Plasma Protein Fraction
Brand names: Plasmanate
Drug class:
Antineoplastic Agents
Usage of Plasma Protein Fraction
Fluid Resuscitation (Shock)
Used for plasma volume expansion in the treatment of certain types of shock, including shock resulting from burns, crushing injuries, abdominal emergencies, or any other cause where there is a predominant loss of plasma fluids and not RBCs.
Adequate replacement for human plasma in the treatment of shock and suitable means of providing human proteins for their osmotic effect; however, albumin solutions may be preferable because they contain a greater percentage of albumin and, since they are more purified, are less likely to cause hypotensive reactions. (See Hypotension under Cautions.)
Initial therapy in infants and small children for shock resulting from dehydration and infection.
Emergency treatment of shock due to hemorrhage. Following the emergency phase of therapy, transfusions of whole blood or RBCs may be indicated, depending on the severity of the blood loss.
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How to use Plasma Protein Fraction
Administration
IV Administration
Administer by IV infusion, preferably at a site at some distance from any site of infection or trauma.
Swab the rubber stopper on vial with iodine tincture followed by a sterile antiseptic swab. Insert a 16-gauge needle or dispensing pin perpendicular to the stopper in the area delineated by a raised ring.
Does not contain preservatives; discard any partially used vials.
Do not mix with protein hydrolysates or solutions containing alcohol.
To minimize administration errors, consult the manufacturer’s administration instructions for proper use.
Rate of AdministrationAdjust rate of infusion according to the clinical response of the patient and changes in BP.
For hypovolemic shock in infants and young children: Infusion at a rate of up to 5–10 mL/minute has been suggested.
As plasma volume approaches normal, do not exceed 5–8 mL/minute. Rapid IV infusion (e.g., >10 mL/minute) may cause vascular overload. (See Infusion Effects under Cautions.)
Dosage
Dosage depends on the patient’s condition and response to therapy.
Pediatric Patients
Fluid Resuscitation (Shock) Hypovolemic Shock IVInfants and young children: Initially, 6.6–33 mL/kg (0.33–1.65 g/kg of protein). Subsequent dosage is determined by the patient’s condition.
Adults
Fluid Resuscitation (Shock) Hypovolemic Shock IVUsual minimum effective dosage: 250–500 mL (12.5–25 g of protein). Subsequent dosage is determined by the patient’s condition.
Prescribing Limits
Adults
Fluid Resuscitation (Shock) Hypovolemic Shock IVDo not exceed 5–8 mL/minute.
Special Populations
No special population dosage recommendations at this time.
Warnings
Contraindications
Warnings/Precautions
Warnings
Risk of Transmissible Agents in Plasma-derived PreparationsPotential vehicle for transmission of human viruses, including hepatitis virus, or other infectious agents.
Despite screening for certain viruses (e.g., human immunodeficiency virus [HIV], hepatitis B virus [HBV], hepatitis C virus [HCV]) and a pasteurization procedure to reduce viral infectious potential associated with plasma protein fraction (PPF), a risk for transmission of infectious agents still remains.
Transmission of nonenveloped viruses, including hepatitis HAV and parvovirus B19, has been documented following administration of plasma-derived coagulation factors.
Report any suspected PPF-associated infections to the manufacturer.
Risk of Creutzfeldt-Jakob DiseaseMay carry a risk of transmitting the causative agent of Creutzfeldt-Jacob disease (CJD) or variant CJD (vCJD).
There have been 3 probable cases of vCJD acquired through transfusion of human RBCs, although, transmission via human plasma derivatives (including plasma-derived albumin) has not been documented to date.
Risk of West Nile VirusEvidence exists that West Nile Virus (WNV) can be transmitted in transplanted organs (e.g., heart, liver, kidney) and blood products (e.g., whole blood, packed RBCs, fresh frozen plasma). However, WNV transmission unlikely through commercially available plasma-derived preparations since WNV is an enveloped virus, like HCV, which is known to be inactivated by the heat and solvent/detergent viral inactivation procedures used in the manufacture of these preparations.
For further information on WNV precautions related to blood and blood products, the FDA’s guidance for industry should be consulted ().
General Precautions
Infusion EffectsRapid infusion may cause vascular overload.
Observe all patients (especially those with normal or increased circulatory volumes) for signs of hypervolemia, including dyspnea, fluid in the lungs, pulmonary edema, cardiac failure, or abnormal increases in BP or central venous pressure.
HypotensionHypotension may occur, especially following rapid IV infusion (i.e., at rates >10 mL/minute) in patients undergoing surgery or in the pre- or postoperative period or during intra-arterial administration in patients on cardiopulmonary bypass. Monitor BP during administration; slow or stop the infusion if sudden hypotension occurs. BP may return to normal spontaneously following slowing or discontinuance of the infusion; vasopressors also may be used to correct hypotension.
Sodium ContentCommercially available PPF contains approximately 145 mEq of sodium per liter.
Trauma or Surgery RiskRapid rise in BP accompanying administration of PPF following injuries or surgery may reveal bleeding points that were not apparent at the lower BP; observe patient carefully to prevent hemorrhage and subsequent shock.
Hematologic EffectsDoes not contain coagulation factors and, therefore, cannot be used to correct coagulation disorders. Contains trace amounts of blood groups A and B isohemagglutins; however, these are at such low concentrations that use of PPF should have no effect on routine blood typing procedures.
Specific Populations
PregnancyCategory C.
Pediatric UseManufacturer states that safety and efficacy not established in pediatric patients; however, protein colloid has been found to be very useful in infants and small children for initial treatment of shock resulting from dehydration and infection.
Hepatic ImpairmentUse with caution in patients with hepatic failure because of added protein, fluid, and sodium load.
Renal ImpairmentUse with caution in patients with renal failure because of added protein, fluid, and sodium load.
Common Adverse Effects
Flushing, urticaria, nausea, headache, back pain.
Disclaimer
Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.
The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
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