GELOFUSINE

Indications

• Low blood volume
• Hypovolemic shock
• Burns
• Cardiopulmonary bypass

Dosage

Children: Initially 10-20 mL per kilogram. Adjust according to the patient's condition and response, using 3.5-4% solution. Use under specialist supervision to mitigate the risk of fluid overload.

Adults: Dose according to requirements, typically administered intravenously. Consult product literature for specific dosing guidance.

Mechanism of action

Gelatin acts as a plasma expander by increasing the oncotic pressure in the vascular compartment, which helps to retain fluid within the bloodstream and restore circulating blood volume. This mechanism aids in maintaining blood pressure and improving tissue perfusion.

Pharmacodynamics

Gelatin solutions increase blood volume and improve hemodynamic stability in patients experiencing hypovolemic conditions. By drawing water into the vascular space, they help to counteract the effects of low blood volume, such as hypotension and compromised organ perfusion.

Pharmacokinetics

Gelatin is administered intravenously, and its effects can be observed relatively quickly. The half-life and the metabolic clearance depend on the formulation and concentration of the solution. Gelatin is gradually metabolized by macrophages and eliminated by the renal system. Close monitoring of fluid balance is essential, particularly in patients with cardiac or renal impairment.

Contra-indications

• Severe liver disease
• History of circulatory disease
• Severe cardiac disease

Adverse effects

• Fever
• Flushing
• Nausea
• Urticaria
• Rare or very rare shock

Interactions

• Calcium salts

Precautions

• Monitor cardiovascular and respiratory function
• Correct dehydration when administering
• Administer slowly to avoid rapid rise in blood pressure and cardiac failure
• Increased capillary permeability

Pregnancy

Consult product literature for specific guidance regarding use in pregnancy.

Breast-feeding

Consult product literature for specific guidance regarding use in breastfeeding.

Storage

Store at controlled room temperature, protect from light. Refer to product-specific storage instructions.

Formulations

• 5% solution for infusion
• 20% solution for infusion
• Concentrated solution (15-25% protein)
• Isotonic solution (3.5-5% protein)

Indications

• Chronic constipation
• Occasional constipation
• Bowel preparation for diagnostic procedures

Dosage

Children: Refer to the BNF for Children for age-appropriate dosing information.

Adults: Refer to specific guidelines or the BNF for detailed dosing information.

Mechanism of action

Polyethylene glycol acts as an osmotic agent in the gastrointestinal tract. It retains water in the lumen of the intestines through osmosis, leading to an increase in stool moisture and volume. This effect promotes peristalsis and facilitates bowel movements.

Pharmacodynamics

PEG is not absorbed from the gastrointestinal tract, thereby acting locally within the intestines. Its osmotic effect draws water into the bowel, increasing the bulk of the stool and stimulating bowel motility. The drug is generally well tolerated, with minimal side effects compared to other laxatives.

Pharmacokinetics

Polyethylene glycol is characterized by its poor absorption. It remains in the gastrointestinal tract and is excreted unchanged in the feces. The onset of action can vary, typically occurring in 1 to 3 days after ingestion, depending on the dosage and individual patient factors.

Pregnancy

Poly is not recommended during pregnancy unless the potential benefits outweigh the risks. Consult a healthcare provider for individualized assessment.

Breast-feeding

Poly may be excreted in breast milk. Caution is advised when administering to nursing mothers, and a healthcare provider should be consulted.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Indications

• Pain management
• Inflammation reduction
• Musculoskeletal disorders
• Postoperative pain

Dosage

Children: Refer to the BNF for Children for paediatric dosing recommendations, as they may differ based on age and weight.

Adults: Refer to specific guidelines or product information for adult dosing recommendations, as they may vary by condition and formulation.

Mechanism of action

Polysuccinate acts by modulating inflammatory pathways and inhibiting the synthesis of pro-inflammatory cytokines. It may also exert analgesic effects by interacting with pain receptors, thereby reducing pain perception. The action is believed to be mediated through its impact on metabolic pathways associated with inflammation.

Pharmacodynamics

Polysuccinate exhibits its pharmacological effects through inhibition of inflammatory responses and modulation of pain signaling pathways. It is thought to reduce swelling and pain in inflamed tissues, contributing to its efficacy in treating conditions like arthritis and post-surgical pain.

Pharmacokinetics

Polysuccinate is absorbed from the gastrointestinal tract, with its bioavailability dependent on the formulation used. The drug undergoes metabolic conversion in the liver, with various metabolic pathways leading to the formation of active metabolites. Excretion occurs primarily through the kidneys, with a half-life that varies based on individual patient factors.

Pregnancy

There is limited data on the use of polysuccinate during pregnancy. Caution is advised.

Breast-feeding

It is not known if polysuccinate is excreted in human milk. Use with caution.

Storage

Store at room temperature, away from light and moisture.