What is the purpose of using the Gemaza drug in ophthalmology? Instructions for use and the purpose of this medication will be listed below. You will also learn about the form of release of the said drug, contraindications for its use and side effects.
Composition, description of the drug and its form
The preparation "Gemaza" (instructions for use of this tool is required to study) contains a recombinant prourokinase, as well as additional substances such as dextran 40 and sodium chloride.
On sale, the drug in question comes in the form of a lyophilisate, which is a white amorphous or porous mass, odorless and intended for the preparation of an intravenous solution.
The Gemaza preparation in glass ampoules is placed in contour cells or plastic pallets, which are sealed in packs of cardboard.
It should also be said that this medication requires the presence of a special substance - a liquid that is poured into bottles.
Pharmacology of an ophthalmic drug
How does Gemaza medication work? The instruction for use states that the action of this enzyme agent is due to its active component - prourokinase. It is an enzyme - serine protease. The chemical structure of this substance is a single-chain molecule (with a molecular mass of 54 thousand Daltons), which includes two polypeptide chains that are connected by a disulfide bridge with molecular weights of 20 and 34 thousand Daltons.
The principle of this agent is based on specific stimulation of the conversion of profibrinolysin to the fibrinolytic component of plasma - fibrinolysin, as well as the ability to destroy fibrin clots.
Kinetic characteristics of the drug
How does local absorption of the Gemaza medication occur? The instruction for use states that the peak concentration of this drug in the tissues of the visual organs is reached after two hours, and after another half day its traces can be found in the patient’s blood.
The half-life of recombinant prourokinase is about 6 hours. It should be noted that due to the use of small doses of the drug, it is impossible to achieve its systemic effect.
The drug "Gemaza": appointment (indications)
The use of the agent in ophthalmic practice is due to its high efficiency in the following cases:
- with subretinal, preretinal and intraretinal hemorrhages;
- with hemophthalmia and hyphema;
- with central vein thrombosis in the branches of the retina or occlusion of the central arteries;
- with revealed fibrinoid syndrome of various origin;
- in order to prevent adhesions after antiglaucomatous interventions.
Prohibitions on the use of solution
In what cases should not be prescribed medication "Gemaza"? Instructions for use (injections should be carried out only by an experienced specialist) indicates the following prohibitions:
- liver diseases, which are accompanied by severe hemostasis;
- tendency to bleeding, including the presence of hemorrhagic diathesis, hemophilia, thrombocytopenia and so on;
- cardiopulmonary resuscitation, as well as other resuscitation procedures conducted for more than 10 minutes;
- gastrointestinal bleeding, including those with a prescription of up to 28 days, spinal or intracranial interventions with a prescription of up to 56 days, extensive surgery or trauma with a prescription of up to 28 days;
- fourth-grade cardiogenic shock (according to Killip's classification);
- active form of tuberculosis;
- chronic renal failure;
- puncture of large vessels, including subclavian vein;
- hemorrhagic (diabetic) lesions of the retina;
- recent hemorrhagic stroke or a history of it;
- hypertensive crisis;
- high systolic or diastolic blood pressure;
- bacterial or septic endocarditis;
- hypersensitivity to sodium chloride, prourokinase or dextran 40;
- stratified aortic aneurysm or suspicion of it;
- period of pregnancy.
The drug "Gemaza": instructions for use
How should I use the drug in question? For this, the contents of 1 ampoule must be diluted in 0.5 ml of 0.9% sodium chloride solution. The resulting solution will be equal to a dose of 5 thousand ME.
The introduction of such a drug should be subconjunctival (i.e., under the conjunctiva) or parabulbar (i.e., to the lower eyelid).
The duration of therapy with this drug is 10 injections per course (no more).
How should Gemaza be used to rinse with a hyphema or a massive effusion of fibrin in the anterior visual organ? To do this, take 0.2 ml of the drug with diluted lyophilisate and bring it to 0.5 ml with 0.9% sodium chloride solution.
For intravitreal administration of this medication, 0.1 ml of the solution should be used and diluted with 0.1-0.2 ml of 0.9% sodium chloride solution. Such a drug can be used once for hemophthalmus of various origins and fibrinoid syndrome.
It cannot be said that the Gamaza drug (the description of the drug was presented above) is very often used as a prophylactic in the adhesive process after antiglaucomatous interventions. For this, it is bred in the same ratio as for subconjunctival use. After this, the medication is injected into the filter pad at the very beginning of the postoperative period.
Side effects of the drug
During treatment with the Gemaza drug, the patient may develop allergic reactions in the form of:
- hyperemia of the skin in the face or injection site;
- swelling;
- allergic tenonitis in the form of chemosis, decreased mobility of the eyeball and conjunctival hyperemia.
Overdose and interaction
With a single administration of the drug in question at a dosage of more than 5 thousand ME, the risk of developing allergic reactions, which have been described in side effects, significantly increases.
In case of surgical interventions and in case of overdose during treatment with this agent, in order to reduce the risk of hemorrhage, it is recommended to additionally use the Etamsilat medication in the form of intramuscular injections (at a dosage of 250-500 mg).
It is strictly forbidden to use Gemaza with Collalizin injections. With other thrombolytics, this agent should be used with extreme caution.
In one syringe, you cannot mix two drugs at once (with the exception of “Dexamethasone”).
Special information
With the development of bradycardia or arterial hypotension, the administration of the drug should be suspended until the heart rate and blood pressure are normalized.
Ophthalmic drug "Gemaza": reviews and similar remedies
What can replace the medication in question? Its analogues are such drugs as Actiliz, Fibrinolizin, Metalliz and Thrombovazim.
What do people who suffer from problems with the visual organs say about this remedy? Most often, reviews about this drug are left by those who use it for hemorrhages in ophthalmic practice. At the same time, patients claim that such injections are very effective and effective. They help well and fully cope with the task.
Despite the unpleasantness of the treatment procedure (such injections are rather painful), patients are advised to be patient a bit, and not to bring their condition to the removal of the vitreous body.
As for the negative reviews about this tool, they are most often associated with the development of side effects, as well as the presence of a huge number of contraindications. In addition, many patients believe that the cost of Gemaza is overpriced (it costs about 750-850 rubles).