Pharmacology Of Dextran (Dextran 40) ; Pharmacokinetics, Mechanism of Action, Uses, Effects

Dextran is a polysaccharide used primarily as a plasma volume expander and to prevent blood clots. Here's a detailed overview of its pharmacology: Mechanism of Action Dextran works by increasing blood volume and improving blood flow, particularly in the microcirculation. It achieves this by: Volume Expansion: Increasing blood volume and reducing blood viscosity. Hemodilution: Diluting the blood to improve circulation. Red Blood Cell Coating: Coating red blood cells and platelets to prevent clumping. Electronegativity Maintenance: Maintaining the electronegativity of red blood cells. Thrombosis Prevention: Reducing platelet adhesiveness and inhibiting thrombus formation. Indications Shock: Treatment of shock due to hemorrhage, burns, surgery, or trauma. Venous Thrombosis Prophylaxis: Prevention of venous thrombosis and pulmonary embolism during high-risk medical procedures. Extracorporeal Circulation: Used as a priming fluid in pump oxygenators during extracorporeal circulation. Administration Dextran is administered intravenously. The dosage varies based on the condition being treated: Shock: Total dosage should not exceed 20 mL/kg for adults and adolescents during the first 24 hours. Extracorporeal Circulation: Generally, 10 to 20 mL of a 10% solution per kilogram of body weight. Thrombosis Prophylaxis: 500 to 1,000 mL on the day of surgery, followed by 500 mL daily for an additional two to three days. Pharmacokinetics Absorption: Rapidly absorbed from the intravenous site. Distribution: Distributed throughout the extracellular fluid. Metabolism: Metabolized by the liver and excreted by the kidneys. Excretion: Excreted primarily in the urine. Side Effects Common side effects include: Allergic Reactions: Rash, itching, or anaphylaxis in rare cases. Hypotension: Low blood pressure due to rapid infusion. Thrombocytopenia: Reduced platelet count. Contraindications Dextran should not be used in patients with: Allergy to dextran or other components. Severe heart failure or severe renal impairment. #Dextran