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RHEOPOLYGLYCIN (RHEOPOLYGLYCINUM)
INSTRUCTION TO PREPARATION

PHARMACOLOGICAL PROPERTY Rheopolyglycyn is the preparation of low-molecular dextrane. Its specific action lays in increasing suspension quality of blood, decreasing of its ropiness, facilitating renovation of blood-flow in capillary tube, preventing and eliminating aggregation formed elements of blood. During quick transfusion volume of plasma may increase approximately twice as much comparing with the volume of given preparation.

INDICATION TO ADMINISTRATION Solution is used for facilitating capillary blood-flow as prevention and treatment traumatic, surgery, toxic and burns shocks; for improvement of arterial and phleboid blood-flow as prevention and treatment of thrombosis, thrombophlebitis, endateritis, Raynauld's disease; as addition to perfusion liquid in apparatus of artificial blood-flow while surgeries on heart; for improvement of micro-circulation and decreasing tendencies towards Thrombosis in transplantant while vascular and plastic surgeries.

ROUT Solution can be injected only after preliminary subderm testing but for cases of emergency (urgent) assistance while shock condition (in this case all possible medicaments for elimination of possible allergy reactions). Intradermal test should be made 24 hours before injection of Rheopolyglycyn.
 Method of intradermal test for defining individual sensibility to preparation.
 Take 0,2-0,3 ml of solution with a medical syringe from the bottle of Rheopolyglycyn and after changing the needle into the sterile needle inject intracutaneously 0,05 ml of preparation into the middle of the third part of internal surface of the lower arm.
 Correctness of injection of preparation in controlled visually (result - receiving "citron").
  The doctor carries out estimation of reaction after 24 hours. Local reaction in the form of redness or papules as well as symptoms of general reaction of organism (nausea, faintness) are the evidence of hypersensibility of the organism towards Rheopolyglycyn and impossibility to use it for this patient.
 One should remember that intradermal test does not give opportunity to define sensibilization towards Rheopolyglycyn with 100% of the patients. That is why in the first 5-10 min. of intravenous injection of the preparation in each case the state of the patient should be carefully observed.
 Dozes and speed of injections of the medicament are set individually.
 While disorder of cappilary blood-flow (different forms of shock) Rheopolyclycin is injected intravenously dropwise in a single doze of 10 ml/kg of body weight. For adults and children the doze per 24 hours is - to 15 ml/kg. It should be taken into account that, together with Rheopolyclycin it is efficient to inject crystalloid solutions in such quantity as to enrich and support  liquid and  electrolyte balances. While cardiovascular and plastic operations Rheopolyclycin is injected intravenously  dropwise: directly before the surgery - in doze of   5-10 ml/kg (children - 10 ml/kg); during surgery - 5 ml/kg (children 10 ml/kg); after surgery during 5 - 6 days - dropwise counting 10 ml/kg for single injection (children under 2-3 years old - to 10 ml/kg). While surgeries with artificial blood-flow Rheopolyclycin is added to blood counting from 10-20 ml/kg of body weight for fulfilling owygenator. While after-surgery period the dozes of medicament are the same as while disorder of capillary blood-flow.
 Children with different forms of shock should receive injections of 5-10 ml/ru body weight (to 15 ml /kg). During cardiovacular surgeries children aged from 2 to 3 receive injections of 10 ml/kg once per 24 hours; 3-6 years old: 7-10 ml/kg (once or twice per 24 hours); 8-13 years old: 5-7ml/kg (once or twice per 24 hours); after 14 years old -10 ml/kg per 24 hours. Solution is injected dropwise 60-90 min.

SIDE EFFECT As a rule the preparation increases diuresis, however if during injection of the preparation decrease of diuresis followed by defluvium of gluey urine is observed, this may be the evidence of deaquation of the patient's organism. In this case it is necessary to inject intravenously crystalloid solutions to supplement and support water-electrolytic balance. Allergic reactions are also possible: in such case preparations of calcium, antihistaminic, cardiovascular and other preparations are prescribed.
CONTRAINDICATION Rheopolyglycyn is contraindicated when thrombocytopenia, diseases of nephros accompanied with anuria, cardiac decompensation and in cases when it is impossible to inject large volume of liquid.

CORRELATION WITH OTHER PHARMARMACEUTICALS To increase the effect Rheopolyglycyn is combined with deintoxication preparations.

SPECIFICS OF ADMINISTRATION Rheopolyglycyn with 5% of glucose is prescribed when functional capacity of nephros is decreased or it is necessary to reduce injection of natrium-chloride. Rheopolyglycyn with isotonic solution of natrium-chloride  is prescribed when there is disorder of carbohydrate metabolism and during other states when injection of carbohydrates is prohibited.  Rheopolyglycyn is used only under supervision of the doctor. During pregnancy Rheopolyglycyn should be prescribed only when the expected positive result of the therapy for a mother exceeds potential risk for a fetus. When it is necessary to use Rheopolyglycyn during the period of lactation, it is necessary to decide the question of interruption of breast feeding.

STORAGE CONDITIONS Keep in dry place, far from the reach of children, at temperature from +10‘ to +25‘.