deca durabolin pills

Voluven is hydroxyethyl starch solution deca durabolin pills, which is derived from amylopectin and characterized by molecular weight and degree of substitution. For Voluven average molecular weight of 130,000 is Yes, and the degree , which means that 10 glucose residues amylopectin for about four hydroxyethyl groups. Deca durabolin pills starch is structurally akin to glycogen, which explains its high tolerance and low risk of anaphylactic reactions.  solution is very stable and does not allow the flocculation temperature fluctuations.
The pharmacokinetics of hydroxyethyl starch is complex and depends on the molecular weight and the degree of molecular substitution substances. After intravenous administration of hydroxyethyl starch molecules smaller than 60 000 – 70 000 Da (threshold of renal filtration) is rapidly excreted in the urine, while larger molecules, including Voluven are split α-amylase blood plasma, and then be output via the kidneys.
The average molecular Voluven weight in the first few minutes after infusion of the blood in vivo plasma 70000 – 80000 Yes and remains above the renal filtration threshold during the entire treatment period.
after 30 minutes after infusion Voluven its plasma concentration is 75% of the maximum, and after 6 hours is reduced to 14%. With a single administration of 500 ml hydroxyethyl starch molecules Voluven completely eliminated from the body within 24 hours.
After the introduction of 500 ml Voluven its clearance in the blood plasma of 31.4 ml / min. After single administration of 500 ml of the product during its half-life in plasma in the first elimination phase was 1.4 hours, and in a second phase -. 12.1 hours
Even after daily administration of the volunteers with 500 ml of 10% solution of HES 130 / 0.4 within 10 days, a significant accumulation of the substance were found in plasma.
in patients with stable renal impairment (mild to severe) and creatinine clearance (CC) <50 ml / min value of AUC was modestly higher (1.7 times) than that patients with CC> 50 ml / min with the same dose of the drug (500 mL). Impaired renal function did not affect the half-life in the terminal phase of elimination, and the value of the maximum HES plasma concentrations. When QA> 30 ml / min in the urine excreted 59% of the administered dose, while QC 15-30 ml / min -. 51%
in comparison with HES 200 / 0.5 Voluven has improved pharmacokinetics (optimized metabolism and excretion), and maintaining its plasma-effect. Thus there was a weakening effect of the drug on hemostasis in multiple high doses and reduced hydroxyethyl starch accumulation in tissues.

Indications for use .

 

  1. Treatment and prevention of hypovolemia.
  2. Acute normovolemic hemodilution.
  3. Therapeutic hemodilution.

Contraindications .

 

  • Increased individual sensitivity to the drug
  • hyperhydration
  • hypervolemia
  • congestive heart failure
  • severe disorders of blood coagulation
  • intracranial hemorrhage
  • a state of dehydration, requiring correction of water and electrolyte balance
  • severe renal insufficiency deca durabolin pills with oliguria or anuria
  • use in patients on hemodialysis.

Dosage and administration .

Continuous intravenous infusion: initial dose 10-20 ml should be administered slowly, the patient should be monitored carefully because of the possibility of occurrence of anaphylactoid reactions.
The daily dose and infusion rate depend on the blood loss, maintenance or restoration of hemodynamic and blood dilution (hemodilution).
Maximum daily dose of 50 ml / kg body weight per day.
in children under 2 years of age undergoing surgery (excluding cardiac) tolerability when applied Voluven deca durabolin pills during operations were consistent with portability 5% albumin.
Voluven is used to replenish blood volume :

 

  • In adults, the maximum daily dose – 50 ml / kg
  • in children aged 10-18 daily dose – 33 ml / kg
  • in children 2-10 years of daily dose – 25 ml / kg
  • in infants and children up to 2 years of daily intake -. 25 ml / kg
    Voluven be administered repeatedly for several days, depending on the needs of the patient.The duration of treatment depends on the duration and severity of hypovolemia, on hemodynamics and on hemodilution.Side effect .When using hydroxyethyl starch in rare cases, there may be increased sensitivity of different severity of the reaction.
    In the case of the reaction of intolerance to the infusion should be discontinued immediately and start the appropriate emergency medical event.
    During the administration of hydroxyethyl starch can be increased amylase levels in the blood serum, which can interfere with the diagnosis of pancreatitis.
    a well-known side effect after prolonged administration of high doses of HES is pruritus.
    At high doses, the dilution effect can lead to dilution of blood components, reduced hematocrit, and coagulation factors and deca durabolin pills other plasma proteins.
    The introduction of hydroxyethyl starch occurring blood coagulation disorders may depend on the dose .Special warnings and precautions .

    As in the case of other solutions during the plasma-treatment to avoid fluid overload. The risk of overhydration especially increased for patients with heart failure or severe renal impairment. In this case, the indications for infusion should be clarified.
    In cases of severe dehydration, preference should be given to the brine. Particular care is required in severe hepatic failure or blood clotting disorders, including severe cases of von Willebrand disease. It is important to comply with a sufficient quantity of water, regular monitoring of renal function and fluid balance. It is necessary to monitor the serum electrolytes.
    The dosage for children should be selected individually according to the needs of the child in colloids and taking into account the severity of the underlying disease, hemodynamic parameters and water balance.
    Voluven® can be used in premature infants only after a careful assessment of risk / benefit ratio.

    The interaction with other drugs and other interactions .

    In the treatment of patients whose blood group is not set, it is necessary to bear in mind that the introduction of large volumes of HES can affect agglutination reaction and give false positive results in the determination of blood groups. Introduction of hydroxyethyl starch can increase in serum amylase. This effect should not be regarded as a violation deca durabolin pills of the function of the pancreas, as well as the result of complex formation gidroksietlkrahmala with amylase, followed by a delay its elimination through the kidneys and extrarenal ways. Currently cases of this interaction is unknown.

    Pregnancy and lactation .

    Clinical data on the use Voluven in pregnant women are not available. Animal studies revealed no direct or indirect adverse effects on pregnancy, embryo / fetus, childbirth and postnatal development. There was also no evidence of teratogenicity.
    Voluven® can be used during pregnancy only if the potential benefit of this justifies the potential risk to the fetus.
    There is currently no clinical data on the use Voluven in nursing mothers.

    Overdose .

    As in the case of other plasma solutions Voluven overdose may lead to overloading of the circulatory system (eg., Pulmonary edema). In this case, the infusion should be stopped immediately, and if necessary, type diuretic.

    Note .

    Should not be mixed with the other drug substance. If, in exceptional cases, it is required, it is necessary to check the compatibility (the appearance of turbidity or sediment), to comply with the rules of deca durabolin pills aseptic mixing and ensure good mixing. Use immediately after opening the bottle or bag. Unused solution should be discarded. Application is possible, if the solution is clear, while the packaging is intact.

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