What Is Dextrorphan?

Dextran-40 is also called low molecular dextran, which can increase plasma colloid osmotic pressure, increase blood volume, reduce platelet adhesion and inhibit red blood cell aggregation, reduce blood viscosity, reduce peripheral circulation resistance, and clear microcirculation. It can increase the effective filtration pressure and glomerular filtration rate of the kidney and exert osmotic diuretic effect in the renal tubule.

Basic Information

Chinese name: Dextran-40
Dosage: Intravenous, not more than 20ml / kg daily

Indication: Low volume shock and thromboembolic disease
Drug alias: Low molecular dextran

Indication of dextran-40

1. Used for rescue shock, shock and toxic shock caused by blood loss, trauma, burn and other reasons. It can also prevent early disseminated intravascular coagulation due to shock.

2. For thrombotic diseases, such as cerebral thrombosis, angina pectoris and myocardial infarction, thromboocclusive vasculitis, retinal arteriovenous thrombosis, skin ischemic ulcers, etc.

3. It is used to prevent venous thrombosis after surgery (limb replantation and vascular surgery), improve blood circulation and increase the success rate of replantation.

4. It is used for extracorporeal circulation to replace part of the blood to pre-fill the artificial heart-lung machine, which not only saves blood, but also improves circulation.

Clinical Application of Dextran-40

Expand blood volume, not more than 20mg / kg daily.

Dextran-40 adverse reactions

Allergic reaction

A small number of patients may develop an allergic reaction after medication, which manifests as itching of the skin, urticaria, red pimples, etc., and can also cause asthma attacks. In severe cases, anaphylactic shock may occur, such as cyanosis of the lips, collapse, blood pressure drop, bronchospasm, etc., which usually occurs when the first dose of this medicine is dropped to a few milliliters. There have been reports of deaths due to anaphylactic shock.

Blood

Can cause coagulopathy, make bleeding longer, bleeding tendency, often related to the dose. Excessive dosage can cause bleeding, such as nosebleeds, bleeding gums, bleeding from skin and mucous membranes, bleeding from wounds, hematuria, and increased menstrual blood.

3. Other

Occasionally fever and chills. After repeated medication or long-term medication discontinuation, periodic high fever or persistent low fever may occur. Lymphadenopathy and joint pain may still be seen in a few patients. Pulmonary edema and renal failure have also been reported.

Dextran-40 Notes

1. Use with caution in patients with severe thrombocytopenia, coagulopathy, and active tuberculosis.

2. The first infusion of this product, the first few milliliter should be slowly and intravenously, and closely observe for 5 to 10 minutes after the start of injection, all abnormal signs should be discontinued immediately.

3. For patients with severe renal insufficiency and decreased urine output, this product can be quickly excreted from the kidney, increasing urine viscosity, which may cause oliguria or renal failure. Therefore, this product is contraindicated in oliguria patients. It should be discontinued once oliguria or anuria occurs during use.

4. Avoid excessive dosage, especially for the elderly, those with atherosclerosis or insufficient fluid replacement.

5. In severe shock, if a large amount of dextran is infused, a certain amount of whole blood should be given at the same time to maintain blood oxygen carrying function. If blood is not transfused at the same time, because the blood is over-diluted in time, the oxygen-carrying function is reduced, and the tissue is insufficiently supplied with oxygen, affecting blood coagulation and hypoproteinemia.

6. In some patients with more bleeding on the surgical wound, this product should not be used too much, so as not to increase bleeding.

7. People with acute vasculitis should not use this product to avoid the spread of inflammation.

8. For dehydrated patients, water and electrolyte disorders should be corrected at the same time.

9. The daily dosage should not exceed 1500mL, otherwise it will easily cause bleeding tendency and hypoproteinemia.

10. This product can be adsorbed on the cell surface and form false agglomeration with red blood cells, which will interfere with blood group identification and blood cross-matching test results. For blood group examinations of transfusion patients, cross-matching tests should be performed before using dextran to ensure blood transfusion safety.

11. This product should not be mixed with vitamin C, vitamin B12, vitamin K, dipyridamole, corticotropin, hydrocortisone, sodium succinate in the same solution.

12. Medication for pregnant and lactating women: Do not use it with painkillers or epidural anesthesia for prevention or treatment during delivery. When the mother is allergic to dextran or has an allergic reaction, it can cause uterine tension to be too high, make the fetus hypoxic, have a lethal risk or cause serious consequences for the infant's nervous system.

13. Use with caution in the following cases: those with a history of allergies, those with poor heart, liver and kidney function, and patients with active tuberculosis.

Contraindications of dextran-40

Congestive heart failure and other hypervolemia, severe thrombocytopenia, bleeding such as coagulopathy, oliguria, and allergic to this product are contraindicated.