Method for prevention of spinal headache in bone marrow donors in spinal and combined spinal epidural anaesthesia
SUBSTANCE: invention refers to medicine, namely to anaesthetics, and can be used for the prevention of spinal headache during spinal or combined spinal epidural anaesthesia in bone marrow exfusion. That is ensured by an intravenous infusion of 6% hydroxyethylstarch 500 ml 30 minutes before the subarachnoid puncture and the spinal and combined spinal epidural puncture or for the first 30 minutes of the anaesthesia.
EFFECT: invention provides preventing postoperative spinal headache in this group of patients.
1 dwg, 1 tbl, 4 ex
The invention relates to medicine, namely to anesthesiology and critical care medicine.
There are ways to prevent postfunctional headache with a puncture subarachnoid space, based on the use of needles of small diameter with a blunt end with a cut parallel to the fibers of the Dura and more acute (15 degrees) angle of the needle relative to the dural sack (Gelfand B. R., Kiriyenko P. A., Grinenko, T. F., reference No. 1, E. Shifman M, reference number 2, Morgan J. Ed., Michael M. C. reference No. 3, Arendt K, Demaerschalk BM, Wingerchuk DM, Camann W. Neurologist, reference No. 4, Schmittner MD, Urban N, Janke A, Weiss C, Bussen DG, Burmeister MA, Beck GC., reference No. 5).
However, these methods of prevention postfunctional headache does not allow, in practice, individually and guaranteed to perform prevention postfunctional headache.
The known method has significant drawbacks, as it is not always possible to prevent this complication. Described cases where, despite the use of needles of small diameter with a blunt end, there were complications in the form of postfunctional headache (Schmittner MD, Terboven Τ, Dluzak Μ, Janke A, Limmer ME, Weiss C, Bussen DG, Burmeister MA, Beck GC, reference No. 6).
As the prototype accepted method of prevention postfunctional headache, requires the use of a needle of small diameter, the tra with a blunt end and cut, the parallel fibers of the Dura, because previously it was found that postfunctional headache occurs mainly when using the puncture needle large diameter (less than 25 G).
The purpose of the invention is to provide a method for prevention postfunctional headache, can prevent the development of this complication as during spinal spinal-epidural anesthesia, and after its completion.
The essence of the invention lies in the fact that in the proposed method of prevention postfunctional headache when performing spinal or spinal-epidural anesthesia when exposee bone marrow 30 minutes prior to puncture of the subarachnoid space and the beginning of the spinal cord, spinal-epidural anesthesia or during the first 30 minutes after the start of anesthesia carry out intravenous infusion of 6% hydroxyethylamine in a volume of 500 ml, which is an increase of circulating blood volume, profilaktirujut arterial hypotension, which is a risk factor postfunctional headache.
The use of the invention allows to obtain the following technical result, the way in spinal spinal-epidural anesthesia to perform early prevention, preventing the development of postfunctional headache
The technical effect is achieved due to the fact that during the 30 minutes prior to lumbar puncture to conduct spinal anesthesia with the donation of bone marrow in an adult patient (donor) is the infusion of 500 ml of 6% solution of hydroxyethylamine.
The method is as follows: within 30 minutes before spinal puncture for conducting spinal anesthesia with the donation of bone marrow in an adult patient (donor) or within 30 minutes after spinal puncture is intravenous infusion of 500 ml of 6% solution of hydroxyethylamine.
Example 1: the Donor bone marrow D., 53 years. Were expose bone marrow in terms of spinal-epidural anesthesia. After one hour from the onset of anesthesia, there was a decrease in mean arterial pressure 65 mm RT.article and diastolic blood pressure by up to 38 mm RT.art., and reduced vegetative index to -1, which corresponds to parasympathicotonia. In connection with the developed arterial hypotension was introduced 500 ml of a colloidal solution. In total during General anesthesia infusion volume was 3000 ml, of these colloids is 20%, the rest - crystalloid solutions. After 20 hours after spinal anesthesia from the donor appeared headache, worse when moving in a vertical position, nausea, vomiting. This rigidness the cervical muscles were absent. Within 7 days were symptomatic therapy, which helped to arrest postfunctional headache.
Example 2: the Donor bone marrow N., 42 years. Expose bone marrow in terms of spinal anesthesia. 30 minutes before spinal anesthesia was introduced 500 ml of 6% solution of hydroxyethylamine. During the intraoperative period smooth. During anesthesia, ventilation and hemodynamic disturbances were noted. The organs and systems without features. In the postoperative period postfunctional headache not occurred.
Example 3:. Donor bone marrow C., 35 years. Were expose bone marrow in terms of spinal anesthesia. 30 minutes prior to lumbar puncture and injection of anesthetic was performed by infusion of 500 ml of 6% solution of hydroxyethylamine. During the intraoperative period smooth. During anesthesia, ventilation and hemodynamic disturbances were noted. HELL within 95-80/70-50 mm RT.art., the heart rate of 90-100 beats per minute. The organs and systems without features. The postoperative period without complications postfunctional headache not occurred.
Example 4: a bone marrow Donor that is, 27 years. Expose bone marrow in terms of spinal anesthesia. 10 minutes after the beginning of anesthesia introduced 500 ml of 6% solution of hydroxyethylamine. For intra who personnage period smooth, ventilation and hemodynamic disturbances were noted. HELL within 100-90/70-60 mm RT.art., pulse 55-85 beats per minute. The organs and systems without features. The postoperative period without complications, postfunctional headache not occurred.
The examples illustrate the results summarized in the table. 1 and in Fig. 1. Previously intravenous injection of colloidal solution in 500 ml completely prevents the development postfunctional headache.
Figure 1 in the main group of 50 people (hatched bars) were conducted intravenous colloidal solution 30 minutes before the start of anesthesia or during the first 30 minutes after it started. In the control group (white bars) introduction colloidal solutions was carried out urgently in 40 minutes after the start of anesthesia in connection with a fall in blood pressure due to symptoms of parasympathetic tone of the nervous system. As a result of application of the proposed technology 50 donors were not observed postfunctional headache, whereas in 9 donors, which was not applied this technology has been registered postfunctional headache, sometimes lasting up to 7 days.
1. Gelfand B. R., Kiriyenko P. A., Grinenko, T. F. Digger. Anesthesiology and intensive therapy. Practical is the resource guide for physicians. 2006
2. Shifman Ε. M. Spinal anesthesia in obstetrics. 2005
3. Morgan J. Ed., Michael M. C. Clinical anesthesiology. Book 1. 2001
4. Rathmell D. P. Regional anesthesia. 2007
5. Arendt, Demaerschalk BM, Wingerchuk DM, Camann W. Neurologist. Atraumatic lumbar puncture needles: after all these years, are we still missing the point. 2009:15(l):17-20.
6. Schmittner MD, Urban N, Janke A, Weiss C, Bussen DG, Burmeister MA, Beck GC. Int J Colorectal Dis. Influence of the pre-operative time in upright sitting position and the needle type on the incidence of post-dural puncture headache (PDPH) in patients receiving a spinal saddle block for anorectal surgery. 2011: 26(1):97-102.
7. Schmittner MD, Terboven T, Dluzak M, Janke A, Limmer ME, Weiss C, Bussen DG, Burmeister MA, Beck GC. High incidence of post-dural puncture headache in patients with spinal saddle block induced with Quincke needles for anorectal surgery: a randomised clinical trial. 2010: 25 (6): 775-81.
The way to prevent postfunctional headache when performing spinal or spinal-epidural anesthesia when exposee bone marrow, which consists in the fact that 30 minutes prior to puncture of the subarachnoid space and the beginning of the spinal cord, spinal-epidural anesthesia or during the first 30 minutes after the start of anesthesia carry out intravenous infusion of 6% hydroxyethylamine in the volume of 500 ml
SUBSTANCE: invention refers to medicine, namely to cardiovascular surgery, and concerns preventing a diffuse intra- and postoperative blood loss in surgery of abdominal aorta. To this effect, performing the aortoiliac operations is combined with measuring preoperative antithrombin III; if the measured value is less than 87±3%, a thromboelastography is performed from the moment of an anaesthetic support started with determining a coagulation index. If the coagulation index is less than 2.89±0.25 as early as at the start of the stage of approaching the abdominal aorta, before any surgically significant blood loss, fresh-frozen plasma of the identical group in a min. amount of 600 ml is administered into the patient. If the following dynamic control shows a decrease of the coagulation index below 1.10±0.28, at least 600 ml of fresh-frozen plasma is additionally administered, providing thereby the coagulation index by the end of the operation not less than 0.52±0.27.
EFFECT: method provides effective prevention of intra- and postoperative blood loss by prevention of intraoperative homeostatic disorders.
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to a concentrated acidic component for producing a hemodialysis solution. The acidic component contains the following ingredients in an amount of producing 1 litre of the solution in water purified for hemodialysis: 204.7-215.0 g of sodium chloride NaCl, 6.2-9.0 g of calcium chloride CaCl2*2H2O, 3.56-7.12 g of magnesium chloride MgCl2*6H2O, 5.22-10.44 g of potassium chloride KCl, 0.021-6.28 g of acetic acid and 0.02-6.2 g of succinic acid. Also, the invention refers to the hemodialysis solution containing the above concentrated acidic component, water purified for hemodialysis, and bicarbonate component. The invention also refers to a method for producing the hemodialysis solution with the method involving supplying the concentrated acidic component into a hemodialysis apparatus, diluting with water purified for hemodialysis, and mixing with bicarbonate component. What is also declared is a kit for producing the concentrated acidic component containing sodium chloride, calcium chloride, magnesium chloride, potassium chloride, succinic acid in the form of dry agents and acetic acid in the form of a liquid agent.
EFFECT: invention provides higher effectiveness by a biochemical compatibility with blood plasma of the hemodialysis solution.
36 cl, 18 tbl, 16 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention relates to a composition, adapted for intravenous introduction, intended for the treatment or prevention of pathological processes of crystallisation or calcification in a person, subjected to dialysis. The composition contains inositol phosphate and/or its pharmaceutically acceptable salt, with a dose of inositol phosphate and/or its salt constituting from 1 nmol/kg to 0.1 mil/kg. The invention also relates to a combined method of treatment, including the intravenous introduction of the said composition of the dialysis liquid simultaneously.
EFFECT: method is intended for the treatment or prevention of pathological processes, associated with an impairment of the regulation of physiologically adequate levels of inositol phosphate in blood plasma of the person, subjected to dialysis.
10 cl, 4 dwg, 1 tbl, 9 ex
SUBSTANCE: what is declared is an infusion solution for filling the deficiency and meeting the physiological needs for water and basic electrolytes, which contains the following ingredients: sodium (Na+) - 27.72-28.28 mmole/l; fumarate(H2C4O4 2-) - 13.86-14.14 mmole/l; potassium (K+) - 18.61-18.99 mmole/l; calcium (Ca2+) - 3.56-3.64 mmole/l; magnesium (Mg2+) - 2.18-2.22 mmole/l; chlorine (Cl-) - 30.0-30.6 mmole/l; glucose (C6H12O6) - 189.1-192.9 mmole/l, water for injections.
EFFECT: solution contains the basic electrolyte concentration balanced for meeting the physiological needs; it is safe for the clinical application and can be used in diseases of various aetiology for patients of any age.
1 tbl, 2 ex
SUBSTANCE: invention refers to medicine and aims at intraoperative and early postoperative infusion therapy. A method involves administering a crystalloid balanced solution of sterofundin iso and a balanced colloidal solution of tetraspan. In the intraoperative period, sterofundin is administered with tetraspan in the volume ratio 3:1. In the early postoperative period, for the first day, sterofundin and tetraspan are administered in the volume ratio 6:1.
EFFECT: method is simple, safe, enables effectively correcting aqueous electrolyte disorders, stabilising systemic hemodynamic parameters, causing no negative effect on haemostasis and electrolyte composition of the blood serum.
1 ex, 1 tbl
SUBSTANCE: invention relates to a concentrated acid component for bicarbonate hemodialysis. The acid component includes sodium (Na+) in an amount of 2450.0-4550.0 mEq/l, chlorine (Cl-) in an amount of 2453.5-4553.5 mEq/l, hydrogen H+ (hydrochloric acid), succinate and citrate, each in an amount of 3.5-98.0 mEq/l. The invention also relates to a diluted acid component for bicarbonate hemodialysis, which includes sodium chloride 70.0-130.0 mEq/l, hydrochloric acid 0.1-2.8 mEq/l, succinic acid 0.1-2.8 mEq/l, and citric acid 0.1-2.8 mEq/l. The invention also relates to a concentrate for preparation of the acid component, which contains hydrochloric acid in a liquid form, and all other components in a dry form, as well as to a method of obtaining the acid component, which includes dissolution of dry chemical reagents from the said concentrate in water and addition of liquid reagents.
EFFECT: invention ensures obtaining a solution for dialysis, applied in case of acute and chronic renal failure.
14 cl, 1 tbl, 3 ex
SUBSTANCE: before transfusion, a preserved blood sample of 2 ml is mixed with an ozonised solution of 0.9% sodium chloride with the ozone concentration of 2 mg/l in the equivalent volume. The 15-minute exposition is followed by evaluating the 2,3 diphosphoglycerate concentration in the prepared packed red cell suspension. The 2,3 diphosphoglycerate concentration in the packed red cell suspension more than 6 mcmole/l testifies to the high effectiveness of planned hemotransfusion.
EFFECT: using the invention provides higher accuracy of determining the suitability of the preserved packed red cells for transfusion that ensures higher clinical effectiveness in the severe patients by fast and stable correction of oxygen delivery and consumption preferentially by functionally adequate red cells.
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to pharmaceutical industry and represents a formulation of a perfluorinated blood substitute emulsion for biomedical applications, containing: perfluorinated hydrocarbons, emulsifying agents and an electrolyte solution differing by the fact that it contains a binary mixture of two perfluorinated hydrocarbons in ratio 1.55 to 1.99 in the concentration of 5 - 1000 g/l, with an average particle size of a perfluororganic compound of 25 - 250 nm; a binary mixture of the emulsifying agents in ratio 1.55 to 1.99 that are non-ionic block copolymers of ethylene oxide and propylene oxide - proxanoles: proxanole-268/proxanole-168; proxanole-268 in the concentration of 1 - 200 g/l with the molecular weight of 7 - 14 thousand Da; proxanole-168 in the concentration of 1 - 200 g/l with the molecular weight of 5 - 7 thousand Da; the electrolyte solution: NaH2PO4 - 0.18-0.25 g/l; NaCl - 5.5-6.5 g/l; and/or KCl - 0.37-0.41 g/l; and/or MgCl2 - 0.17-0.21 g/l; and/or NaHCO3 - 0.35-0.7 g/l; and/or glucose - 1.5-2.5 g/l.
EFFECT: invention ensures formulating the perfluorinated blood substitute with better aggregation and sedimentation stability and lower toxicity.
2 cl, 9 ex
SUBSTANCE: invention relates to medicine, namely to surgery, anesthesiology and intensive therapy, oncology, and can be applied in operations on account of non-organ retroperitoneal tumours. For this purpose prognostic criteria are determined on the basis of clinical and anamnestic parameters: Long stands for longitudinal dimension of tumour, in cm; Transv stands for transverse dimension of tumour, in cm; Rad stands for radical character of operation: 1 point means presence of radical intervention; 0 points means absence, palliative surgery, exploratory laparotomy; AddRes means carrying out additional resection of organs: 1 point means presence of organ resection; 0 points means operation only on tumour ablation; PorS stands for surgery on main vessels: 1 point stands for vascular plasty of arteries, resection of fragments of inferior vena cava, aorta; DifG stands for diffusion growth of tumour without capsulation: 1 point means presence; 0 points means absence. After that, coefficient of regression Z is calculated: Z=-0.581+0.038×Long+0.02×Transv+0.073×Rad+0.166×AddRes+0.133×PorS+0.102×DifG and substituted into formula:
EFFECT: method makes it possible to select optimal tactics of compensation of intravascular volume of colloids in operations in said category of patients due to more accurate calculation of blood loss volume.
SUBSTANCE: invention relates to medicine, namely to intensive therapy and narcology, and can be used in treatment of patients with frostbites, who are in the state of narcotic intoxication of different severity. For this purpose determined are: area of affection, degree of frostbite, degree of narcotic intoxication, physiological needs of organism and pathological loss during a day. After that, volume of infusion therapy is calculated by formula: V=(Cfs×S)+(Cn×MVDIT)+PN+PL, where: V is volume of infusion therapy, in ml; Cfs is coefficient of frostbite severity: 1.0 in case of I and II degree frostbites; 2.0 in case of III-IV severity degree frostbite; S is area of affected surface, in cm2; Cn is coefficient of narcotic intoxication severity: 1.0 - in case of changed reactivity to narcotic substance; 1.5 - in case of psychic dependence (obsessive attraction); 2.0 - in case of physical dependence (compulsive attraction); 2.5 - in case of abstinence syndrome; MVDIT is minimal volume of disinfection infusion therapy in case of application of dezomorphin, equal to 1250 ml of infusion solutions per day; PN stands for physiological needs of organism during a day; PL stands for pathological loss during a day, constituting 500 ml in case of I and II degree of frostbites and 1000 ml in case of III and IV degree of frostbites.
EFFECT: method ensures adequate and differentiated performance of infusion therapy in said category of patients taking into account degree of narcotic intoxication, which contributes to prevention of "mutual aggravation", minimisation of disorders of hemostasis, microcirculation, as well as prevention of encephalopathy of complex genesis, including carrying out necrotomy and fasciotomy.
SUBSTANCE: pulmonary injury is simulated by the intratracheal administration of acetone 0.03ml into rats. One hours later, a combined solution containing 7.2% sodium chloride and 6% hydroxyethyl starch, in an amount of 4 ml/kg is administered intravenously once.
EFFECT: reducing animal mortality by reducing hypoxemia and an area of the infiltrative pulmonary injury, preventing an alveolar pulmonary oedema and a degree of haemorrhagic impregnation.
2 dwg, 2 tbl
SUBSTANCE: starch or sorbite photosensitiser powder is administered into a laryngeal pharynx that is further exposed to laser light. The laser light exposure is performed at wave length 0.685 mcm, powder 18-20 mWt, energy density 18-28.8 J/cm2.
EFFECT: implementing the method provides the reliable laryngeal fixation of the photosensitiser, maintains the constant concentration of the photosensitiser for the whole therapeutic session, and thereby faster reduction of the inflammatory process.
2 cl, 4 ex
SUBSTANCE: invention refers to medicine, namely surgery and intensive care, and may be used in treating the patients with developed sepsis with underlying abdominal and retroperitoneal diseases. For this purpose, the management starts with a session of endotoxin absorption. That is followed by the intravenous administration of a bactericidal antibiotic, e.g. such as β-lactam or fluoroquinolone in the amount of 1.1-1.5 daily dose; then 30-60 minutes later, endotoxin sorption is combined with de-hydration hemofiltration in a dose of 45 ml/kg/h for 6-8 hours. The whole procedure is accompanied by the infusion therapy using active solutions specified in a group of low- and high-molecular hydroxyethyl starch and dextran in the amount of 5-10 ml/kg/h. Before the beginning of endotoxin sorption, as well as one day after the termination of hemofiltration and sorption, the blood endotoxin concentration is controlled. If the recorded endotoxin concentration is decreased at least by 60%, another procedure is performed.
EFFECT: method provides higher survival rate in the patients suffering the above pathology, as well as reduces a risk of septic shock ensured by the pathogenically caused regimen of the combination of various human body effects providing a degree of systemic endotoxemia to be decreased.
2 cl, 2 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to pharmaceutical industry, and represents a composite probiotic preparation containing probiotic lactic acid bacilli and bifidus bacteria cells, or mixtures thereof, and a polymer additive in an enterosoluble capsule, differing by the fact that the probiotic lactic acid bacilli and bifidus bacteria cells belong to the species Lactobacillus plantarum, Lactobacillus fermentum, Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum, Bifidobacterium longum, while the polymer additive used as a binding agent and being a polysaccharide, is specified in a group: amylopectin, waxy corn starch, native potato starch, soluble potato starch, wheat starch, maltodextrin, or mixtures thereof with the above ingredients of the composite preparation are taken in ratio 108-1012 probiotic lactic acid bacilli and bifidus bacteria cells per 0.01-1 g of the polymer additive.
EFFECT: invention provides creating more effective and stable probiotic preparation for preventing and treating intestinal dysbacterioses and intestinal infections, as well as increasing an ability of the preparation to produce nitrogen monoxide by NO-synthase mechanism.
2 cl, 1 ex, 1 tbl, 5 dwg
SUBSTANCE: invention refers to medicine and aims at prevention of complications following the intestinal operations, at prevention of intestinal anastomotic leak, ischemic disorders in enteroenteroanastomosis in periotonitis, acute intestinal obstruction. There are involved the intra- and immediate postoperative introductions of hydroxyethyl starch (HES) 130/0.4 and balanced polyionic crystalloid solutions in ratio 1:3. The volume is gradually reduced to achieve the volume 3 times less than the initial one by the 7th day.
EFFECT: method enables reducing a probability of postoperative intestinal anastomotic leak.
FIELD: medicine, pharmaceutics.
SUBSTANCE: declared invention refers to chemical-pharmaceutical industry, and concerns a plasma-substitute compound with the rheological and hemodynamic properties on the basis of a block copolymer of ethylene oxide and propylene oxide, and hydroxyethylstarch, and using it in medicine and cosmetology.
EFFECT: preparing the plasma-substitute compound with the improved rheological and hemodynamic properties of mixed two active ingredients: the surfactant proxanol - the block copolymer of ethylene oxide and propylene oxide of molecular weight 1 to 20 kDa and the hemodynamic agent hydroxyethylstarch of molecular weight 40 to 200 kDa in the ratio of 1/1 to 10/10 respectively with an acceptable electrolyte solution.
10 cl, 8 ex
SUBSTANCE: invention relates to medicine, radiodiagnostics and can be used for detection and evaluation of extension of cervical tumours by means of magnetic-resonance tomography with application of intravaginal contrasting viscous substance (IVCVS). First, carried out is native examination of area of interest with analysis of T1 fast spin-echo SI in sagittal, axial planes and in plane with perpendicular location of examination axis to tumour, as well as coronary T2 SI in mode with fat-suppression. After that, performed is dynamic examination with contrast amplification in the same planes. Double contrasting is performed, which includes intravenous introduction of contrasting preparation gadolinium and intravaginal introduction of IVCVS, as such used is colloidal starch solution with viscosity 55000-65000 cP in volume 80-120 ml. Dynamic scanning is started when contrasting preparation in visualised in terminal part of abdominal aorta.
EFFECT: method ensures high accuracy of evaluation of tumour extension, increase of visualising image characteristics due to contrasting light background with respect to dark vagina wall, reduction of IVCVS allergenicity.
2 dwg; 2 ex
SUBSTANCE: invention relates to medicine, radiodiagnostics and can be used for detection and estimation of spread of tumours located in rectal ampulla, by method of magnetic resonance tomography. Method includes native and dynamic MR-examination in axial, sagittal and coronary planes, with application of intrarectal contrasting viscous substance (ICVS) and intravenous contrasting preparation of gadolinium, with further comparative analysis of images. As ICVS used is colloidal solution of starch with viscosity 55000-65000 cP in volume 150-200 ml. Dynamic MR-examination is started when contrasting preparation of galidonium is detected in terminal part of abdominal aorta.
EFFECT: method ensures reduction of ICVS allegenicity and increase of image visualisation characteristics due to contrasting light background relative to dark intestine wall.
2 dwg, 2 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention relates to chemistry and deals with a pharmaceutical substance based on hydroxiethylated starch, its production method and a pharmaceutical composition for production of a medication with volemic action. The invention may find application in chemistry and medicine. The pharmaceutical substance represents a water-soluble powder of amylopectin hydroxiethylated starch with ratio of substituted hydroxiethylated C2/C6 atom groups is equal to 2 - 20, average molecular weight (Mw) remaining within the range of 100-450 kDa and the substitution degree amounting to 0.25-0.75. For production of the pharmaceutical substance of hydroxiethylated starch one uses starch with amylopectin content equal to 60-98% that is hydrolysed in suspension with an acid until an inherent viscosity value [η]=0.10-0.2. The hydrolysed starch is dissolved in water at T=70-105°C, hydroxiethylated in an inert gas atmosphere an alkylating agent and a catalyst until substitution degree is 0,25-0.75. The reaction mixture is neutralised; the produced solution is cleared of low-molecular fractions of hydroxiethylated starch and impurities by ultrafiltration method, filtered in a sterile way and dried. Additionally, the invention deals with a pharmaceutical composition for production of a medication with volemic action using the above method.
EFFECT: development of a pharmaceutical substance volemic action as well as optimisation of the pharmaceutical substance production method enabling regulation of substitution degree within the interval required, obtaining a favourable ratio of substituted hydroxiethyl groups.
21 cl, 5 ex
SUBSTANCE: present invention provides water-soluble iron-carbohydrate derivative complexes which are suitable for the therapy of iron deficiency states, and the preparation thereof, medicaments comprising them, and the use thereof in the prophylaxis or therapy of iron deficiency states. The medicaments are suitable in particular for parenteral administration. A water-soluble iron-carbohydrate derivative complex obtained from the reaction of an aqueous iron (III) salt solution and (b) an aqueous solution of the product of the oxidation and subsequent derivatization of one or more maltodextrins, wherein the oxidation is carried out with an aqueous hypochlorite solution at a pH value in the alkaline range, wherein when one maltodextrin is used its dextrose equivalent is from 5 to 20 and when a mixture of a plurality of maltodextrins is used the dextrose equivalent of the mixture is from 5 to 20 and the dextrose equivalent of the individual maltodextrins in the mixture is from 2 to 40, and the subsequent derivatization is carried out with a suitable reagent. The process for the preparation of the iron-carbohydrate complex, wherein one or more maltodextrins is oxidized in aqueous solution, at an alkaline pH value, with an aqueous hypochlorite solution, the subsequent derivatization is carried out with a suitable reagent, and the resulting solution is reacted with the aqueous solution of an iron (III) salt, wherein when one maltodextrin is used its dextrose equivalent is from 5 to 20 and when a mixture of a plurality of maltodextrins is used the dextrose equivalent of the mixture is from 5 to 20 and the dextrose equivalent of the individual maltodextrins in the mixture is from 2 to 40.
EFFECT: most derivatised maltodextrin ligands exhibit increased stability towards enzymatic degradation by amylase as compared with underivatised maltodextrin, which can promote retarded and uniform degradation of the iron-maltodextrin derivative complexes according to the invention in the body.
15 cl, 11 tbl, 45 ex
FIELD: medicine, transfusion, infusion therapy.
SUBSTANCE: invention proposes antioxidant representing hydroxyethylated starch or pullulan chemically modified with steric-hindranced phenol. Fragment of steric-hindranced phenol represents β-(4-hydroxy-3,5-di-tert.-butylphenyl)-propionyl or β-(4-hydroxy-3,5-di-tert.-butylphenyl)-α-(N-benzoylamino)-acryloyl and its content is from 2 wt.-% up to limit solubility of polymer in water and doesn't exceed 10 wt.-% for modified hydroxyethylated starch and 12 wt.-% for modified pullulan. Plasma substitute showing antioxidant and antiradical activity represents indicated polymeric antioxidant in physiological solution or Ringer-Lock solution in plasma substitute based on the corresponding non-modified polymer. Also, invention describes a method for maintenance the level of arterial pressure and processes of antioxidant protection of body under condition of acute blood loss by using the indicated plasma substitute. As compared with analogs, new plasma substitute shows two kinds of activity: antioxidant and antiradical that are sufficient for operative increase of arterial pressure and its stabilization at the level of physiological norm, and for decreasing amount of free radicals and enhancing antioxidant protection of body in acute massive blood loss.
EFFECT: valuable medicinal properties of agents.
5 cl, 6 tbl, 4 ex