hetastarch

REMS

Adjunct for fluid replacement and volume expansion in the early management of shock or impending shock caused by:
- Burns,
- Hemorrhage,
- Surgery,
- Sepsis,
- Trauma.
Adjunct in leukapheresis (improves collection of granulocytes).

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity;
Severe bleeding disorders;
HF;
Pulmonary edema;
Oliguric or anuric renal failure;
OB: Early pregnancy.

Use Cautiously in:

Thrombocytopenia;
Severe renal impairment (if CCr <10 mL/min, initial dose may be the same; subsequent doses should be ↓ to 25–50% of usual dose);
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children;
Geri: ↑risk of adverse reactions in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

CV: HF, peripheral edema

EENT: parotid and submaxillary gland enlargement

GI: vomiting

Derm: pruritus, urticaria

F and E: fluid overload

Hemat: ↓hematocrit, ↓platelet function

MS: myalgia

Neuro: headache

Resp: pulmonary edema

Misc: chills, fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

Premixed infusion: 30 g/500 mL 0.9% NaCl (6% solution)

Route/Dosage ⬆ ⬇

IV (Adults ): Plasma volume expansion: 30–60 g (500–1000 mL of 6% solution), may be repeated; not to exceed 90 g (1500 mL/day). In acute hemorrhagic shock, up to 20 mL/kg/hr may be used; leukapheresis: 250–700 mL infused at a constant fixed ratio of 1:8 to 1:13 to venous whole blood.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

A synthetic molecule that acts as a colloidal osmotic agent similar to albumin.

Therapeutic effects:

Plasma volume expansion.

Classifications ⬆ ⬇

Therapeutic Classification: volume expanders

Pharmacologic Classification: colloids

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Distributes into intravascular space.

Metabolism/Excretion: Molecules with a molecular weight of 50,000 or less are excreted unchanged by the kidneys. Larger molecules are slowly degraded before excretion.

Half-Life: 90% has half-life of 17 days; remaining 10% has half-life of 48 days.

Time/Action Profile ⬆ ⬇

(volume expansion)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	end of infusion	24 hr or longer

Patient/Family Teaching ⬆ ⬇

Explain to patient the rationale for use of this solution.
Instruct patient to notify health care professional if dyspnea, itching, or flu-like symptoms occur.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Indications ⬇