Plasma Protein Fraction
Jeneng merek: Plasmanate
Kelas obat:
Agen Antineoplastik
Panganggone Plasma Protein Fraction
Resusitasi Cairan (Kejut)
Digunakake kanggo ekspansi volume plasma ing perawatan jinis kejut tartamtu, kalebu kejut amarga kobong, ciloko remuk, kahanan darurat weteng, utawa sabab liyane sing ana predominan. kelangan cairan plasma lan dudu RBC.
Panggantos sing nyukupi kanggo plasma manungsa ing perawatan kejut lan sarana sing cocog kanggo nyedhiyakake protein manungsa kanggo efek osmotik; Nanging, solusi albumin bisa uga luwih disenengi amarga ngemot persentase albumin sing luwih gedhe lan, amarga luwih diresiki, luwih cenderung nyebabake reaksi hipotensi. (Deleng Hipotensi ing Ati-ati.)
Terapi wiwitan ing bayi lan bocah cilik kanggo kejut amarga dehidrasi lan infeksi.
Pengobatan darurat kanggo kejut amarga pendarahan. Sawise fase darurat terapi, transfusi getih wutuh utawa RBC bisa dituduhake, gumantung saka keruwetan mundhut getih.
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Carane nggunakake Plasma Protein Fraction
Administrasi
IV Administrasi
Diwenehake kanthi infus IV, luwih becik ing papan sing adoh saka papan infeksi utawa trauma.
Sapu stopper karet ing vial nganggo tincture yodium banjur swab antiseptik steril. Lebokake jarum 16-gauge utawa pin dispensing jejeg stopper ing area delineated dening ring munggah.
Ora ngemot pengawet; Mbuwang bokor sing wis digunakake sebagian.
Aja nyampur karo hidrolisat protein utawa larutan sing ngemot alkohol.
Kanggo nyilikake kesalahan administrasi, deleng instruksi administrasi pabrikan supaya bisa digunakake kanthi bener.
Tarif AdministrasiSetel tingkat infus miturut respon klinis pasien lan owah-owahan BP.
Kanggo kejutan hipovolemik ing bayi lan bocah cilik: Infus kanthi tingkat nganti 5-10 mL/ menit wis disaranake.
Yen volume plasma nyedhaki normal, ora ngluwihi 5-8 mL/menit. Infus IV kanthi cepet (umpamane,> 10 mL / menit) bisa nyebabake kakehan vaskular. (Deleng Efek Infus ing Ati-ati.)
Dosis
Dosis gumantung saka kondisi pasien lan respon kanggo terapi.
Pasien Pediatrik
Resusitasi Cairan ( Kejut) Kejut Hipovolemik IVBayi lan bocah cilik: Awal, 6,6–33 mL/kg (0,33–1,65 g/kg protein). Dosis sabanjure ditemtokake dening kondisi pasien.
Dewasa
Resusitasi Cairan (Kejut) Kejut Hipovolemik IVDosis efektif minimal biasa: 250–500 mL (12,5–25 g protein). Dosis sabanjure ditemtokake dening kondisi pasien.
Watesan Resep
Dewasa
Resusitasi Cairan (Kejut) Kejut Hipovolemik IVAja ngluwihi 5-8 mL/menit .
Populasi Khusus
Saiki ora ana rekomendasi dosis populasi khusus.
Pènget
Kontraindikasi
Volume getih mundhak.
Pènget/PanandhapPènget
Resiko Agen Tular ing Preparasi sing asalé saka Plasma
Potensi kendaraan kanggo nularaké virus manungsa, kalebu virus hepatitis, utawa agen infèksi liyane.
Sanajan diskrining kanggo virus tartamtu ( contone, virus immunodeficiency manungsa [HIV], virus hepatitis B [HBV], virus hepatitis C [HCV]) lan prosedur pasteurisasi kanggo nyuda potensial infèksi virus sing ana hubungane karo fraksi protein plasma (PPF), risiko transmisi agen infèksi isih tetep. .
Tularan virus sing ora ana envelope, kalebu hepatitis HAV lan parvovirus B19, wis didokumentasikake sawise administrasi faktor koagulasi sing asale saka plasma.
Lapokake infeksi sing dicurigai ana hubungane karo PPF menyang pabrikan.
Risiko Penyakit Creutzfeldt-JakobBisa nggawa risiko nularake agen penyebab penyakit Creutzfeldt-Jacob (CJD) utawa varian CJD (vCJD).
Ana 3 kasus kemungkinan vCJD sing dipikolehi liwat transfusi sel darah merah manungsa, sanajan, transmisi liwat turunan plasma manungsa (kalebu albumin sing asale saka plasma) durung didokumentasikake nganti saiki.
Risiko Virus West NileAna bukti yen West Nile Virus (WNV) bisa ditularake ing organ sing ditransplantasikan (contone, jantung, ati, ginjel) lan produk getih (contone, getih wutuh, RBC sing dikemas, beku seger. plasma). Nanging, transmisi WNV ora mungkin liwat preparat asale saka plasma sing kasedhiya kanthi komersial amarga WNV minangka virus sing dibungkus, kaya HCV, sing dikenal ora aktif dening prosedur inaktivasi virus panas lan solvent/deterjen sing digunakake ing pabrik preparat kasebut.
Kanggo informasi luwih lengkap babagan pancegahan WNV sing ana hubungane karo getih lan produk getih, pandhuan FDA kanggo industri kudu takon ().
Pancegahan Umum
Efek InfusInfus kanthi cepet bisa nyebabake kakehan vaskular.
Amati kabeh pasien (utamane sing volume sirkulasi normal utawa tambah) kanggo tandha hipervolemia, kalebu dyspnea, cairan. ing paru-paru, edema paru, gagal jantung, utawa kenaikan tekanan darah sing ora normal utawa tekanan vena pusat.
HipotensiHipotensi bisa kedadeyan, utamane sawise infus IV kanthi cepet (yaiku, ing tingkat> 10 mL / menit) ing pasien. ngalami operasi utawa ing periode sadurunge utawa pasca operasi utawa sajrone administrasi intra-arteri ing pasien kanthi bypass kardiopulmoner. Ngawasi BP sajrone administrasi; alon utawa mungkasi infus yen tiba-tiba hipotensi. BP bisa bali menyang normal kanthi spontan sawise kalem utawa mandheg saka infus; vasopressor uga bisa digunakake kanggo mbenerake hipotensi.
Konten SodiumPPF sing kasedhiya sacara komersial ngemot kira-kira 145 mEq sodium saben liter.
Resiko Trauma utawa BedahPeningkatan BP kanthi cepet sing diiringi administrasi PPF sawise ciloko utawa operasi bisa mbukak titik getihen sing ora katon ing BP ngisor; ngawasi pasien kanthi ati-ati kanggo nyegah pendarahan lan kejut sakteruse.
Efek HematologiOra ngemot faktor koagulasi lan mulane, ora bisa digunakake kanggo mbenerake gangguan koagulasi. Ngandhut jumlah tilak saka klompok getih A lan B isohemagglutin; Nanging, iki ana ing konsentrasi sing sithik, mula panggunaan PPF mesthine ora duwe pengaruh marang prosedur ngetik getih rutin.
Populasi Spesifik
KandhutanKategori C.
Panggunaan PediatrikProdusen nyatakake yen safety lan khasiat ora ditetepake ing pasien pediatrik; Nanging, koloid protein ditemokake migunani banget ing bayi lan bocah cilik kanggo perawatan awal kejut amarga dehidrasi lan infeksi.
Gangguan HepatikGunakake kanthi ati-ati ing pasien gagal ati amarga tambah protein, cairan. , lan beban sodium.
Gagal GinjalGunakake kanthi ati-ati ing pasien gagal ginjal amarga tambah protein, cairan, lan beban sodium.
Efek Umum sing Sabar
Mbusak, urtikaria, mual, sirah, nyeri punggung.
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