Dextran + Sodium Chloride

This is indicated in Aid in Hysteroscopy, Thromboembolic disorders, Prophylaxis of pulmonary embolism or venous thrombosis in moderate- to high-risk patients undergoing surgery, Prophylaxis of postoperative thromboembolic disorders, Hypovolaemic shock.

Dextran produce expansion of plasma volume. It also reduces blood viscosity and inhibits sludging or aggregation of red blood cells.

Sodium chloride is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives.

Intrauterine-
Aid in hysteroscopy:

• Adult: As dextran 70: 50-100 mL of a 32% solution instilled into the uterus as a rinsing and dilatation fluid.

Intravenous-
Thromboembolic disorders:

• Adult: As dextran 40: Initially, 500 ml of a 10% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr, followed by 500 ml infused over 4-6 hr on the next and subsequent alternate days for not more than 10 days.
• Child: As dextran 40: Up to 5 ml/kg in infants and 10 ml/kg in children.

Intravenous-
Prophylaxis of pulmonary embolism or venous thrombosis in moderate- to high-risk patients undergoing surgery:

• Adult: As dextran 70: Initially, 500-1000 mL of a 6% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr during or immediately after surgery, followed by 500 mL on the next day and on subsequent alternate days for up to 2 wk after surgery in high-risk patients.

Intravenous-
Prophylaxis of postoperative thromboembolic disorders:

• Adult: As dextran 40: 500 ml of a 10% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr during or at the end of the surgery. Dose may be repeated the following day and treatment may be continued on alternate days for up to 10 days in high-risk patient.
• Child: As dextran 40: Up to 10 ml/kg in children.

Intravenous-
Hypovolaemic shock:

• Adult: As dextran 40: Initially, 10 ml/kg given by rapid infusion as a 10% solution in sodium chloride 0.9% or glucose 5%. Doses may be given daily for up to 5 days. As dextran 70: Initially, 500-1000 mL of a 6% solution in sodium chloride 0.9% or glucose 5% infused at a rate of 20-40 mL/min. Maintenance: 10 ml/kg/day for3 days (Dextran 70).

Dextran: Enzyme inducers e.g. phenytoin or carbamazepine and enzyme inhibitors e.g. cimetidine.

Sodium Chloride: May affect serum concentrations of lithium.

Hypersensitivity. Severe renal disease with oliguria or anuria. Marked cardiac decompensation. Pregnancy.

GI disturbances; headache, dizziness; allergic reactions; raised liver enzyme values; alopecia; bone marrow suppression.

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Lactation.

Plasma expanders

Store at 25°C.