Глюкоза Раствор, флакон, 200 мл, 5 %, для инфузий

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для регидратации в случаях потери жидкости особенно у пациентов с высокой потребностью в углеводах; для разведения и растворения вводимых парентерально лекарственных препаратов для профилактики и лечения гипогликемии."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"\n\nДля концентрации 5%:"}},{"type":"paragraph","data":{"text":"Декомпенсированный сахарный диабет; гиперосмолярная кома; гемодилюция и внеклеточная гипергидратация гиперволемия; гипергликемия и гиперлактатемия; тяжелая почечная недостаточность (с олигурией или анурией); декомпенсированная сердечная недостаточность; генерализованные отеки (в том числе отек легких и головного мозга) и цирроз печени с асцитом; прочие известные формы непереносимости глюкозы (например метаболический стресс); гиперчувствительность к компонентам препарата; введение раствора в течение первых 24 ч после травмы головы: использование той же инфузионной системы что и для гемотрансфузии из-за риска гемолиза и тромбоза; пациенты с известной непереносимостью кукурузы или продуктов из кукурузы (при получении декстрозы из кукурузы); противопоказания к любым препаратам добавляемым к раствору глюкозы."}},{"type":"paragraph","data":{"text":"Для концентрации 10%:"}},{"type":"paragraph","data":{"text":"Декомпенсированный сахарный диабет и несахарный диабет; гиперосмолярная кома; гемодилюция и внеклеточная гипергидратация или гиперволемия; гипергликемия и гиперлактатемия; тяжелая почечная недостаточность (с олигурией или анурией); декомпенсированная сердечная недостаточность; генерализованные отеки (в том числе отек легких и головного мозга) и цирроз печени с асцитом; прочие известные формы непереносимости глюкозы (например метаболический стресс); гиперчувствительность к компонентам препарата; введение раствора в течение первых 24 ч после травмы головы; использование той же инфузионной системы что и для гемотрансфузии из-за риска гемолиза и тромбоза; пациенты с известной непереносимостью кукурузы или продуктов из кукурузы (при получении декстрозы из кукурузы); противопоказания к любым препаратам добавляемым к раствору глюкозы."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Гипонатриемия сахарный диабет внутричерепная гипертензия детский возраст."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Для концентрации 5% и 10%:"}},{"type":"paragraph","data":{"text":"Раствор декстрозы 5% (или 10%) можно безопасно применять во время беременности и в период грудного вскармливания при условии что электролитный баланс и баланс жидкости контролируются и находятся в пределах физиологической формы."}},{"type":"paragraph","data":{"text":"Если раствор декстрозы добавляется к лекарственному препарату свойства лекарственного препарата и его применение во время беременности и в период грудного вскармливания рассматриваются отдельно."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Растворы декстрозы вводят в/в капельно."}},{"type":"paragraph","data":{"text":"5% раствор: максимально до 150 капель/мин, максимальная суточная доза для взрослых - 2 л;"}},{"type":"paragraph","data":{"text":"10% раствор: максимально до 60 капель/мин, максимальная суточная доза для взрослых - 500 мл;"}},{"type":"paragraph","data":{"text":"20% раствор: максимально до 40 капель/мин, максимальная суточная доза для взрослых - 300 мл;"}},{"type":"paragraph","data":{"text":"40% раствор: максимально до 30 капель/мин, максимальная суточная доза для взрослых - 250 мл."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Для концентрации 5% и 10%:"}},{"type":"paragraph","data":{"text":"Нежелательные реакции (HP) сгруппированы по системам и органам в соответствии со словарем MеdDRA и классификацией частоты развития НР ВОЗ:"}},{"type":"paragraph","data":{"text":"Очень часто (≥ 1/10)"}},{"type":"paragraph","data":{"text":"Часто (≥1/100 до < 1/10)"}},{"type":"paragraph","data":{"text":"Не часто (≥1/1000 до < 1/100)"}},{"type":"paragraph","data":{"text":"Редко (≥1/10000 до < 1/1000)"}},{"type":"paragraph","data":{"text":"Очень редко (< 1/10000)"}},{"type":"paragraph","data":{"text":"Частота неизвестна - (частота не может быть определена на основе имеющихся данных)"}},{"type":"paragraph","data":{"text":"Со стороны иммунной системы"}},{"type":"paragraph","data":{"text":"Частота неизвестна: анафилактические реакции повышенная чувствительность."}},{"type":"paragraph","data":{"text":"Со стороны обмена веществ и питания"}},{"type":"paragraph","data":{"text":"Частота неизвестна: нарушения водно-электролитного баланса (гипокалиемия гипомагниемия и гипофосфатемия) гипергликемия гемодилюция дегидратация гиперволемия."}},{"type":"paragraph","data":{"text":"Со стороны сосудов"}},{"type":"paragraph","data":{"text":"Частота неизвестна: венозный тромбоз флебит."}},{"type":"paragraph","data":{"text":"Со стороны кожи и подкожных тканей"}},{"type":"paragraph","data":{"text":"Частота неизвестна: повышенное потоотделение."}},{"type":"paragraph","data":{"text":"Со стороны почек и мочевыводящих путей"}},{"type":"paragraph","data":{"text":"Частота неизвестна: полиурия."}},{"type":"paragraph","data":{"text":"Общие нарушения и расстройства в месте введения"}},{"type":"paragraph","data":{"text":"Частота неизвестна: озноб лихорадка инфекция в месте инъекции раздражение в месте инъекции экстравазация болезненность в месте инъекции."}},{"type":"paragraph","data":{"text":"Лабораторно-инструментальные данные"}},{"type":"paragraph","data":{"text":"Частота неизвестна: глюкозурия."}},{"type":"paragraph","data":{"text":"Нежелательные реакции также могут быть связаны с препаратом который был добавлен к раствору. Вероятность других нежелательных реакций зависит от свойств конкретного добавляемого лекарственного препарата."}},{"type":"paragraph","data":{"text":"При возникновении нежелательных реакций введение раствора следует прекратить."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: длительное инфузионное введение препарата может привести к гипергликемии глюкозурии гиперосмолярности осмотическому диурезу и обезвоживанию. Быстрая инфузия может создавать накопление жидкости в организме с гемодилюцией и гиперволемией а при превышении способности организма окислять глюкозу быстрое введение может вызвать гипергликемию. Также может иметь место снижение содержания калия и неорганического фосфата в плазме крови."}},{"type":"paragraph","data":{"text":"При применении раствора декстрозы для инфузий для разведения и растворения других лекарственных препаратов для внутривенного введения клинические признаки и симптомы передозировки могут быть связаны со свойствами применяемых лекарственных препаратов."}},{"type":"paragraph","data":{"text":"Лечение: при появлении симптомов передозировки следует приостановить введение раствора оценить состояние пациента ввести инсулин короткого действия при необходимости провести поддерживающую симптоматическую терапию."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Для концентрации 5% и 10%:Совместное применение катехоламинов и стероидов снижает усваивание декстрозы (глюкозы).Для увеличения осмолярности 5% раствор декстрозы можно комбинировать с 09% раствором натрия хлорида."}},{"type":"paragraph","data":{"text":"При смешивании с другими лекарственными препаратами необходимо визуально контролировать их на несовместимость."}},{"type":"paragraph","data":{"text":"Для разведения или растворения других лекарственных средств препарат следует применять только при наличии указаний о разведении раствором декстрозы соответствующей концентрации в инструкции по применению на данный лекарственный препарат."}},{"type":"paragraph","data":{"text":"При отсутствии информации о совместимости препарат не следует смешивать с другими лекарственными средствами."}},{"type":"paragraph","data":{"text":"Перед добавлением какого-либо лекарственного средства необходимо убедиться что оно растворимо и стабильно в воде в диапазоне pH препарата. После добавления в препарат совместимого лекарственного средства полученный раствор следует вводить незамедлительно."}},{"type":"paragraph","data":{"text":"Лекарственные средства с известной несовместимостью использовать нельзя."}},{"type":"paragraph","data":{"text":"При введении растворов декстрозы через ту же инфузионную систему что и для гемотрансфузии возможен риск гемолиза и тромбоза."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Для концентрации 5% и 10%:"}},{"type":"paragraph","data":{"text":"Поскольку у пациентов с сахарным диабетом почечной недостаточностью или находящихся в остром критическом состоянии переносимость глюкозы (декстрозы) может быть нарушена следует особо тщательно контролировать их клинико-биологические параметры в частности концентрацию глюкозы в крови и содержание электролитов в плазме крови в том числе магния и фосфора. При наличии гипергликемии следует скорректировать скорость введения препарата или назначить инсулин короткого действия (подкожно 4-5 ЕД из расчета 1 ЕД инсулина короткого действия на 4-5 г декстрозы)."}},{"type":"paragraph","data":{"text":"Обычно глюкоза полностью усваивается организмом (в норме почками не выводится) поэтому появление глюкозы в моче может являться патологическим признаком."}},{"type":"paragraph","data":{"text":"В случае продолжительного введения или применения декстрозы в высоких дозах необходимо контролировать концентрацию калия в плазме крови и при необходимости вводить калий дополнительно чтобы избежать гипокалиемии."}},{"type":"paragraph","data":{"text":"При эпизодах внутричерепной гипертензии необходим тщательный контроль концентрации глюкозы в крови."}},{"type":"paragraph","data":{"text":"Применение растворов декстрозы может приводить к гипергликемии. Поэтому их не рекомендуется вводить после острого ишемического инсульта так как гипергликемия сопряжена с усилением ишемического повреждения головного мозга и препятствует выздоровлению."}},{"type":"paragraph","data":{"text":"Особо тщательный клинический мониторинг требуется в начале внутривенного введения препарата."}},{"type":"paragraph","data":{"text":"Для регидратационной терапии растворы углеводов следует применять в комбинации с растворами электролитов во избежание нарушения электролитного баланса (гипонатриемия гипокалиемия)."}},{"type":"paragraph","data":{"text":"Необходимо контролировать концентрацию глюкозы и содержание электролитов в крови водный баланс а также кислотно-основное состояние организма."}},{"type":"paragraph","data":{"text":"Перед применением раствор следует осмотреть. Применять только прозрачный раствор без видимых включений и при отсутствии повреждений упаковки. Вводить непосредственно после подключения к инфузионной системе. Раствор следует вводить с применением стерильного оборудования с соблюдением правил асептики и антисептики."}},{"type":"paragraph","data":{"text":"Во избежание воздушной эмболии следует удалить воздух из инфузионной системы с помощью раствора."}},{"type":"paragraph","data":{"text":"Добавляемые вещества могут вводиться перед инфузией или в ходе инфузии через место ввода (при наличии специального порта для ввода препаратов). Добавление в раствор других лекарственных средств или нарушение техники введения может вызвать лихорадку вследствие возможного попадания в организм пирогенов."}},{"type":"paragraph","data":{"text":"При развитии нежелательных реакций инфузию следует немедленно прекратить."}},{"type":"paragraph","data":{"text":"При добавлении других лекарственных препаратов перед парентеральным введением необходимо проверить изотоничность полученного раствора. Полное и тщательное перемешивание в асептических условиях является обязательным. Растворы содержащие дополнительные вещества следует применять немедленно их хранение запрещено."}},{"type":"paragraph","data":{"text":"При введении дополнительных питательных веществ следует определить осмолярность полученной смеси до начала инфузии. Полученную смесь необходимо вводить через центральный или периферический венозный катетер в зависимости от конечной осмолярности."}},{"type":"paragraph","data":{"text":"Совместимость дополнительно вводимых лекарственных средств необходимо оценить перед их добавлением в раствор (аналогично применению других парентеральных растворов). Необходимо следовать рекомендациям по разведению добавляемых лекарственных средств в соответствии с инструкцией по их применению. Необходимо проверить полученный раствор на изменение цвета и/или появление осадка нерастворимых комплексов или кристаллов. Оценка совместимости дополнительно вводимых лекарственных средств с препаратом входит в компетенцию врача."}},{"type":"paragraph","data":{"text":"С микробиологической точки зрения разведенный препарат следует применять незамедлительно. Исключение составляют разведения приготовленные в контролируемых и асептических условиях."}},{"type":"paragraph","data":{"text":"Дети"}},{"type":"paragraph","data":{"text":"У новорожденных особенно у недоношенных или родившихся с низкой массой тела повышен риск развития гипо- или гипергликемии поэтому в период внутривенного введения растворов декстрозы необходим тщательный контроль концентрации глюкозы в крови во избежание отдаленных нежелательных последствий."}},{"type":"paragraph","data":{"text":"Гипогликемия у новорожденных может приводить к длительным судорогам коме и повреждению головного мозга."}},{"type":"paragraph","data":{"text":"Гипергликемию связывают с внутрижелудочковым кровоизлиянием отсроченными бактериальными и грибковыми инфекционными заболеваниями ретинопатией недоношенных некротическим энтероколитом бронхолегочной дисплазией продолжительной госпитализацией и смертностью."}},{"type":"paragraph","data":{"text":"Во избежание потенциально летальной передозировки внутривенных препаратов у новорожденных особое внимание необходимо уделять способу применения. При использовании инфузионного насоса перед удалением системы с насоса или его отключением необходимо закрыть все зажимы системы независимо от наличия в системе устройства препятствующего свободному току жидкости."}},{"type":"paragraph","data":{"text":"Устройства для внутривенной инфузии и прочее оборудование для введения препаратов следует регулярно контролировать."}},{"type":"paragraph","data":{"text":"Если препарат содержит декстрозу полученную из кукурузы применение препарата противопоказано пациентам с известной непереносимостью кукурузы или продуктов из кукурузы так как возможны следующие проявления гиперчувствительности: анафилактические реакции озноб и лихорадка."}},{"type":"paragraph","data":{"text":"Для препаратов в контейнерах:"}},{"type":"paragraph","data":{"text":"Следует утилизировать контейнеры после однократного применения."}},{"type":"paragraph","data":{"text":"Следует утилизировать каждую неиспользованную дозу."}},{"type":"paragraph","data":{"text":"Не соединять повторно частично использованные контейнеры."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Не применимо (в связи с использованием препарата исключительно в стационаре)."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для инфузий 5% и 10% ."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В сухом недоступном для детей месте при температуре не выше 30 °С."}},{"type":"paragraph","data":{"text":"Примечание. Несмачиваемость внутренней поверхности бутылок не является противопоказанием к применению препарата."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не использовать по истечении срока указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"ОАО \"Биохимик\", 430030, Мордовия Республика, Саранск, Васенко, д. 15а, Россия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ОАО \"Биохимик\""}}]}],"source":null},"description_toggle":false,"short_description":"Глюкоза усиливает окислительно-восстановительные процессы в организме улучшает антитоксическую функцию печени усиливает сократительную деятельность миокарда является источником легкоусвояемых углеводов. Фармакодинамические свойства 5% и 10% растворов декстрозы аналогичны свойствам глюкозы - основного источника энергии клеточного метаболизма. 5% раствор декстрозы представляет собой изотонический раствор с осмолярностью 278 мОсм/л. Потребляемая калорийность 5% раствора декстрозы составляет 200 ккал /л. 10% раствор декстрозы представляет собой гипертонический раствор с осмолярностью около 555 мОсм/л. Потребляемая калорийность 10% раствора декстрозы составляет 400 ккал/л. В рамках парентерального питания 5% и 10% растворы декстрозы вводят в качестве источника углеводов (отдельно или как часть парентерального питания при необходимости). 5% и 10% растворы декстрозы позволяют восполнять недостаточность жидкости без одновременного введения ионов. Декстроза поступая в ткани фосфорилируется превращаясь в глюкозо-6-фосфат который активно включается во многие звенья обмена веществ организма. При применении растворов декстрозы для разведения и растворения вводимых парентерально лекарственных препаратов фармакодинамические свойства раствора будут зависеть от добавляемого вещества. Глюкоза метаболизируется двумя различными путями: анаэробным и аэробным. Декстроза распадаясь на пировиноградную или молочную кислоту (анаэробный гликолиз) метаболизируется до двуокиси углерода и воды с высвобождением энергии. 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