Overview
Aprotinin (Aprotinin) Dosage and Administration:
Usually, the patient is first given an initial dose of 500,000 units, then every hour, 50,000 units. The patient should be in a supine position at the time of administration. In the following days, as a result of the improvement of the patient’s condition and laboratory parameters, the daily dose is gradually reduced to 300,000-500,000 units.
With coagulopathies (impaired function Beriplast the blood coagulation system), combined with secondary hyperfibrinolysis (enhanced dissolution of blood clots), higher doses are administered (1,000,000 units or more). With prolonged minor bleeding, it is advisable to use the product topically (1,000,000 units) using gauze soaked in 10 ml of aprotinin solution.
In the postoperative period and for prophylactic purposes, immediately before the operation, 200,000 units are administered intravenously, slowly. On the day of the operation, also on the first and second day thereafter, after 6 hours, 100,000 units are administered intravenously, slowly; possible use of the product in the form of a long drip infusion.
For children, the product is prescribed according to the same schemes as for adults, but in lower doses, depending on the body weight of the baby (the dose is calculated per kg of the baby's weight, based on the fact that the doses of the product recommended by adults are set for body weight of 70 kg).
Before the introduction of aprotinin, whenever possible, a skin test should be performed to assess the individual tolerance of the product. If side effects occur during the administration of aprotinin, discontinue the administration of the product immediately. In cases where for some reason it is impossible to carry out a continuous drip infusion, the product can prescribe administered subcutaneously after 2-3 hours.
Aprotinin (Aprotinin) contraindications:
Disseminated intravasal coagulopathy (systemic intravascular coagulation disorder); high susceptibility to the product.
Aprotinin (Aprotinin) side effects:
Allergic reactions.
Release form:
Raster for injection in ampoules of 10 ml (100 000 units) in a pack can used 25 pcs.
Synonyms:
Antagozan, Amprotibin, Gordox, Contrical, Trasilol, Traskolan.
Storage conditions:
List B. In a cool place.
Attention!
Before applying the medication "Aprotinin (Aprotinin)" need to consult a doctor.
The instruction is provided solely to familiarize yourself with " Aprotinin (Aprotinin)".
Pharmacological properties
Single-chain polypeptide consisting of 58 amino acid residues transversely linked by three disulfide bridges. Obtained from the lungs of cattle. It is a multivalent inhibitor of proteolytic enzymes (trypsin, chymotrypsin, plasmin and kallikrein). Due to its ability to inactivate, proteinases are used to treat patients with acute pancreatitis.
Aprotinin inhibiting serum fibrinolytic enzyme ?? plasmin, has a hemostatic effect in coagulopathies. The inhibitory effect on the kallikrein-kinin system allows the use of aprotinin for the prevention and treatment of various forms of shock (endotoxic, traumatic, hemolytic).
Indications
Acute pancreatitis, pancreatic necrosis, chronic recurrent pancreatitis; acute non-specific postoperative mumps; angioedema; severe forms of shock of various origins (endotoxic, traumatic, burn, hemorrhagic shock ?? as part of complex therapy); extensive and deep tissue damage; primary hyperfibrinolytic bleeding and coagulopathy, characterized by secondary hyperfibrinolysis; myocardial infarction.
Prevention of enzymatic autolysis of the pancreas during surgical interventions on this organ (sequestrectomy, cyst removal, removal of the pancreatic head for a tumor, surgery for pancreatic islet adenoma (Langerhans), surgery for pancreatic injuries, pancreatolithectomy), as well as for research glands.
Prevention of postoperative pancreatitis in operations on the abdominal organs, including operations on the bile ducts (accompanied by cholangiography), in operations for ulcerative lesions of the stomach or duodenum, penetrating into the pancreas, with partial resection of the pancreas, with splenic organs of the abdominal cavity located around the pancreas caused by its enzymatic autolysis, impaired wound healing after surgery on organs, located in the upper half of the abdominal cavity, as well as for the prevention of postoperative pulmonary emboli and bleeding, fat embolism with polytrauma, especially with fractures of the lower extremities and skull bones.
Application
The dose is selected individually depending on the condition of the patient. In acute pancreatitis ?? 500 000 ?? 1,000,000 EIC (without diluting the solution), iv at a rate of up to 5 ml / min, then 100,000 ?? 500,000 EIC daily iv. With an improvement in the general condition of the patient, the dose is gradually reduced. If necessary, treatment is continued for up to 15 days. In severe conditions after iv bolus administration, it is recommended to continue iv drip treatment at a rate of 100,000 EIC / h Beriplast 8–12 hours until improvement is achieved. With hyperfibrinolytic hemorrhage, iv is prescribed drip at a dose of 100,000 ?? 200,000 EIC, and if necessary ?? up to 500,000 EIC depending on the intensity of bleeding. For prophylactic purposes in surgery, iv or iv drip is prescribed at a dose of 200,000 × 400,000 EICs before, during and after the operation, and then 100,000 EICs over the next 2 days.
Contraindications
DIC, hypersensitivity to aprotinin, I trimester of pregnancy.
Side effects
Possible skin-allergic reactions (erythema, urticaria), rarely ?? bronchospasm, nausea, vomiting, myalgia, fluctuations in blood pressure, in rare cases ?? psychoses, hallucinations, confusion.
special instructions
Before using aprotinin, a skin test should be performed to determine possible hypersensitivity.
Interactions
