatedly during the day (monitoring of liver function indicators is necessary).

For parenteral nutrition of patients, including diabetes mellitus, for adults, 600–1000 ml (10-15 ml / kg of patient’s body weight), once and repeatedly during the day.

In case of traumatic, burn, postoperative and hemolytic shock - for adults, 600–1000 ml (10-15 ml / kg of patient’s body weight), once and repeatedly during the day.

In acute blood loss, for adults, 1000–1400 ml (up to 20 ml / kg). In this case, xylate infusion is also recommended at the prehospital stage, in a specialized ambulance.

In the preoperative period and after various surgical interventions - for adults at a dose of 400-600 ml (6-10 ml / kg), in / drip, once or repeatedly, daily, for 3-5 days.

Contraindications

Hyperosmolar coma, anuria.xylate should not be administered in cases where fluid infusion is contraindicated (edema, cerebral hemorrhage, thromboembolism, cardiovascular decompensation, stage III ag).

Side effects

Allergic reactions (itching, urticaria); rarely - tachycardia, fever, irritation of peripheral veins at the injection site. it is not recommended to use the drug for general dehydration and violations of water-electrolyte metabolism. a hypertensive reaction may occur, in this case, antihypertensive drugs are administered under the control of hell.

special instructions

To achieve a hemodynamic effect, xylate is administered to adults intravenously at a rate of 40-60 drops / min. if necessary, jet injection of the drug is allowed after the test by drip at a rate of 30 drops / min. after the administration of 15 drops, the administration of the drug is stopped, and after 3 minutes, in the absence of reaction, they are injected jet.

Antiketogenic properties of the drug are manifested at a rate of administration equal to the rate of xylitol utilization.

For liver diseases, the drug is used under the control of liver function indicators. Since Xylate has a choleretic effect, its administration in gallstone disease should be carried out under the close supervision of a physician. The introduction of the drug Xylate to patients with diabetes mellitus must be carried out under the control of glycemia.

Caution should be prescribed for diseases accompanied by dehydration of the body, since Xylate as a hyperosmolar solution can enhance it due to the transition of fluid from tissues to the vascular bed.

During pregnancy and breastfeeding. A study of the use of Xylate during pregnancy and lactation was not conducted, data are not available.

Children. A study of the use in children has not been conducted, data are not available.

The ability to influence the reaction rate when driving vehicles or working with mechanisms. The drug is used exclusively in a hospital.

Interactions

The drug should not be mixed with phosphate and carbonate-containing solutions. xylate should not be a carrier solution for other drugs. the addition of drugs can lead to physico-chemical changes.

Incompatibility. The drug should not be mixed with phosphate and carbonate-containing solutions. Adding drugs can lead to physico-chemical changes. If such an addition is necessary, then compliance with sterility, thorough mixing and drug interaction should be monitored.

Overdose

With an overdose of the drug, nausea, bloating, diarrhea, abdominal pain, disturbance of the water-electrolyte balance (in the form of a hypertensive reaction; in this case, antihypertensive drugs administered under the control of hell) can be observed.

Storage conditions

At a temperature of 2–25 ° c. freezing of the drug is not allowed.