HAEMACEL INFUSION (Colloidal infusion of Polygeline with electrolytes 3.5%)

Indications

• Dehydration
• Hyponatremia
• Hypernatremia
• Hypokalemia
• Hyperkalemia
• Hypocalcemia
• Hypercalcemia
• Hypomagnesemia
• Hypermagnesemia
• Acid-base imbalances

Dosage

Children: Electrolyte dosing in children varies depending on the specific electrolyte and the child's condition. Refer to pa

Adults: Electrolyte dosing varies based on the specific electrolyte and the clinical situation. Refer to specific guidelines or consult with a healthcare professional for appropriate dosing.

Mechanism of action

Electrolytes exert their effects by dissociating into ions in solution, which then participate in various physiological processes. For instance, sodium and potassium ions are crucial for generating action potentials in neurons and muscle cells, while calcium ions are vital for muscle contraction and neurotransmitter release. The movement of these ions across cell membranes is regulated by transporters and channels, influencing cellular excitability and overall homeostasis.

Pharmacodynamics

Electrolytes function mainly through their roles in fluid balance and neuromuscular activity. Sodium is primarily involved in maintaining osmotic pressure and is vital for the conduction of electrical impulses in nerves and muscles. Potassium is critical for cardiac rhythm and muscle function. Calcium is essential for muscle contractions, neurotransmitter release, and blood coagulation. Magnesium serves as a cofactor for numerous enzymatic reactions and helps regulate calcium levels.

Pharmacokinetics

Electrolytes are absorbed in the gastrointestinal tract and distributed throughout the body fluids. Their levels are regulated by the kidneys, which filter excess electrolytes to maintain homeostasis. Electrolytes can be lost through sweat, urine, and feces, and their replacement may be necessary in cases of dehydration, diarrhea, or other conditions causing imbalances. The half-lives of various electrolytes can vary, but they are typically rapidly equilibrated within the body's compartments.

Contra-indications

• Severe renal impairment
• Hyperkalemia
• Hypercalcemia
• Hypermagnesemia
• Severe dehydration

Adverse effects

• Nausea
• Vomiting
• Diarrhea
• Abdominal cramps
• Hypernatremia
• Hypokalemia
• Hyperkalemia
• Arrhythmias
• Muscle weakness

Interactions

• Diuretics (especially potassium-sparing diuretics may increase serum potassium levels)
• ACE inhibitors (may increase potassium levels)
• Lithium (sodium fluctuations can affect lithium levels)
• Digoxin (potassium levels can influence digoxin toxicity)

Precautions

• Monitor serum electrolyte levels regularly
• Use with caution in patients with renal impairment
• Monitor patients with cardiac conditions closely
• Assess fluid status and hydration before administration

Pregnancy

Electrolyte supplementation should be managed carefully during pregnancy, considering the specific needs of the mother and fetus.

Breast-feeding

Electrolytes are generally safe during breastfeeding, but specific needs should be evaluated.

Storage

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

Formulations

• Oral electrolyte solutions
• Intravenous electrolyte solutions
• Electrolyte tablets or powders

Indications

• Hypovolemia
• Fluid resuscitation during surgical procedures
• Shock
• Burns

Dosage

Children: Refer to BNF for Children for appropriate dosing information.

Adults: Refer to specific clinical guidelines and BNF for dosing recommendations.

Mechanism of action

Polygeline works by increasing oncotic pressure within the vascular compartment, which draws fluid into the intravascular space from the interstitial compartments. This helps to expand blood volume and improve circulation, particularly in cases of hypovolemia due to trauma, surgery, or other causes.

Pharmacodynamics

Polygeline exhibits a rapid onset of action, with effects on plasma volume restoration observable within minutes of administration. Its colloidal properties allow it to maintain plasma volume for a sustained period, although the duration of action may vary depending on the patient's condition and the volume of fluid administered. The safety profile of polygeline is generally favorable, with minimal risk of allergic reactions or anaphylaxis compared to other colloids.

Pharmacokinetics

Polygeline is administered intravenously, where it is rapidly distributed into the vascular space. The elimination half-life is variable, influenced by factors such as the patient's renal function and fluid balance. Polygeline is metabolized in the liver and excreted primarily through the kidneys. Its colloidal nature means that it does not distribute into the interstitial space as readily as crystalloids, allowing it to maintain intravascular volume longer.

Contra-indications

• Hypersensitivity to polygeline or any of its components
• Severe dehydration
• Active bleeding disorders

Adverse effects

• Allergic reactions including rash and itching
• Headache
• Nausea and vomiting
• Hypotension
• Tachycardia
• Fluid overload

Interactions

• Caution when used with anticoagulants, as it may enhance the risk of bleeding
• May interact with diuretics, leading to altered fluid balance

Precautions

• Use with caution in patients with renal impairment
• Monitor fluid balance in patients with heart failure or hypertension
• Assess for potential allergic reactions prior to administration

Pregnancy

There are limited data on the use of polygeline during pregnancy. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is not known whether polygeline is excreted in human milk. Caution should be exercised when administering to nursing mothers.

Storage

Store at room temperature, away from light and moisture. Keep out of reach of children.

Formulations

• Intravenous solution