Pharmacological properties
Gluxyl has an energetic, detoxifying, rheological, anti-shock and alkalizing effect. The main active ingredients in the drug are glucose, xylitol and sodium acetate.
Glucose is not only the main source of energy in the body, but also a necessary component for the synthesis of a number of substances. The most important of these is protein metabolism. Glucose is metabolized in all cells and serves as the most important source of energy, primarily for the brain, red blood cells and bone marrow cells. It is important that glucose is utilized even under anaerobic conditions. The maximum rate of glucose utilization by the body is 0.5 g / h.
Xylitol is a pentahydric alcohol, which when administered intravenously is rapidly incorporated into the general metabolism, 80% of which is absorbed by the liver and accumulated in the form of glycogen, the rest of xylitol is absorbed by the tissues of other organs (kidneys, heart, pancreas, adrenal glands, brain) and excreted in the urine. The product of carbohydrate metabolism - xylitol - is a pentitol and is directly included in the pentose phosphate cycle of metabolism. Xylitol, unlike fructose and sorbitol, does not cause a decrease in the liver level of adenine nucleotides (ATP, ADP, AMP), it is safe for administration to patients with increased sensitivity to fructose or with a deficiency of the enzyme fructose-1,6-diphosphatase. It is believed that xylitol has a more pronounced antiketogenic, nitrogen-preserving effect than glucose, and is equally well absorbed both in the pre- and postoperative periods. Given that xylitol is an energy source with insulin-independent metabolism, has antiketogenic and lipotropic effects, it is recommended for use as a means of parenteral nutrition for patients, especially those who have undergone surgical interventions on the gastrointestinal tract. The maximum rate of xylitol utilization is 0.25 g/kg/h.
It has been established that the combined use of glucose and xylitol does not cause an increase in the concentration of metabolites, which is observed with their separate use.
Sodium acetate is a slow-acting alkaline agent. It causes the accumulation of bases due to the metabolism of the buffered drug and is prescribed for those types of metabolic acidosis in which the accumulation of excess H + occurs slowly (for example, in renal and deficient non-respiratory acidosis). In such cases, there is no need for urgent correction, the restoration of buffer bases can occur due to the metabolism of sodium acetate. When using sodium acetate, unlike sodium bicarbonate solution, the correction of metabolic acidosis occurs more slowly, as sodium acetate is included in the metabolism, without causing sharp fluctuations in pH. Oxygen consumption during acetate metabolism is less than during lactate metabolism. Sodium acetate is completely metabolized into an equivalent amount of sodium bicarbonate within 1.5-2 hours, does not cause the phenomena of intracellular interstitial edema of the brain and increased aggregation of platelets and erythrocytes.
Due to its composition, Gluksyl belongs to the group of multicomponent hyperosmolar solutions. After intravenous administration of the drug, the osmotic pressure of the blood increases, the evacuation of fluid from the tissues into the vascular bed increases, metabolic processes are intensified, the detoxification function of the liver improves, cardiac activity increases, and diuresis increases.
Indication
The drug is recommended for use as a means to compensate for the body's need for calories during parenteral nutrition, to reduce intoxication, correct acid-base imbalances in shock conditions (taking into account blood and urine osmolarity), in burn disease, protracted purulent processes, liver diseases, various infectious diseases and toxicoinfections, and in the postoperative period.
Application
Adults Glyuksil is administered intravenously drip at a rate of 40-60 drops per minute, i.e. 1.7-2.5 ml/kg/h or 120-180 ml/h with a body weight of 70 kg.
The maximum dose is 1400 ml/day with a body weight of 70 kg or 1 g xylitol/kg body weight per day + 1.5 g glucose/kg body weight per day.
The maximum infusion rate is 180 ml/h for a body weight of 70 kg (60 drops per minute) or 0.125 g xylitol/kg body weight per hour + 0.187 g glucose/kg body weight per hour.
Contraindication
Hypersensitivity to the components of the drug, diabetes mellitus and conditions accompanied by hyperglycemia, hyperosmolar coma, anuria. Gluxyl should not be administered in cases where fluid infusion is contraindicated (edema, hemorrhagic stroke, thromboembolism, severe cardiovascular failure in the decompensation phase, stage III AG).
Side effects
Nausea, flatulence, diarrhea, abdominal pain. Gluxyl, like other hypertonic and hyperosmolar solutions, with prolonged administration may cause irritation of peripheral veins at the injection site.
Special instructions
The drug is used taking into account the osmolarity of blood and urine. Gluksyl is administered under the control of blood glucose levels and, if necessary, insulin is used. In liver diseases, the drug is prescribed under the control of liver function indicators. Since Gluksyl has choleretic properties, its administration to patients with cholelithiasis should be carried out with caution, under the supervision of a physician. The possibility of using Gluksyl during pregnancy and breastfeeding, as well as in children, has not been established.
The drug should not be mixed with phosphate- and carbonate-containing solutions. Gluksyl should not be used as a carrier solution for other drugs. Their addition may lead to physicochemical changes in Gluksyl.
Overdose
When administering large amounts of the drug, liver dysfunction and depletion of the pancreatic insular apparatus are possible. With a significant overdose of the drug, hyperglycemia, nausea, flatulence, diarrhea, abdominal pain may occur. In this case, the drug is immediately discontinued.
Storage conditions
In a dry place at a temperature of 2-25 °C. Do not allow the drug to freeze.
