HAES STERIL 6% 30G/500ML INFUSION

Indications

• Hypovolemia
• Shock
• Fluid resuscitation

Dosage

Children: Refer to the BNF for Children for paediatric dosing guidelines.

Adults: Refer to the BNF for appropriate dosing guidelines depending on the clinical scenario and formulation used.

Mechanism of action

Hydroxyethyl starch works by increasing oncotic pressure in the blood, thereby drawing fluid into the vascular space. This helps to expand blood volume and improve circulation. The mechanism involves its ability to mimic natural plasma proteins, resulting in an effective volume expansion.

Pharmacodynamics

Hydroxyethyl starch acts as a colloid, helping to maintain intravascular volume. It is metabolized in the body, with its effects depending on the degree of substitution and molecular weight. The drug's colloidal properties facilitate the retention of fluid within the vascular system, which is crucial in treating conditions such as hypovolemia and shock.

Pharmacokinetics

Hydroxyethyl starch is administered intravenously and is distributed throughout the vascular system. It is gradually metabolized by the reticuloendothelial system, primarily the liver and spleen. The elimination half-life varies depending on the molecular weight and concentration of the formulation used. Higher molecular weight formulations tend to persist longer in circulation.

Pregnancy

Not established. Use with caution and only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Use with caution. Limited data available.

Storage

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

Indications

• Fluid replacement therapy
• Electrolyte balance restoration
• Induction of abortion (hypertonic solutions)

Dosage

Children: Refer to the BNF for Children for specific dosing recommendations based on the clinical context.

Adults: Refer to the BNF for specific dosing recommendations based on the clinical context.

Mechanism of action

Sodium and chloride, the major electrolytes of the extracellular fluid, work together to control extracellular volume and blood pressure. Disturbances in sodium concentrations can lead to disorders of water balance. The abortifacient activity of hypertonic sodium chloride may be mediated by prostaglandins released from damaged decidual cells, leading to uterine contractions sufficient for evacuation of the fetus and placenta.

Pharmacodynamics

Sodium, the major cation in extracellular fluid, is vital for controlling water distribution, fluid balance, and osmotic pressure. It also plays a role in regulating acid-base equilibrium alongside chloride and bicarbonate. Chloride, as the predominant extracellular anion, closely follows sodium metabolism, and fluctuations in acid-base balance correlate with changes in chloride concentration.

Pharmacokinetics

Isotonic solutions like sodium chloride are typically administered intravenously or intramuscularly, allowing for rapid systemic absorption. The distribution of sodium and chloride occurs mainly in the extracellular fluid compartment, with excretion primarily via the kidneys. Sodium levels are tightly regulated by various homeostatic mechanisms, including hormonal regulation by aldosterone.

Pregnancy

Intra-amniotic instillation of 20% sodium chloride injection can induce abortion and fetal death. Caution is advised.

Breast-feeding

Caution is advised due to potential effects on the neonate.

Storage

Store in a cool, dry place away from direct light. Protect from freezing.

Formulations

• 20% sodium chloride injection

Indications

• Nutritional supplementation
• Energy source in enteral nutrition
• Excipient in pharmaceutical formulations

Dosage

Children: Refer to specific guidelines or product inserts for dosing information, as it can vary based on the context of use.

Adults: Refer to specific guidelines or product inserts for dosing information, as it can vary based on the context of use.

Mechanism of action

Starch is broken down into glucose units by enzymes such as amylase during digestion. The glucose is then absorbed in the intestines and utilized for energy production in the body's cells. This pathway involves hydrolysis of the glycosidic bonds, converting starch into simpler sugars.

Pharmacodynamics

Starch primarily serves as an energy source. Its digestion and absorption lead to an increase in blood glucose levels, which provides energy for metabolic processes. In this context, it plays a crucial role in maintaining energy homeostasis in the body.

Pharmacokinetics

Starch is not absorbed in its polymeric form; it must first be enzymatically hydrolyzed into simpler sugars such as maltose and glucose. The digestion and absorption of starch occur predominantly in the small intestine, with glucose being readily absorbed into the bloodstream. The rate of absorption can vary depending on the type of starch and its physical form.

Adverse effects

• Allergic reactions
• Gastrointestinal discomfort
• Diarrhea
• Constipation

Precautions

• Use with caution in individuals with known allergies to starch or starch derivatives
• Monitor for gastrointestinal symptoms in patients with a history of digestive disorders

Pregnancy

Starch is generally considered safe for use during pregnancy. However, it should be consumed in moderation as part of a balanced diet.

Breast-feeding

Starch is deemed safe for nursing mothers when used in moderation as part of a balanced diet.

Storage

Store in a cool, dry place away from moisture and direct sunlight.

Formulations

• Powder
• Granules
• Tablets
• Suspensions

Mechanism of action

Sodium and chloride - major electrolytes of the fluid compartment outside of cells (i.e., extracellular) - work together to control extracellular volume and blood pressure. Disturbances in sodium concentrations in the extracellular fluid are associated with disorders of water balance. Intra-amniotic instillation of 20% sodium chloride injection induces abortion and fetal death. Although the mechanism has not been conclusively determined, some studies indicate that the drug's abortifacient activity may be mediated by prostaglandins released from decidual cells damaged by hypertonic solutions of sodium chloride. Hypertonic sodium chloride-induced uterine contractions are usually sufficient to cause evacuation of both the fetus and placenta; however, abortion may be incomplete in 25-40% of patients. /20% injection/

Pharmacodynamics

Sodium, the major cation of the extracellular fluid, functions primarily in the control of water distribution, fluid balance, and osmotic pressure of body fluids. Sodium is also associated with chloride and bicarbonate in the regulation of the acid-base equilibrium of body fluid. Chloride, the major extracellular anion, closely follows the metabolism of sodium, and changes in the acid-base balance of the body are reflected by changes in the chloride concentration.