Hydroxyethyl starch nandrolone phenylpropionate profile was obtained from amylopectin and characterized by molecular weight and degree of substitution. For nandrolone phenylpropionate profilea average molecular weight HES is 130000 Yes, and the degree of substitution of about is structurally akin to glycogen, which explains its high tolerance and low risk of anaphylactic reactions.
nandrolone phenylpropionate profile is izoonkoticheskim solution, ie, intravascular plasma volume during its infusion increases equivalent to the entered terms.
duration volemic effect depends largely on the degree of molar substitution and to a lesser extent on the molecular weight.
HES is subjected to prolonged hydrolysis, resulting in the formation of active oncotically oligo- and polysaccharides of various molecular weights that are excreted by the kidneys.
nandrolone phenylpropionate profile can lower hematocrit and plasma viscosity .
volume effect resulting from the introduction of isovolemic nandrolone phenylpropionate profilea lasts at least 6 hours.
HES is a mixture of molecules with various degrees of molar substitution and different molecular weights, both of these values affect the clearance rate. Small molecules are derived using klubochnoy filtration are larger molecules undergo enzymatic hydrolysis of α-amylase and subsequently excreted by the kidneys. The rate of hydrolysis is lower, the higher the degree of substitution. About 50% of the administered dose is excreted in the urine within 24 hours.
After a single injection of 1000 ml nandrolone phenylpropionate profilea plasma clearance of 19 ml / min, AUC 58 mg • hr / ml, area under the curve of concentration vs. time -.. 58 mg-h / ml. The half-life of serum corresponds to 12 hours.
- Prevention and treatment of hypovolemia and shock, for example, due to injury or bleeding, intraoperative blood loss, burns, sepsis;
- Acute normovolemic hemodilution, therapeutic hemodilution;
- Filling machine of extracorporeal circulation.
- Hyperhydration, including pulmonary edema;
- Chronic heart failure;
- Renal failure with oliguric or anuricheskim syndrome;
- Revealed sensitization to the SEC;
- Intracranial hemorrhage;
- Severe hypernatremia and hyperchloremia;
- Severe hepatic insufficiency.
Special care should be used nandrolone phenylpropionate profile:
- In patients with hepatic impairment;
- When coagulation disorders, particularly haemophilia and diagnosed or suspected disease Ville brand;
- The safety and efficacy of administration to children nandrolone phenylpropionate profilea poorly understood, so its use in children is possible if the expected therapeutic effect of its use outweighs the potential.
Pregnancy and lactation
nandrolone phenylpropionate profile appointed during pregnancy only in those situations where the potential benefits from the use of the drug in the mother than the potential risk to the fetus (especially in the first trimester). There are no data on the use of this drug in nursing mothers,
The method of administration and dosage
for intravenous administration.
The daily dose and rate of administration depend on the loss of blood and hemodynamic parameters.
For the early detection of the maximum threat of anaphylactic reactions nandrolone phenylpropionate profilea first 10-20 ml should be injected slowly under constant control of medical personnel. The maximum daily dose daily dose and rate of administration depend on the bleeding amount and determined to maintain and restore haemodynamic parameters. The maximum daily dose nandrolone phenylpropionate profilea should not exceed 50 ml / kg body weight, corresponding to 3 g of HES / kg / day (approximately 3500 ml / day for body weight of 70 kg) . The maximum speed of the introduction of maximum injection rate depends on the clinical situation. In the acute stage of the shock to the recommended rate of introduction of 20 ml / kg body weight per hour, corresponding to 0.33 ml / kg body weight per minute (1.2 g HES per kg body weight per hour). In a critical situation possible the rapid introduction of 500 ml (under pressure). With the drug under pressure if nandrolone phenylpropionate profilea use plastic containers all the air from containers and systems for administration must be previously removed to avoid the risk of embolism. The duration of therapy depends on the duration and severity of hypovolemia and hemodynamic effect of the therapy and the level of hemodilution.
most frequently occurring side effects are directly related to the main effects of HES solutions and dose of the drug. Perhaps the reduction in coagulation factors due to hemodilution as a result of HES solutions without concurrent administration of blood components.
Allergic reactions occur infrequently and do not depend on the dose of the drug. The effect on the circulatory and lymphatic systems are often due to hemodilution a decrease in hematocrit and concentration of proteins in the blood plasma. The depending on the administered dose HES solutions may cause a decrease in the concentration of coagulation factors and thus affect blood clotting. Bleeding time and aPTT index (activated partial thromboplastin time) can be increased and FVIII / vWF activity (von Willebrand Factor VIII) can be reduced. The effect on biochemical parameters Introduction HES leads to an increase in the concentration of α-amylase in the plasma, which is associated with the formation of complex α- amylase with starch, which, in turn, is slowly eliminated by renal and extrarenal that may be mistakenly interpreted as a sign of biochemical pancreatitis. anaphylactic reactions anaphylactic reactions of varying severity occur with the introduction of HES solutions. Therefore, all patients receiving HES solutions should be under constant medical supervision. In the event of an anaphylactic reaction of any infusion should be discontinued immediately and started emergency treatment. Do not proven effective prophylactic use of corticosteroids. Repeat for a few days, HES solutions may cause pruritus.
Avoid volume overload, which can occur when an overdose nandrolone phenylpropionate profilea, which is particularly dangerous for patients with concomitant cardiac disease, renal failure, for elderly patients.
It should monitor electrolytes in the blood serum, water balance, renal function. It is necessary to ensure adequate administration of water.
In case of severe dehydration should initially to normalize the water-electrolyte balance.
In order to correctly determine group membership of a patient’s blood, the blood sample should be taken prior to the introduction nandrolone phenylpropionate profilea.
To maximize early detection of threats anaphylactic reactions the first 10-20 ml should be administered nandrolone phenylpropionate profilea slowly under constant control of medical personnel.
Do not use if solution is not transparent and contains visible particulate matter, or if the container is damaged or bag previously opened.
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