Dextran 40 10% + Sodium Chloride 0.9%
Indications
Dextran 40 10% + Sodium Chloride 0.9% is used for:
Thromboembolic disorders, Hypovolaemic shock, Pulmonary embolism, Venous thrombosis
Adult Dose
Intravenous
Thromboembolic disorders
Adult: As dextran 40: Initially, 500 ml of a 10% solution in sodium chloride 0.9% infused over 4-6 hr, followed by 500 ml infused over 4-6 hr on the next and subsequent alternate days for not more than 10 days.
Prophylaxis of postoperative thromboembolic disorders
Adult: As dextran 40: 500 ml of a 10% solution in sodium chloride 0.9% infused over 4-6 hr during or at the end of the surgery. Dose may be repeated the following day and treatment may be continued on alternate days for up to 10 days in high-risk patient.
Hypovolaemic shock
Adult: As dextran 40: Initially, 10 ml/kg given by rapid infusion as a 10% solution in sodium chloride 0.9% Doses may be given daily for up to 5 days.
Child Dose
Intravenous
Thromboembolic disorders
Child: As dextran 40: Up to 5 ml/kg in infants and 10 ml/kg in children.
Prophylaxis of postoperative thromboembolic disorders
Child: As dextran 40: Up to 10 ml/kg in children.
Renal Dose
Extreme caution
Administration
Contra Indications
Hypersensitivity. Severe renal disease with oliguria or anuria. Marked cardiac decompensation. Pregnancy.
Precautions
Lactation: not known if distributed into breast milk, avoid
Pregnancy-Lactation
Interactions
Dextran: Enzyme inducers e.g. phenytoin or carbamazepine and enzyme inhibitors e.g. cimetidine.
Sodium Chloride: May affect serum concentrations of lithium.
Adverse Effects
Side effects of Dextran 40 10% + Sodium Chloride 0.9% :
Congestive heart failure, Mild hypotension, Tightness of chest, Thrombocytopenia, Anaphylaxis, Injection site infection/phlebitis, Acute renal failure, Acidosis (if NaCl soln used), Pulmonary edema, Wheezing
Mechanism of Action
Dextrans produce expansion of plasma volume. It also reduces blood viscosity and inhibits sludging or aggregation of red blood cells.