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Hartmann SOLUTION solution for infusions
Instruction
For medical use of the medicinal product
Hartmann's solution
(Hartman's solution)
Composition:
Active ingredients: sodium chloride, potassium chloride, sodium lactate, calcium chloride dihydrate, magnesium chloride hexahydrate;
100 ml of solution contain: sodium chloride - 0.6 g; potassium chloride - 0.04 g; sodium lactate - 0.303 g; calcium chloride dihydrate - 0.02013 g; magnesium chloride hexahydrate - 0.02 g;
ionic composition per 1000 ml of solution: Na + - 129.7 mmol; K + - 5.36 mmol; Ca ++ - 1.37 mmol;
Mg ++ - 0.98 mmol; Cl ¯ - 112.74 mmol; lactate - 27.03 mmol;
excipient: water for injections.
Dosage form.
Solution for infusion.
Main physicochemical properties: clear colorless liquid; theoretical osmolarity 277.18 mosmol/l; pH 5.5-7.5.
Pharmacotherapeutic group.
Blood substitutes and perfusion solutions. Solutions used to correct electrolyte imbalances. Electrolytes.
PBX code B05B B01.
Pharmacological properties.
Pharmacodynamics.
Saline solution with balanced electrolyte content. Fills the deficit of circulating blood volume. Corrects water-base balance, has a detoxifying effect. Lactate, which is part of the drug, is converted into bicarbonate anions as a result of metabolic processes, which contribute to the restoration of the acid-base balance of the blood. The solution is close to isotonic.
Pharmacokinetics.
When administered intravenously, the osmolarity of the blood increases for a short period of time. The drug does not remain in the blood for a long time and after about half an hour passes into the tissues. The components of the drug are excreted in the urine.
Clinical characteristics.
Indication.
Hypovolemia and isotonic dehydration in combination with metabolic acidosis. For pre-, intra- and postoperative maintenance of fluid balance. Rehydration of the interstitial space after colloidal replacement of the circulating blood volume.
Contraindication.
Hypervolemia, hypernatremia (including due to the use of corticosteroids), hyperkalemia, hypermagnesemia, hyperchloremia, hypercalcemia, extracellular hyperhydration, hypertensive dehydration, alkalosis, lactic acidosis, arterial hypertension, cardiovascular and / or renal failure (including acute renal failure), liver failure (due to reduced formation of bicarbonate from lactate), pulmonary edema, thrombophlebitis, conditions with increased blood clotting, decompensated heart disease; oliguria and anuria, cerebral edema.
Interaction with other drugs and other types of interactions.
When using potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors and potassium preparations, the risk of developing hyperkalemia increases. When using the solution simultaneously with cardiac glycosides, the toxic effect of the latter is enhanced due to the presence of Ca ++ ions in the solution.
The drug is incompatible with cefamandole, amphotericin, ethyl alcohol, thiopental, aminocaproic acid, metaraminol, ampicillin, vibramycin and monocycline.
Sodium retention in the body may increase with the simultaneous use of the following drugs: nonsteroidal anti-inflammatory drugs, androgens, anabolic hormones, estrogens, corticotropin, mineralocorticoids, vasodilators or ganglioblockers.
Due to the presence of lactate, which alkalizes the pH, caution should be exercised when using the drug simultaneously with drugs whose renal elimination depends on pH. Renal clearance of salicylates, barbiturates, lithium may decrease, and sympathomimetics and stimulants (such as dexamfetamine sulfate, fenfluramine hydrochloride) may increase.
Application features.
Blood should be monitored for electrolytes, fluid, changes in pH and pCO2. The drug should be used with caution in patients with respiratory failure, acute dehydration, and in patients who are simultaneously receiving a course of corticosteroid therapy.
Due to the content of sodium ions, the drug should be used with caution in patients with congestive heart failure, especially in the postoperative period, in elderly patients, as well as in patients with clinical conditions accompanied by sodium retention and edema, in patients with hypoxia and hepatic failure.
Since the drug contains sodium lactate, it should be used with extreme caution in patients prone to hypernatremia (for example, with adrenocortical insufficiency, diabetes insipidus, or massive tissue damage) and in patients with heart disease.
Solutions containing sodium should be used with caution in patients receiving corticosteroids or corticotropin.
The use of intravenous solutions can cause fluid and/or solute overload, hyperhydration, congestion, and pulmonary edema. The risk of dilution is inversely proportional to electrolyte concentration. The risk of solution overload, which causes congestion with peripheral edema and pulmonary edema, is directly proportional to electrolyte concentration.
If any manifestations of a hypersensitivity reaction occur, the solution should be discontinued immediately and appropriate treatment should be administered.
In patients with reduced kidney function, the use of the solution may lead to sodium or potassium retention.
Calcium administration should be done with ECG monitoring of cardiac activity, especially in patients receiving digitalis. Serum calcium levels do not always reflect tissue calcium levels.
Due to the presence of calcium ions in the drug, caution is required when administered simultaneously with blood products, as there is a risk of coagulation.
Lactate is a substrate for gluconeogenesis, so blood glucose levels should be carefully monitored in patients with type 2 diabetes.
Use during pregnancy or breastfeeding.
The drug should be used during pregnancy only if the expected benefit of treatment outweighs the possible risk to the fetus. There are no clinical data on the use of the drug during breastfeeding.
The ability to influence the reaction speed when driving vehicles or other mechanisms.
There are no data on the effect of the drug on the ability to drive or operate other mechanisms, as it should be used exclusively in a hospital setting.
Method of administration and doses.
Administer intravenously. Administer intravenously drip. The dose is determined by the doctor depending on the patient's condition. The maximum rate of administration is 5 ml/kg/h, i.e. 350 ml/h with a body weight of 70 kg. The maximum daily dose for adults is 40 ml/kg/day (on average 2500-3000 ml at a rate of 60 drops/min). The duration of treatment depends on the patient's condition. During the first 24 hours, it is necessary to provide the daily requirement and half of the fluid deficit, during the next 2 days - ¼ of the fluid deficit daily. Thus, the total fluid deficit is restored within 72 hours. When restoring previously lost fluid, it is necessary to take into account the ongoing loss and restore it.
Children.
There is no experience with the use of the drug in pediatric practice.
Overdose.
In case of overdose or too rapid administration of the solution, water and electrolyte balance disorders, cardiopulmonary decompensation (including acute circulatory failure, pulmonary edema) are possible. In this case, the drug should be discontinued and symptomatic therapy should be carried out.
Excessive administration of lactate can lead to the development of metabolic alkalosis, which, in turn, may be accompanied by hypokalemia. Symptoms: mood swings, fatigue, shortness of breath, muscle weakness, polydipsia, polyuria, impaired thinking, arrhythmia. Muscle hypertonicity, twitching and tetanic convulsions may develop in patients with hypocalcemia.
Adverse reactions.
Violations of water-electrolyte and acid-base balance: electrolyte metabolism disorders (including hypernatremia, hyperkalemia, hyperchloremia), hypervolemia, hyperhydration, metabolic alkalosis, chloride acidosis.
General reactions of the body: allergic or anaphylactic reactions (increased body temperature, itching, coughing, sneezing, difficulty breathing, local or generalized urticaria, angioedema).
Infusion site changes: inflammation, swelling, rash, itching, erythema, pain, burning, numbness at the infusion site, thrombophlebitis.
Mental disorders: panic attack.
In case of adverse reactions, the administration of the solution should be stopped, the patient's condition should be assessed and appropriate assistance should be provided.
Expiration date.
5 years.
Storage conditions.
Store at a temperature not exceeding 25 ° C. Keep out of the reach of children.
Incompatibility.
"Hartmann's solution" is not recommended for use as a means for diluting antibiotics during their infusion, as well as for diluting anti-inflammatory drugs, sodium thiopental, ethyl alcohol, aminocaproic acid due to their chemical incompatibility.
Packaging.
200 ml or 250 ml, or 400 ml, or 500 ml in bottles.
Vacation category.
According to the recipe.
Producer.
Private Joint Stock Company "Infusion".
Location of production and its address of place of business.
Ukraine, 23219, Vinnytsia region, Vinnytsia district, Vinnytsia Khutora village, Nemyrivske Shosse str., 84a.
