Средство для регидратации и дезинтоксикации, восстанавливает... Инструкция
Показания к применению
Шок термическая травма острая кровопотеря; дегидратация; кишечный свищ; острые кишечные инфекции (тяжелое течение невозможность приема регидратирующих средств для перорального приема); лечебный плазмаферез; коррекция водного и солевого баланса при остром разлитом перитоните и кишечной непроходимости.
Противопоказания
Повышенная чувствительность к компонентам средства; гипернатриемия, гиперхлоремия, гиперкальциемия, гиперкалиемия, ацидоз, хроническая сердечная недостаточность III-IV функционального класса по NYHA, отек легких, отек головного мозга, гиперкоагуляция, гиперволемия, тромбофлебит, метаболический алкалоз, тяжелая хроническая почечная недостаточность с ...
Активные вещества: натрия хлорид - 8,6 г, калия хлорид - 0,3 г, кальция хлорида гекса- гидрат (в пересчете на безводный) - 0,25 г.
Вспомогательные вещества: вода для инъекций - до 1,0 л.
Ионный состав (на 1 литр): натрия-иона 147,2 ммоль, калия-иона 4,0 ммоль, кальция- иона 2,2 ммоль, хлорид-иона 155,6 ммоль.
Теоретическая осмолярность 309 мОсм/л.
Описание
Самый известный и широко применяемый многокомпонентный физиологический раствор. Применяется как плазмозамещающее средство для восстановления нарушений водно-солевого баланса при дегидратации различного генеза, гипонатриемии, гиповолемическом шоке, при метаболических нарушениях с потерей жидкости и т.д. Входит в национальный список ЖНВЛП.
Фармакотерапевтическая группа
Электролитов баланс восстанавливающее средство
Фармакологические свойства
Средство для регидратации и дезинтоксикации, восстанавливает водный и электролитный состав крови. При использовании в качестве средства восполнения ОЦК, из-за быстрого выхода из кровеносного русла в экстравазальиое пространство, эффект сохраняется лишь в течение 30-40 мин (в связи с чем раствор пригоден только для кратковременного восполнения ОЦК).
Основной катион внеклеточной жидкости натрий участвует в контроле распределения воды, водного баланса, осмотического давления жидкостей организма. Также связывается с хлором и бикарбонатом в регуляции кислотно-щелочного баланса организма.
Основной катион внутриклеточной жидкости калий принимает участие в синтезе углеводов и синтезе белков, проведении нервного импульса и мышечного сокращения.
Кальций в ионизированной форме нужен для функционального механизма свертывания крови, нормальной функции сердца, регуляции нейромышечной возбудимости.
Основной внеклеточный анион хлор тесно связан с метаболизмом натрия, участвует в регуляции кислотно-щелочного баланса организма.
Показания к применению
Шок термическая травма острая кровопотеря; дегидратация; кишечный свищ; острые кишечные инфекции (тяжелое течение невозможность приема регидратирующих средств для перорального приема); лечебный плазмаферез; коррекция водного и солевого баланса при остром разлитом перитоните и кишечной непроходимости.
Противопоказания
Повышенная чувствительность к компонентам средства; гипернатриемия, гиперхлоремия, гиперкальциемия, гиперкалиемия, ацидоз, хроническая сердечная недостаточность III-IV функционального класса по NYHA, отек легких, отек головного мозга, гиперкоагуляция, гиперволемия, тромбофлебит, метаболический алкалоз, тяжелая хроническая почечная недостаточность с олиго- и анурией, сопутствующая терапия ГКС.
С осторожностью: артериальная гипертензия; сердечно-сосудистые заболевания (в т.ч. хроническая сердечная недостаточность I-II функционального класса по NYHA), одновременный прием сердечных гликозидов, одновременное введение с препаратами крови из-за риска коагуляции, печеночная недостаточность; преэклампсия; периферические отеки различного генеза; гиперальдостеронизм и другие патологии, связанные с гипернатриемией или гиперкалиемией (почечная недостаточность легкой и средней степени тяжести, надпочечниковая недостаточность, острая дегидратация, экстенсивный распад тканей); заболевания и состояния, предрасполагающие к повышению концентрации витамина D (в т.ч. саркоидоз).
Применение при беременности и в период грудного вскармливания
Применение при беременности и в период грудного вскармливания
Исследование возможности применения препарата Рингера раствор при беременности и в период грудного вскармливания не проводилось. В связи с этим препарат следует применять у беременных женщин только после оценки соотношения польза/риск а при применении препарата у кормящих женщин следует воздержаться от кормления грудью.
Способ применения и дозы
Суточная доза для взрослых - 5-20 мл/кг при необходимости может быть увеличена до 30-50 мл/кг.
Суточная доза для детей - 5-10 мл/кг скорость введения - 30-60 кап/мин при шоке первоначально вводят 20-30 мл/кг. Курс лечения - 3-5 дней.
При лечебном плазмаферезе вводят в объеме в 2 раза превышающем объем удаленной плазмы (12 - 24 л) в случае выраженной гиповолемии - в сочетании с коллоидными растворами. Максимальный объем вводимого раствора - 3 л/сут.
Взаимодействие с другими лекарственными средствами
При комбинации с любыми другими препаратами необходимо визуально контролировать фармацевтическую совместимость.
Одновременное применение с НПВС, андрогенами, анаболическими гормонами, эстрогенами, кортикотропином, минералокортикоидами, вазодилататорами или ганглиоблокаторами может увеличить задержку натрия в организме.
Одновременное применение с калийсберегающими диуретиками, ингибиторами АПФ, антагонистами рецепторов ангиотензина II, такролимусом, циколспорином и препаратами калия увеличивает риск развития гиперкалиемии.
Одновременное применение с тиазидными диуретиками или витамином D увеличивает риск развития гиперкальциемии.
В комбинации с сердечными гликозидами увеличивается вероятность токсических эффектов последних.
Особые указания
В случае быстрого введения большого объема необходимо контролировать кислотноосновное состояние (КОС) и концентрацию электролитов. Изменение pH крови (закисление) приводит к перераспределению ионов калия (К+) (снижение pH ведет к увеличению содержания К+ в сыворотке крови).
Влияние на способность управлять автомобилем и движущимися механизмами
Не установлено влияние препарата на способность управлять транспортом и другими механизмами.
Форма выпуска
Раствор для инфузий по 200 мл 400 мл в бутылки стеклянные. Бутылку с инструкцией по применению помещают в пачку из картона коробочного. 24 бутылки по 200 мл 12 бутылок по 400 мл в пачках помещают в ящик из гофрокартона.
Для стационара: 24 бутылки по 200 мл 12 бутылок по 400 мл с равным количеством инструкций по применению помещают в ящик из гофрокартона.
Условия хранения
При температуре не выше 25 °С. Допускается замораживание при транспортировании. Хранить в недоступном для детей месте.
Срок годности
2 года. Не применять по истечении срока годности.
Условия отпуска
По рецепту.
Производитель
Открытое акционерное общество "Красфарма" (ОАО "Красфарма"), 660042, Красноярский край, Красноярск, 60 лет Октября, д.2, Россия.
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Применяется как плазмозамещающее средство для восстановления нарушений водно-солевого баланса при дегидратации различного генеза, гипонатриемии, гиповолемическом шоке, при метаболических нарушениях с потерей жидкости и т.д. Входит в национальный список ЖНВЛП."}}]},{"id":6,"name":"Фармакотерапевтическая группа","slug":"","body":[{"type":"paragraph","data":{"text":"Электролитов баланс восстанавливающее средство"}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"Средство для регидратации и дезинтоксикации, восстанавливает водный и электролитный состав крови. При использовании в качестве средства восполнения ОЦК, из-за быстрого выхода из кровеносного русла в экстравазальиое пространство, эффект сохраняется лишь в течение 30-40 мин (в связи с чем раствор пригоден только для кратковременного восполнения ОЦК)."}},{"type":"paragraph","data":{"text":"Основной катион внеклеточной жидкости натрий участвует в контроле распределения воды, водного баланса, осмотического давления жидкостей организма. Также связывается с хлором и бикарбонатом в регуляции кислотно-щелочного баланса организма."}},{"type":"paragraph","data":{"text":"Основной катион внутриклеточной жидкости калий принимает участие в синтезе углеводов и синтезе белков, проведении нервного импульса и мышечного сокращения."}},{"type":"paragraph","data":{"text":"Кальций в ионизированной форме нужен для функционального механизма свертывания крови, нормальной функции сердца, регуляции нейромышечной возбудимости."}},{"type":"paragraph","data":{"text":"Основной внеклеточный анион хлор тесно связан с метаболизмом натрия, участвует в регуляции кислотно-щелочного баланса организма."}}]},{"id":5,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Шок термическая травма острая кровопотеря; дегидратация; кишечный свищ; острые кишечные инфекции (тяжелое течение невозможность приема регидратирующих средств для перорального приема); лечебный плазмаферез; коррекция водного и солевого баланса при остром разлитом перитоните и кишечной непроходимости."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к компонентам средства; гипернатриемия, гиперхлоремия, гиперкальциемия, гиперкалиемия, ацидоз, хроническая сердечная недостаточность III-IV функционального класса по NYHA, отек легких, отек головного мозга, гиперкоагуляция, гиперволемия, тромбофлебит, метаболический алкалоз, тяжелая хроническая почечная недостаточность с олиго- и анурией, сопутствующая терапия ГКС."}},{"type":"paragraph","data":{"text":"\u003ci\u003eС осторожностью: \u003c/i\u003eартериальная гипертензия; сердечно-сосудистые заболевания (в т.ч. хроническая сердечная недостаточность I-II функционального класса по NYHA), одновременный прием сердечных гликозидов, одновременное введение с препаратами крови из-за риска коагуляции, печеночная недостаточность; преэклампсия; периферические отеки различного генеза; гиперальдостеронизм и другие патологии, связанные с гипернатриемией или гиперкалиемией (почечная недостаточность легкой и средней степени тяжести, надпочечниковая недостаточность, острая дегидратация, экстенсивный распад тканей); заболевания и состояния, предрасполагающие к повышению концентрации витамина D (в т.ч. саркоидоз)."}}]},{"id":10,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Применение при беременности и в период грудного вскармливания"}},{"type":"paragraph","data":{"text":"Исследование возможности применения препарата Рингера раствор при беременности и в период грудного вскармливания не проводилось. В связи с этим препарат следует применять у беременных женщин только после оценки соотношения польза/риск а при применении препарата у кормящих женщин следует воздержаться от кормления грудью."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Суточная доза для взрослых - 5-20 мл/кг при необходимости может быть увеличена до 30-50 мл/кг."}},{"type":"paragraph","data":{"text":"Суточная доза для детей - 5-10 мл/кг скорость введения - 30-60 кап/мин при шоке первоначально вводят 20-30 мл/кг. Курс лечения - 3-5 дней."}},{"type":"paragraph","data":{"text":"При лечебном плазмаферезе вводят в объеме в 2 раза превышающем объем удаленной плазмы (12 - 24 л) в случае выраженной гиповолемии - в сочетании с коллоидными растворами. Максимальный объем вводимого раствора - 3 л/сут."}}]},{"id":11,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Гипергидратация гипокалиемия; аллергические реакции."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"При комбинации с любыми другими препаратами необходимо визуально контролировать фармацевтическую совместимость."}},{"type":"paragraph","data":{"text":"Одновременное применение с НПВС, андрогенами, анаболическими гормонами, эстрогенами, кортикотропином, минералокортикоидами, вазодилататорами или ганглиоблокаторами может увеличить задержку натрия в организме."}},{"type":"paragraph","data":{"text":"Одновременное применение с калийсберегающими диуретиками, ингибиторами АПФ, антагонистами рецепторов ангиотензина II, такролимусом, циколспорином и препаратами калия увеличивает риск развития гиперкалиемии."}},{"type":"paragraph","data":{"text":"Одновременное применение с тиазидными диуретиками или витамином D увеличивает риск развития гиперкальциемии."}},{"type":"paragraph","data":{"text":"В комбинации с сердечными гликозидами увеличивается вероятность токсических эффектов последних."}}]},{"id":14,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":" В случае быстрого введения большого объема необходимо контролировать кислотноосновное состояние (КОС) и концентрацию электролитов. Изменение pH крови (закисление) приводит к перераспределению ионов калия (К\u003csup\u003e+\u003c/sup\u003e) (снижение pH ведет к увеличению содержания К\u003csup\u003e+\u003c/sup\u003e в сыворотке крови). "}}]},{"id":16,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Не установлено влияние препарата на способность управлять транспортом и другими механизмами."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для инфузий по 200 мл 400 мл в бутылки стеклянные. Бутылку с инструкцией по применению помещают в пачку из картона коробочного. 24 бутылки по 200 мл 12 бутылок по 400 мл в пачках помещают в ящик из гофрокартона."}},{"type":"paragraph","data":{"text":"Для стационара: 24 бутылки по 200 мл 12 бутылок по 400 мл с равным количеством инструкций по применению помещают в ящик из гофрокартона."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре не выше 25 °С. Допускается замораживание при транспортировании. Хранить в недоступном для детей месте."}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года. 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