Pentastarch
When ATH:
B05AA07
Pharmacological action.
Plazmozameshchath means, hydroxyethyl starch (HES). HES – This high-molecular compound, consisting of polymerized glucose residues, which is obtained by hydroxyethylation of amylopectin – Natural polisaharidami, contained in the starch of potato and waxy maize. Amylopectin is rapidly hydrolysed in the blood, during his presence in the bloodstream is about 20 m. To improve stability and increase the duration of amylopectin subjected hydroxyethylation. The depth of this process is characterized by a degree of substitution.
The intensity and duration of action of drugs obemzameschayuschego HES defined molecular weight and degree of substitution substance HES. The higher the degree of substitution, the longer it is retained in the circulating blood HES. When the ratio of C2/C6 more 8 HES is metabolised in the body much more slowly, at a ratio of less than 8.
Pentastarch has a molecular weight of about 200 000 Daltons and a degree of substitution of about 0.5; C ratio2/C6, defining features replacement, is 6.
It improves the rheological properties of blood by reducing the hematocrit, reduces plasma viscosity, reduces erythrocyte aggregation, It contributes to the restoration of impaired microcirculation.
RES deposited in cells, that has no clinical significance.
Pharmacokinetics
After i / v infusion pentastarch subjected to intensive metabolism, being split (by amylase serum) to low molecular weight fragments. The metabolic products with a molecular weight of less than 50 000 Dalton quickly excreted by the kidneys. About 70% the dose is excreted in the urine within 24 h and about 80% – in a week.
Testimony
As a means of plasma-hypovolemia and shock, associated with surgery, wounds, infectious diseases and burns; microcirculatory disorders; Therapeutic hemodilution.
Dosage regimen
Set individually, depending on age, evidence, clinical situation. Enter a / v infusion.
Side effect
Allergic reactions: possible urticaria, anaphylactic reactions; rarely – hard, but reversible itching.
Contraindications
Gipergidratatsiya, gipervolemia, decompensated heart failure, Renal failure with oliguria or anuria, cardiogenic pulmonary edema, intracranial bleeding, severe bleeding disorders, Hypersensitivity to the HES.
Pregnancy and lactation
Pentastarch is contraindicated for use in the I trimester of pregnancy.
In experimental studies, found, that pentastarch has no embryotoxic and teratogenic effects.
Cautions
Be wary of bleeding diathesis, degidratacii (It requires a preliminary corrective therapy).
It should be taken into account, that too rapid in / introduction, as well as the use of HES in large doses can cause acute volume overload of the circulatory system.
During treatment it is necessary to control the plasma ionogram, OCK, renal function, monitor the introduction of a sufficient liquid.
With the development of hypersensitivity reactions should immediately stop the introduction of HES and carry out the necessary urgent measures.
When using HES may increase serum amylase activity, that is not associated with clinical symptoms of pancreatitis.
Pentastarch can be used for leukapheresis.
Pentastarch not mutagenic action.
Drug Interactions
Pentastarch incompatible with solutions of other drugs.
