|
Pronunciation |
|
(HET
a
starch) |
|
|
U.S. Brand
Names |
|
Hespan® |
|
|
Generic
Available |
|
No |
|
|
Synonyms |
|
HES; Hydroxyethyl Starch |
|
|
Pharmacological Index |
|
Plasma Volume Expander, Colloid |
|
|
Use |
|
Blood volume expander used in treatment of shock or impending shock when
blood or blood products are not available; does not have oxygen-carrying
capacity and is not a substitute for blood or plasma |
|
|
Pregnancy Risk
Factor |
|
C |
|
|
Contraindications |
|
Severe bleeding disorders, renal failure with oliguria or anuria, or severe
congestive heart failure |
|
|
Warnings/Precautions |
|
Anaphylactoid reactions have occurred; use with caution in patients with
thrombocytopenia (may interfere with platelet function); large volume may cause
drops in hemoglobin concentrations; use with caution in patients at risk from
overexpansion of blood volume, including the very young or aged patients, those
with congestive heart failure or pulmonary edema; large volumes may interfere
with platelet function and prolong PT and PTT times |
|
|
Adverse
Reactions |
|
<1%: Peripheral edema, heart failure, circulatory overload, fever, chills,
headaches, itching, pruritus, vomiting, bleeding, prolongation of PT, PTT,
clotting time, and bleeding time, myalgia, hypersensitivity |
|
|
Overdosage/Toxicology |
|
Symptoms of overdose include heart failure, nausea, vomiting, circulatory
overload, bleeding
Treatment is supportive |
|
|
Stability |
|
Do not use if crystalline precipitate forms or is turbid deep
brown |
|
|
Mechanism of
Action |
|
Produces plasma volume expansion by virtue of its highly colloidal starch
structure, similar to albumin |
|
|
Pharmacodynamics/Kinetics |
|
Onset of volume expansion: I.V.: Within 30 minutes
Duration: 24-36 hours
Metabolism: Molecules >50,000 daltons require enzymatic degradation by the
reticuloendothelial system or amylases in the blood prior to urinary and fecal
excretion
Elimination: Smaller molecular weight molecules are readily excreted in urine
|
|
|
Usual Dosage |
|
I.V. infusion (requires an infusion pump):
Adults: 500-1000 mL (up to 1500 mL/day) or 20 mL/kg/day (up to 1500 mL/day);
larger volumes (15,000 mL/24 hours) have been used safely in small numbers of
patients
Dosing adjustment in renal impairment: Clcr <10
mL/minute: Initial dose is the same but subsequent doses should be reduced by
20% to 50% of normal |
|
|
Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
|
No information available to require special precautions |
|
|
Dental Health:
Effects on Dental Treatment |
|
No effects or complications reported |
|
|
Patient
Information |
|
Report immediately any respiratory difficulty, acute headache, muscle pain,
or abdominal cramping. Pregnancy precautions: Inform prescriber if you
are pregnant. |
|
|
Nursing
Implications |
|
Anaphylactoid reactions can occur, have epinephrine and resuscitative
equipment available |
|
|
Dosage Forms |
|
Infusion, in sodium chloride 0.9%: 6% (500 mL) |
|
|
References |
|
Brutocao D, Bratton SL, Thomas JR, et al,
"Comparison of Hetastarch With Albumin for Postoperative Volume Expansion in Children After Cardiopulmonary Bypass,"
J Cardiothoracic Vasc Anesth, 1996, 10(3):348-51.
|
|
Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved
|