Fluorescein Sodium
When ATH:
S01JA01
Characteristic.
Orange-red powder, easily soluble in water to form a fluorescent solutions.
Pharmacological action.
Diagnostic.
Application.
Fluorescence Angiography retinal vessels, angioscopy vasculature of the fundus and of the iris.
Contraindications.
Hypersensitivity, kidney disease, pregnancy (especially I trimester).
Restrictions apply.
Childhood (safety and effectiveness in children have not identified), polyvalent allergy (history), bronchial asthma, lactation.
Pregnancy and breast-feeding.
It should refrain from carrying out angiography during pregnancy (especially in the I trimester).
Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)
If necessary, use during lactation should be considered, that fluorescein sodium passes into breast milk.
Side effects.
Cardio-vascular system and blood (hematopoiesis, hemostasis): gipotenziya, rarely, cardiac arrest, basilar arterial ischemia.
From the digestive tract: gastrointestinal discomfort, nausea, vomiting, diarrhea or constipation.
Allergic reactions: rash, itch, bronchospasm, anaphylaxis, shock.
Other: headache, convulsions, thrombophlebitis at the injection site, rarely is the unconscious state of. When systemic absorption can cause transient fluorescence of skin and urine. When you get under the skin — skin rejection, superficial phlebitis, subcutaneous pellets, toxic neuritis along the cubital vein. Complications from extravasation can cause severe pain, continued for several hours.
Dosing and Administration.
Angiography retinal vessels: introduced into the cubital vein, fast (2-3 with). Adults - 5 ml 10% solution (fluorescence in retinal vessels appear through 12-30 with) and by the standard technique (serial pictures) carried out a diagnostic study. Repeated administration (if necessary) carried out not earlier than 3 day. Before the introduction of checking the sensitivity of the patient to the drug: in/to enter 0,1 ml 1% solution. In the absence of a local reaction through 30 min angiography. Children - 35 mg/4.5 kg.
Angiography or angioscopy vasculature of the fundus and of the iris: quickly introduced into the cubital vein. Syringe, filled with a solution for injection, connected to a transparent tube or 25-bar graph venous needle to the Sieving screen. Cannulate, gaining the patient's blood into the syringe in such a way, a small air bubble to share the patient's blood in the syringe barrel by fluorescein. When the light is slowly injected into a vein blood back, carefully watching the skin on the tip of the needle. If the tip of the needle exactly in the vein, turning off the lights and injected drug. Fluorescence in the vessels of the retina and choroidal vessels, which is seen by a standard equipment, It appears after 9-14 with. Before the introduction of the sample is carried out on an allergic reaction: 0,05 ml give/to, for 30-60 minutes, watching the reaction.
Precautions.
When administered avoided extravasates, t. to. high pH solution can lead to a strong shock surrounding tissue. In the formation of a vast infusion immediately cease extravasates, conducted conservative treatment of damaged tissue, and anesthesia.
To use caution in patients with allergies or asthma history. When allergic reactions as a matter of urgency injected epinephrine (0,1%) w / w or w / o, used antihistamines, soluble steroids and aminophylline / in. When the probability of response to the injection of fluorescein is necessary to provide the possibility of oxygenation.
Cautions.
May cause transient skin staining and urine yellowish. The coloration of the skin lasts 6-12 h, urine-24-36 h.
Do not use while wearing contact lenses because of their potential staining. After the procedure, the patient, wearing contact lenses, can use them no earlier than 1 no, pre-wash the eyes with sterile normal saline.
If it is impossible to / in, if there is no need to obtain the early phases of angiograms (eg, the diagnosis of cystoid macular edema), fluorescein sodium can be applied inside the dose 1 g. It usually takes from 10 to 15 min until, when the dye appears in the fundus.
