Reosorbilakt solution for inf. 200 ml

Pharmacological properties

Plasma substituting solution. reosorbilakt has rheological, antishock, disintoxication effect, eliminates acidosis. the main pharmacological active agents of medicine are sorbitol and sodium a lactate. at introduction to a vascular bed from sodium of a lactate are released sodium, so2 and n2o, forming hydrosodium carbonate which leads to increase in an alkaline reserve of blood. unlike hydrocarbonate solution the correction of a metabolic acidosis when using sodium of a lactate priskhodit gradually in process of inclusion it in a metabolism; at the same time there are no sharp fluctuations rn. the pharmacological activity is shown only by 50% of the entered lactate sodium (l-isomer), the second half of medicine (d-isomer) is not metabolized and removed with urine. effect of sodium of a lactate is shown in 20–30 min. after introduction. sorbitol quickly joins in metabolism, 80–90 its % are utilized in a liver and collect in the form of a glycogen. in a liver sorbitol turns into fructose which is transformed further to glucose in the beginning, and then — into a glycogen. a part of sorbitol is spent for the emergency power needs, other — is deposited in the form of a glycogen. isotonic solution of sorbitol has dezagregantny effect and thus improves microcirculation and perfusion of fabrics.

Indication

For desintoxication, improvement of microcirculation, correction of box, improvement of a hemodynamics at traumatic, operational, hemolytic and burn shock, sharp blood loss, at a burn disease, long purulent processes, infectious diseases, chronic hepatitis, for preoperative preparation and during the postoperative period, at obliterating diseases of blood vessels.

Use

In/in struyno or by drop infusion. at traumatic, burn, postoperative, hemolytic shock on 600–1000 ml (10–15 ml on 1 kg of body weight of the patient) in the beginning struyno, then by drop infusion; if necessary enter repeatedly. at chronic hepatitis enter 400 ml (6–7 ml on 1 kg of body weight) by drop infusion, repeatedly at sharp blood loss — on 1500–1800 ml (up to 25 ml on 1 kg of body weight). during the preoperative period and after surgeries in a dose of 400 ml (6–7 ml on 1 kg of body weight) by drop infusion, once or repeatedly daily within 3–5 days. at obliterating diseases of blood vessels enter at the rate of 8–10 ml on 1 kg of body weight, in/in by drop infusion every other day; on a course of treatment — 10 infusions.

Contraindication

Alkalosis, states at which input of the fluid is limited (stroke, a thrombembolia, dekompensirovanny heart failure, a stage iii hypertension).

Side effects

Alkalosis.

Special instructions

under control of indicators of box and function of a liver.

Interaction

Cannot be mixed about phosphate - and karbonatsoderzhashchy solutions.

Overdose

Is shown by an alkalosis; medicine introduction is immediately stopped.

Storage conditions

B the dry, protected from light place, at a temperature of 2-24 °C.

Relevant information

Reosorbilakt — popular Ukrainian medicine for in/in introductions which found broad application in practice of almost all specialties. despite simplicity of structure, its components join in many exchange processes in an organism of the sick person, allowing to modify a homeostasis quickly.

Structure and chemical properties

Reosorbilakt is ready crystalloid solution with plasma substituting and disintoxication properties. It is transparent solution which theoretical osmolarity is 891 mosmol/l, pH is in limits 6.00-7.60. Such characteristics provide the components which are its part: sorbitol (60.0 mg/ml), sodium lactate (19.0 mg/ml), sodium chloride (6.0 mg/ml), Calcii chloridum dihydrate (0.1 mg/ml), potassium chloride (0.3 mg/ml), chloride magnesium hexahydrate (0.2 mg/ml). Water for injections (instruction of MZ of Ukraine) acts as solvent. Drug for convenience of selection of a dose is produced in bottles for in/in introductions of 200 or 400 ml.

Pharmacodynamics and pharmacokinetics

mainly at the expense of sorbitol and sodium lactate. Sorbitol belongs to polyatomic alcohol and is known in the food industry as sweetener. But it has still a large amount of the effects used in medicine. Sorbitol due to the properties on deduction of moisture has positive impact on digestive tract as osmotic laxative. In addition, being Mannitolum stereoisomer (osmotic diuretic), it renders bile-expelling, diuretic and systemic disintoxication effect. Also sorbitol is an alternative energy source — its energy value makes 354 kcal on 100 g. It does not treat carbohydrates that allows to use it for nutritive support of patients even with diabetes without correction of a dosage of insulin. Isotonic solution of sorbitol positively influences a capillary blood-groove, improving rheological properties of blood.

Sodium the lactate is considered the most relevant means for correction of a homeostasis thanks to a number of advantages for today. First, it is an alternative energy source and is actively metabolized even in the conditions of an unstable hemodynamics. Secondly, the lactate — more favorable anion in comparison with chloride as joins in biochemical reactions and does not render side effects, characteristic of a hyperchloremia (for example violations of kidney filtration, giperkhloremichesky acidosis) (Aramendi I., 2016). Thirdly, it improves microcirculation and gas exchange (Thibault Duburcq, 2017). Besides, antiedematous effect of sodium of a lactate is implemented due to decrease in intracellular osmotic pressure.

(on action similar to effects of acid-forming diuretics).

also as a source of calcium ions which are involved in processes of transfer of a nervous impulse, the inflammatory answer, fibrillation, reduction smooth and striated muscles, especially a myocardium.

Last effect is complemented potassium with chloride which has specific effect on work of the carrying-out system of heart. Potassium ions render negative inotropic and bathmotropic and also moderate diuretic action. Introduction of the medicines containing potassium ions at a hypopotassemia of various genesis is especially relevant (for example owing to repeated vomiting and diarrhea, at long intake of diuretics, against the background of dekompensirovanny diabetes).

Effect of introduction Reosorbilakt begins

from first minutes and reaches a maximum in 20–30 min. when metabolism joins a lactate and sorbitol. At lactate sodium introduction to the blood course it is metabolized with formation of sodium of bicarbonate that promotes increase in maintenance of the alkaline buffer in blood. At the same time only a half of the administered medicament as sodium the lactate exists in the form of L- and D-isomers, first of which active is considered active, and the second is brought with urine in not changed look.

In 40–60 min. develops moderate diuretic and disintoxication effects. Further smooth decrease in effect of active ingredients of medicine is observed.

Indication and a route of administration

Reosorbilakt it is widely used both in medicine of medical emergencies, and in out-patient treatment of various diseases. Kapillyarostabiliziruyushchy and rheological properties of medicine are used for treatment of disorders of microcirculation at shock of any genesis (burn, traumatic, toxic, etc.) and also at various violations of peripheral blood supply — an endarteritis, phlebitis and thrombophlebitises (including posttraumatic), a Raynaud's disease, etc.

is Especially effective Reosorbilakt in complex treatment of intestinal impassability. In early phases of sharp impassability in combination with other methods of conservative therapy (decompression, an enema) it activates a vermicular movement of a small and large intestine and significantly improves blood supply of an intestinal wall. In late phases of intestinal impassability when intoxication and dehydration because of liquid sequestration develop in the third space, Reosorbilakt perfectly is suitable for correction of water-salt balance in a complex of preoperative preparation. At hard cases of intestinal impassability it is used during the postoperative period for prevention of paresis of intestines and the fastest healing of a zone of surgical intervention (anastomosis, an ostomy).

Also by Reosorbilakt it is shown at infectious diseases which are followed by the expressed intoxication, repeated vomiting and diarrhea and also in surgical practice at the violations causing a syndrome of the system inflammatory answer (sepsis). Reaction of an organism to specific or nonspecific defeat of an organism waste products (toxins) of various bacteria and parasites is characterized by violations of viscosity of blood and a tone of a capillary bed.

Thanks to property to improve a capillary blood-groove, we will use medicament during the early period at posttraumatic violations and also for treatment of a burn disease. In these diseases the existence of a wound surface of the big square is a prerequisite for release of a large number of mediators of pain and pro-inflammatory cytokines which negatively influence a capillary blood-groove in all organism. Also directly in a defeat zone the hypostasis quickly develops that causes development of a local tissue acidosis and violations of blood supply because of a sladzh of erythrocytes.

Thanks to holekinetichesky effect of Reosorbilakt sorbitol application in treatment of such diseases of biliary tract as dyskinesia of a gall bladder, a postcholecystectomy syndrome. As a part of complex therapy it improves bile outflow, interferes with formation of a biliary sladzh and improves processes of digestion of food.

Reosorbilakt it is shown for application as a part of complex conservative therapy at sharp pancreatitis. Effects of improvement of a capillary blood-groove, decrease in local acidosis and reduction of hypostasis have indirect effect on pathogenesis of a disease.

in neurologic practice, in particular for treatment of ischemia of a brain and diabetic neuropathy (S.A. Zhivolupov, 2013) and also at hypostasis of a brain and neuritis (Aramendi I., 2016). In these cases the major importance is attached to antiedematous effect which allows to eliminate a compression of various structures of the central and peripheral nervous system. And improvement of rheological properties of blood favorably influences the centers of tranzitorny ischemia in structures of a brain.

Dose of medicine is selected individually depending on a clinical situation and weight of a condition of the patient. Range of doses at the same time is 6–25 ml/kg of body weight. Usually Reosorbilakt is entered intravenously by drop infusion in a dose of 200-400 ml (1–2 bottles) in day. In hard cases the increase in a dose to 1000 ml and partial introduction struyno before stabilization of a state is allowed.

Contraindication

for Reosorbilakt's application carry the Alkalosis of any genesis To somatic contraindications (respiratory, metabolic, etc.), the IDCS, hemorrhage in a brain, gastrointestinal bleeding at an unstable hemostasis, sharp thrombophlebitises (because of risk of tromboembolic episodes). It is not recommended to use Reosorbilakt for first aid at injuries to a final stop of bleeding (because of property to reduce viscosity of blood medicine can prevent a thrombogenesis). Also severe forms of heart failure, a sharp renal failure belong to contraindications (in the absence of a hemodialysis).

Feature of application

Reosorbilakt can be entered exclusively intravenously. Its hit in muscle tissue or hypodermic fatty tissue can cause their necrosis because of existence in composition of Calcii chloridum.

Reosorbilakt with care to patients with cholelithiasis as its holekinetichesky effect can provoke migration of concrements from a gall bladder in the biliary tract located below.

At Reosorbilakt's overdose note the symptoms characteristic of an alkalosis. As components of medicine are metabolized in a human body, there is no need for additional correction of acid-base balance, it is enough to stop its introduction.

in a liver to fructose therefore medicine is contraindicated to patients with a rare disease — intolerance of fructose.

Sorbitol belongs to regidrant and metabolic means therefore application Reosorbilakt can be followed by strengthening of a vermicular movement and the increased gas generation.

Drug is osmotic diuretic, that is has property to bring liquid out of intercellular space in a vascular bed, sharply increasing OCK. Therefore patients should appoint medicine with care with heavy arterial hypertension. Also when assigning his patients with dehydration need to consider diuretic effect and it is obligatory to combine Reosorbilakt with other infusion or oral solutions for rehydration.

Drug is not contraindicated to pregnant women, during breastfeeding and to children. However when assigning the pregnant women need to consider potential tonic action on myometrium because of Calcii chloridum which is contained in Reosorbilakta. As for infusional therapy at children, it is necessary to dose medicine infuzomaty under stringent control of an acid-base condition of blood.

did not exclude reactions of individual intolerance.

Reosorbilakt categorically cannot be mixed with karbonato- and fosfatosoderzhashchy solutions because of a possibility of mutual neutralization or formation of insoluble salts. Drug cannot be used as solvent for other medicines.

Conclusion

Thus, finds for Reosorbilakt broad application in modern medical practice. It is suitable as for plan assignment in a complex with other medicines, and for correction of medical emergencies at a pre-hospital and hospital stage. The wide range of effects allows to include it in the plan of conservative therapy, preoperative preparation and therapy during the early postoperative period for prevention of complications (acidosis, intestines paresis, hypostases, etc.)