What is Gordox medicine? Indications for use of this tool will be presented below. We will also tell you about the form in which this drug is produced, whether it has contraindications, how to use it correctly, what side effects may occur after use, etc.
Drug release form, packaging and composition
In what form can Gordox medication be purchased? Indications for use of this tool are such that it is most effective only with intravenous administration. Therefore, the drug in question is only available in 10 ml ampoules in the form of a solution.
The active element of this tool is aprotinin. The medicine also includes such auxiliary components as water for injection, benzyl alcohol and sodium chloride. In one cardboard pack there are 25 ampoules.
Pharmacological properties of the drug
Why is Gordoks needed? Indications for use of this tool include diseases of the digestive system. The active component of the drug has antiproteolytic, hemostatic and antifibrinolytic effects. It is effective for diseases of the pancreas. In addition, this medication is able to significantly reduce the fibrinolytic activity of the blood. It is often prescribed as a preventive therapy for any type of shock condition.
The principle of action of a medical device
What is Gordox medicine? Use in children and adults should be carried out only as directed by a doctor. This is due to the fact that this drug is an inhibitor of proteolytic enzymes, which has antifibrinolytic properties.
After the formation of reversible stoichiometric complexes, the active substance of the drug inhibits the work of tissue and plasma kallikrein, plasmin and trypsin. As a result of this effect, the fibrinolytic activity of the blood decreases.
In addition, aprotinin is able to activate the contact phase of blood coagulation, inhibit numerous mediators, weaken inflammatory reactions, and reduce the formation of thrombin and fibrinolysis.
What is Gordox used for? Indications for use include surgery. Thanks to this tool, the volume of blood loss is reduced, as well as the need for blood transfusion.
Pharmacokinetics of the drug
How fast is Gordox? The use in veterinary medicine and therapy shows that after intravenous administration, the concentration of the active component in the blood decreases very soon due to the distribution of the drug in the intercellular space. The initial half-life of the drug is observed after 0.4-0.8 hours, and the end - after 5-10 hours.
Communication with plasma proteins is 80%.
Aprotinin accumulates to a greater extent in the kidneys, and to a lesser extent in cartilage tissues. The accumulation of the drug in the kidneys is due to its binding to the epithelial cells of the renal tubules. As for the accumulation in cartilage, this is due to the affinity of aprotinin, which, in fact, is their basis.
The accumulation of the active substance of the drug in other organs is comparable to its concentration in plasma. In this case, the lowest percentage is found in the brain. It should also be noted that a limited amount of aprotinin is able to penetrate the placental barrier.
The active component of the drug is metabolized in the kidneys (lysosomal enzymes) to inactive metabolites. In a small amount, aprotinin is excreted with urine.
The drug "Gordox": indications for use
We will provide reviews about this tool below. As for this section of the article, I want to tell you about why the medication in question is prescribed for patients.
So, the following pathological conditions are indications for the use of this drug:
- chronic pancreatitis (the drug is used for frequent relapses, as well as for severe illness);
- acute pancreatitis (the drug is used only as part of complex therapy);
- pancreatitis, which developed as a result of injuries or surgical interventions;
- pancreatic necrosis;
- primary bleeding that occurred on the background of hyperfibrinolysis (after operations, various injuries, after childbirth and before them, with polymenorrhea);
- as a preventive measure of postoperative nonspecific mumps;
- angioedema;
- diagnostic examinations on the pancreas, as well as operations;
- signs of a shock condition (e.g., toxic, traumatic, or hemorrhagic);
- various tissue injuries (extensive and deep).
Why else use the medicine "Gordoks"? Indications for use include such a deviation as coagulopathy, in which severe bleeding is observed, as well as secondary hyperfibrinolysis (as an adjunct therapy).
We can not say that this drug is actively prescribed for the prophylactic treatment of bleeding after surgery and pulmonary emboli.
Contraindications to the use of a medicinal product
In what cases can not use the drug "Gordoks"? Application for pancreatitis is most common, this is the main indication. As for contraindications, the following can be attributed to them:
- hypersensitivity of the patient or severe allergic reactions to the active substance of the drug (i.e. aprotinin);
- first and third trimesters of pregnancy;
- period of breastfeeding.
It should also be noted that the medication in question should be used with caution when stopping blood circulation due to the increasing risk of renal failure, deep hypothermia, as well as with allergies (after previous aprotinin therapy).
The drug "Gordox": instructions for use
With pancreatitis, as well as with other indications, the drug is administered slowly intravenously. The maximum rate of administration of the drug should be approximately 5-10 ml per minute.
During the infusion of medication, the patient should only be in a supine position. The drug must be administered exclusively through the main veins. Moreover, using them to introduce other drugs is strictly prohibited.
Due to the fact that after using the medication there is a high risk of developing anaphylactic and allergic reactions, all patients need to enter a test volume of 1 ml (or 10 thousand KIE) 10 minutes before the main dosage. If after this no negative reactions have followed, then a therapeutic dose of the drug is administered.
It should also be noted that the use of histamine blockers of H1 and H2 receptors is possible ¼ hours before the infusion of the drug. In any case, all standard emergency measures must be provided that are aimed at treating an allergic or anaphylactic reaction.
For adults, the drug in question is recommended to be administered intravenously at an initial dosage of 1-2 million KIE. Do it slowly, for a quarter of an hour after the start of anesthesia, as well as before sternotomy.
After the completion of the bolus administration of the drug, the patient is given an infusion (at a rate of 250-500 thousand KIE per hour) until the end of the operation. The total amount of aprotinin administered throughout the course should not be higher than 7 million KIE.
For people with impaired renal function, as well as elderly patients, dosage adjustment is not required.
Side effects of the drug
What are the side effects of the drug "Gordoks", indications, contraindications of which were described above?
As practice shows, patients receiving aprotinin for the first time do not experience the development of anaphylactic or allergic reactions. As for re-administration of the drug, the incidence of side effects increases to 5%. Especially often this happens if such a use of the drug was carried out within 6 months.
With repeated use of the product after more than 6 months, the possible risk of developing anaphylactic and allergic reactions is approximately 0.9%.
The risk of developing severe side effects increases significantly if aprotinin has been used more than two times in six months.
If during repeated use of the drug no signs of allergic reactions were observed, subsequent use of the drug can quite easily lead to the development of adverse events, even with a fatal outcome.
Signs of anaphylactic and allergic reactions after using the drug can manifest itself in the form of various disorders of the digestive tract, cardiovascular and respiratory systems, as well as skin integuments.
In case of side effects, the use of the medication should be immediately discontinued. It is also necessary to ensure that all urgent standard measures are carried out (for example, infusion therapy, the administration of epinephrine, adrenaline, corticosteroids).
So what are the undesirable effects that occur after using the drug "Gordoks"? Application in ophthalmology, therapy and veterinary medicine can cause the appearance of the following deviations:
- Allergy: anaphylactic, anaphylactoid and allergic reactions, anaphylactic shock (can be fatal).
- Cardiovascular system: thrombosis, ischemia, pericardial effusion, myocardial infarction, thrombosis or occlusion of the coronary arteries, pulmonary thromboembolism and arterial thrombosis, which can occur with impaired functioning of such vital organs as the lungs, kidneys and brain.
- Hematopoietic system: coagulopathy, including DIC.
- Urinary system: impaired renal function and renal failure.
- Local adverse reactions: thrombophlebitis, reactions in the area of infusion or injection.
Special instructions for the use of the drug
Now you know how to use a medicine like Gordox. Instructions for use in pancreatitis and other diseases were presented a little higher. However, before starting treatment with this drug, it is recommended to conduct skin tests, which will determine the individual's sensitivity to the active substance of the drug (that is, aprotinin).
If a history of allergic reactions was indicated, then before conducting therapy, the patient must take GCS and histamine H1 receptor blockers.
With the appearance of such deviations as hyperfibrinolysis and DIC, the drug should be used only after these phenomena are completely eliminated. The same applies to those cases when the patient has a preventive effect of heparin.
Extremely carefully considered drug is prescribed to those patients who received muscle relaxants for several days before starting therapy.
Gordox contains benzyl alcohol. In this regard, its maximum volume per day should not exceed 90 mg per kg of human weight.
Gordox is not a substitute for a drug like Heparin.
After the ampoule with the solution has been opened, it should be used immediately. During repeated use of the drug, administering the medicine from an open container is prohibited.
It is highly undesirable to mix the Gordoks medicine with other medicines.
Can I administer the drug to pets?
Is Gordox allowed to dogs and cats? Use in animals is allowed. However, the dosage of the drug should be determined only by the veterinarian and only after an ultrasound examination of the abdominal cavity of the pet.
How to enter "Gordoks"? The use of this medicine in cats and dogs should be extremely careful. This is due to the fact that the medication in question is allergenic.
The drug is administered intravenously through a special catheter. It can also be administered subcutaneously, in the area of the so-called “scruff”. It should be noted that in the first two days of pancreatitis therapy it is necessary to carry out intravenous infusions. And only after the pet is able to take food without vomiting, the medication can be administered at the withers for another 5-7 days.
What should be the dosage for treatment with Gordox? The use in dogs of medium size and weight category (about 15 kg) implies the introduction of a drug in an amount not exceeding 10 thousand KIE (three times a day). As for cats (weighing about 5 kg), the dosage should be 5 thousand KIU (it is recommended that you first consult with your veterinarian).
For the introduction of a medicinal substance through a dropper, the contents of the ampoule are collected in a syringe, and then the animal skin is pulled and the needle is carefully guided into the subcutaneous space. In this case, the medicine is slowly squeezed out of the syringe.
Drug Reviews
According to the reviews of therapists and veterinarians, the drug Gordoks quite effectively and quickly treats chronic as well as acute pancreatitis. In addition, he is able to stop any bleeding.
The only disadvantage of this medication is a huge number of side effects that can even lead to death. Therefore, the use of this drug should only be indicated and only as directed by the attending doctor. Moreover, during treatment with this agent, the patient must always be under the strict supervision of his doctor.