Fibrinolysis inhibitors have a hemostatic effect, which is manifested in various pathologies and surgical interventions. They stop bleeding, so they are often used during operations. One of the commonly used drugs in this case is Trasilol. Instructions for use indicate that it also stops the development of destructive processes in the pancreas, the functioning of the kallikrein-kinin system. Therefore, it is widely used in the treatment and prevention of shock of various origins and forms. Also in medicine can be used, in addition to the medication "Trasilol", "Contrical", "Gordoks". All these drugs are of animal origin.
Description and description of the medication
According to the instructions for use, "Trasilol" is a proteinase inhibitor , presented in the form of a powder for the preparation of a solution for infusion or a ready-made solution, which contains such an active component as aprotinin in an amount of 500,000 KIU (in 50 ml). As additional components are sodium hydroxide, sodium chloride and others.
According to the instructions, "Trasilol " is prescribed in the following cases:
- hyperfibrinolytic bleeding;
- diagnostics and surgical interventions on the pancreas and closely located organs;
- angioedema;
- prevention of postoperative mumps in acute form;
- missed pregnancy over a long period of time;
- pancreatitis
- peptic ulcer;
- sepsis;
- kidney pathology;
- cirrhosis of the liver;
- prophylaxis of bleeding before, during and after labor;
- detachment of the placenta;
- various forms of shock;
- deep and extensive tissue damage;
- as a complex therapy - coagulopathy;
- prevention of postoperative pulmonary embolism and embolism in fractures of the legs and bones of the skull.
Therapeutic effect
According to the instructions for use, "Trasilol" is a multivalent proteinase inhibitor. It inhibits plasmin, trypsin, chymotrypsin, calidinogenase, kallikrein, which play a leading role in the appearance of pathological reactions in blood plasma and tissues.
The drug has a wide spectrum of inhibitory effect (antifibrinolytic, hemostatic, antiproteolytic), is used for disorders of other enzyme systems.
The medicine is effective in pathologies of the pancreas and other conditions, "Trasilol" is actively used for pancreatitis. The medication helps to reduce the fibrinolytic activity of the blood, exhibits a hemostatic effect in case of coagulopathy, blocks the kallikrein-kinin system, which allows it to be used in the development of a shock condition.
80% of the active substance binds to plasma proteins, the substance accumulates in the kidneys and cartilage, the lowest concentration is observed in the brain. A small amount of substance crosses the placenta. Aprotinin is metabolized in the kidneys, excreted with urine.
The drug does not have toxic, embryotoxic and fetotoxic effects. As well as teratogenic and mutogenic effects. Its use in cardiopulmonary bypass surgery leads to a decrease in the inflammatory response, which reduces the amount of blood loss and the need for blood transfusion.
"Trasilol": instructions for use
Before administering the drug, all patients must pass the aprotinin-specific antibody test.
Also, all patients ten minutes before administration of the drug, it is necessary to introduce a test dose in the amount of 10,000 KIU to detect negative reactions (allergies). When administering the medicine, doctors should be alert. You must have at hand standard emergency care for the treatment of anaphylactic reactions, since there is a risk of allergies.
The drug is administered intravenously in a supine position. First, for the purpose of therapy - in a dosage of 50,000 KIE with a speed of 5 ml / min Then the drug begins to be administered dropwise at a dosage of 50,000 KIE per hour.
In the presence of bleeding or hemorrhage, the drug is administered intravenously in an amount from 100 to 200 thousand KIU, in severe cases, the dosage is increased to 500 000 KIU.
With coagulopathies, the dosage of the drug is 1 million KIE.
During operations, as well as prophylaxis before, during and after interventions, the preparation is administered in meleno amount in the amount of 200 to 400 thousand KIUs intravenously, by drop or drop, then the dosage is reduced to 100,000 KIUs over two days.
After surgery on the pancreas or closely located organs, a medication of 200,000 KIU is prescribed, and then for two days - 100,000 KIU every six hours.
According to the instructions for use, “Trasilol” for acute pancreatitis is first prescribed in an amount of from 500,000 to 1 million KIU, then for two to six days the drug is administered in a dosage of 50,000 to 3,000 thousand KIU. With an exacerbation of the chronic form of pancreatitis, the drug is administered once at a dosage of 25,000 KIE / hour for six days.
In obstetric practice, the drug is prescribed in a dosage of 1 million KIU, and then 200,000 KIU every hour until the bleeding stops. In childhood, with a violation of hemostasis, a medication is used in an amount of 20,000 KIE per kilogram of body weight per day.
In rheumatology, intraarticular injections with a solution in the amount of 200,000 KIE are used. You can use the drug topically. To do this, they moisten gauze and apply to the place where the blood runs from.
Usage restrictions
"Trasilol" can not be used in some cases:
- hypersensitivity to the components of the drug;
- the presence of aprotinin-specific antibodies;
- the first and last trimesters of bearing a child;
- period of breastfeeding;
- children's age up to six years;
- disseminated intravascular coagulation.
The use of the drug in the second trimester of pregnancy is possible if there is a strong need.
Adverse Reactions
When using the drug, the risk of developing allergic reactions increases. The probability of their manifestation is especially high when the drug is used twice within six months. In isolated cases, death can occur.
So, "Trasilol" can cause the development of such symptoms:
- asthma;
- increase in blood pressure;
- hives;
- nausea.
If these symptoms occur, drug therapy is stopped, symptomatic treatment is performed.
Also, the drug can provoke the following adverse reactions:
- myocardial infarction;
- phlebitis at the injection site;
- ischemia, coronary artery thrombosis;
- pulmonary embolism;
- anaphylactic shock;
- oliguria;
- acute kidney failure;
- lowering blood pressure;
- conjunctivitis;
- rhinitis;
- vomiting with rapid administration;
- bronchospasm and myalgia.
But such reactions are rare.
Excess doses
In medical practice, no cases of overdose have been recorded. There is no special antidote for drug poisoning. Therapy is symptomatic.
Additional Information
In medicine, it is customary to consider Trasilln as a drug incompatible with other drugs. You can not enter the solution simultaneously with other medicines. But this medication is still compatible with a 20% glucose solution, as well as with Ringer's solution.
With caution, a medication is prescribed to those who took muscle relaxants three days before. Simultaneous administration of antihistamines is also allowed to eliminate the risk of allergic reactions.
Store the drug in a place with low humidity, the air temperature should not exceed twenty-five degrees. Do not freeze the finished solution. The shelf life of the drug is three years.
If any adverse reactions occur, the drug should be stopped.
Cost and purchase of medication
You can not buy the drug in all pharmacies in the country, usually it is dispensed in public institutions. A prescription from a doctor is required to purchase the drug “Trasilol”. The cost of the medicine is approximately two thousand five hundred and eighty rubles per package.
Analogs
If for some reason it is not possible to use the medication, the doctor prescribes one of the analogues of the medicine. "Trasilol" analogues has the following:
- Gordoks.
- Aprotex.
- "Antagozan."
- Aprocal.
- Aprotimbine.
- Amprotinin.
- "Contrivance."
- "Contrikal."
- "Countertin."
Most often, the drug is replaced by "Contrikal". It is dispensed in ampoules, each of which contains 10,000 KIEs. The price of one ampoule is about ninety rubles.
Conclusion
Doctors often use this medication in their practice. But it is necessary before its introduction to conduct a test to detect aprotinin-specific antibodies. “Trasilol” can cause the development of allergic reactions, therefore, during therapy with this drug, it is necessary to carefully monitor the patient's condition, if necessary, stop the administration of the solution, conduct symptomatic therapy.
The drug is often prescribed for acute pancreatitis or exacerbation of its chronic form. In this case, the patient is relieved. The medicine is also indispensable during surgical interventions, when the risk of blood loss and the development of bleeding increases.