Dextran-hm
Dextran-hm Uses, Dosage, Side Effects, Food Interaction and all others data.
Dextran-hm is a polysaccharide that differs from others in that its glucose units are joined together 1:6 glucoside links. The main chain of glucose has short branches at frequent intervals which are probably joined by 1:3 and 1:4 glucoside links. The chains can be composed of about 200,000 glucose units. Many bacteria, like Leuconostoc, can synthesize dextran from sucrose, and this activity is used commercially to obtain dextran.
Dextran-hm 40 is a sterile, nonpyrogenic preparation of low molecular weight dextran (average mol. wt. 40,000) in 5% Dextrose Injection or 0.9% Sodium Chloride Injection. It is administered by intravenous infusion.
Dextran-hm 75 is a complex branched glucan with an average molecular weight 75000 Daltons. It is produced from certain bacteria that with α-1,6 glycosidic linkages between glucose molecules and α-1,3 linkages between branches. When labelled with technetium Tc99m, dextran 75 is intravenously administered as an imaging agent to detect and diagnose conditions in the vascular compartment such as pericardial effusion or ventricular aneurysm.
| Trade Name | Dextran-hm |
| Generic | Dextran |
| Dextran Other Names | Dextran |
| Weight | 32% + 10%, 6% + 5% |
| Type | Intrauterine solution, intravenous solution, high molecular weight |
| Protein binding | Dextran is highly retained in the vascular system by binding to plasma proteins including albumin. |
| Groups | Approved, Investigational, Vet approved |
| Therapeutic Class | |
| Manufacturer | |
| Available Country | United States |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Dextran-hm is a low molecular weight dextran used as an adjunctive treatment of shock or impending shock due to hemorrhage, burns, surgery or other trauma, as well as the prophylaxis of venous thrombosis and pulmonary embolism during high-risk medical procedures.
Dextran-hm is used as the restoration of blood mass during surgical interventions if there is hypovolemia due to trauma or dehydration. It is as well used after the presence of hemorrhage in cases of blood loss to a level inferior to 15% of the blood mass, if compatibility test cannot be completed or when blood lots need to be tested for pathogen detection. Dextran-hm is also used for the prevention of profound postoperative venous thrombosis.
Dextran-hm as well presents ophthalmic applications as solutions or ointments for the temporary relief of xerophthalmia or minor ocular irritations.
Dextran-hm is also used to associated treatment for these conditions: Blood Circulation Disorder, Capillary disorder, Dry Eyes, Ocular Irritation, Pulmonary Embolism, Pulmonary Embolism caused by procedures associated with a high incidence of thromboembolic complications, Shock, Thrombosis, Venous, Venous Thrombosis caused by procedures associated with a high incidence of thromboembolic complications, Thrombotic events, Plasma Volume Replacement, Priming fluid in pump oxygenators therapy
How Dextran-hm works
In preclinical studies, the mechanism of action is thought to be related to the blockage of the uptake of tissue plasminogen activator by mannose-binding receptors. This process has a direct effect by enhancing endogenous fibrinolysis.
Toxicity
Some reports have shown adverse effects when used in therapeutical doses and some teratogenic effects have been demonstrated when used in large doses. The current LD50 reported in rats is 10700 mg/kg.
Food Interaction
- Avoid herbs and supplements with anticoagulant/antiplatelet activity. Dextran-hm has antithrombotic activity, which may increase the bleeding risk if combined with antiplatelet/anticoagulant herbs. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.
Volume of Distribution
The reported volume of distribution of dextran suggested a distribution throughout the blood volume. This volume of distribution is reported to be of around 120 ml. The organ that presented a higher accumulation of dextran was the liver.
Elimination Route
Dextran-hm presents a very low oral bioavailability that is reduced as the chain gets longer. Thus, the bioavailability of dextran is inversely proportional to the length of the carbohydrate chain.
Half Life
The elimination half-life will depend on the length of the carbohydrate chain. The higher the molecular weight of the dextran the longer it will be the elimination half-life. The half-life will go from 1.9 hours from dextran 1 to 42 hours in the case of dextran 60.
Elimination Route
The elimination of dextran will depend on the length of the carbohydrate chain, the administration route, and the molecular weight. For dextran 1, it is reported to be mainly secreted unchanged in the urine in a ratio of 80% of the administered dose when administered parentally. It is registered that the weight threshold for unrestricted glomerular filtration is about 15 kDa and if the dextran overpasses 50 kDa it will not be renally eliminated in any significant amount.
Innovators Monograph
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