Dextran + Dextrose

This is indicated in thromboembolic disorders, hypovolaemic shock, pulmonary embolism, venous thrombosis

Dextrans produce expansion of plasma volume. It also reduces blood viscosity and inhibits sludging or aggregation of red blood cells.

Dextrose is a monosaccharide that is used as a source of calories and water for hydration. It helps to reduce loss of body protein and nitrogen. It also promotes glycogen deposition in the liver. When used with insulin, it stimulates the uptake of potassium by cells, especially in muscle tissue, thus lowering serum potassium levels.

Adult: IV Hypovolaemic shock As dextran 40 (10% soln): 10 mL/kg/day for up to 5 days.

Thromboembolic disorders:

• As dextran 40 (10% soln): Initial: 500 ml on day 1, followed by 500 ml on day 2 and subsequently on alternate days up to 10 days. Prophylaxis of post-op thromboembolic disorders. 500 ml during or at the end of surgery. May repeat dose next day and continue treatment on alternate days for up to 10 days in high-risk patients.

Child: As dextran 40: Up to 5 ml/kg in infants and 10 ml/kg in children.

Administration

Hypersensitivity. Severe renal disease with oliguria or anuria. Marked cardiac decompensation. Pregnancy.

Dextran:

• Enzyme inducers e.g. phenytoin or carbamazepine
• enzyme inhibitors e.g. cimetidine.

Congestive heart failure, Mild hypotension, Tightness of chest, Thrombocytopenia, Anaphylaxis, Injection site infection/phlebitis, Acute renal failure, Acidosis (if NaCI soln used), Pulmonary edema, Wheezing

Pregnancy Category - C

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks

Caution should be taken during pregnency

Plasma expanders