Department of Pharmacy
Department of Nursing
Critical Care
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Generic Name: |
Dextran 40 |
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Trade Name: |
Rheomacrodex, low molecular weight Dextran, 10% Dextran 40, 10% LMD , 10% Gentran 40 |
|
Actions: |
Unknown,
but postulated to prevent or diminish platelet aggregation Plasma expansion (colloid) |
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Indications: |
-
Prophylaxis of thrombosis - Improvement of
circulation in transplantation and graft procedures - Plasma expansion |
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Administration Guidelines: |
|
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Usual Dose and Route |
Prophylaxis of
thrombosis: 2
to 3 G/hour (20-30mL/hr) IV; not to exceed 200g in 24 hours Volume expansion: 500-1000mL IV bolus over 10-30 minutes; not to exceed 20mL/kg/day during first 24 hours. |
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Standard Concentration: |
50
g/500 ml Dextrose 5 % in WATER (premixed) 50 g/500 ml 0.9 % Sodium Chloride (premixed) |
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Special Considerations: |
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Dextran 40 has been associated with severe and fatal anaphylatic reactions. patients should be monitored closely during the first
several minutes of administration. - Patients should be
adequately hydrated: low urine specific gravity or urine output may indicate
poor renal excretion of dextran and warrant discontinuing the drug. - Monitor serum
osmolality. Discontinue if greater than 300 mOsm/mL - Should not be used
in patients with severe renal insufficiency - Should be used with caution with any clinical state in which there is an increase risk of bleeding |
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Precautions and Side Effects: |
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Mild urticaria - Nausea and vomiting - Wheezing, tightness
in chest - Hypotension - Anaphylaxis - Renal failure -Concomitant administration of antiplatelet drugs greatly increases the risk of bleeding |
Rev:1/08