Albumex 5/Albumex 20

Human albumin

Albumex 5 Initial plasma expander of choice if shock is associated w/ significant hypoalbuminaemia (albumin conc <25 g/L), or if it is clinically desirable to avoid infusing large vol of crystalloid soln. Following initial resuscitation w/ crystalloid or synthetic colloid soln in patients requiring extended support of intravascular vol eg, seriously ill patients w/ multiple organ failure or systemic capillary leak syndrome. Priming the pump for cardiopulmonary bypass surgery for patients w/ poor left ventricular function, & other complicating factors eg, long bypass time, anaemia or repeat surgery. For post-op hypovolaemia if further colloid is required after a moderate amount of synthetic colloid (1-2 L) has been given, or there is ongoing bleeding or anaemia, until cross-matched blood is available. Replacement soln in plasma exchange procedures, particularly when vol exchanged >20 mL/kg. Albumex 20 During hypoproteinaemia in acutely ill patients w/ existing/anticipated clinical problems/complications from reduced oncotic pressure, &/or as adjunct to diuretic therapy. Resuscitation of patients in shock due to acute loss of blood or plasma. Maintains adequate plasma vol & colloid osmotic pressure in burns. In combination w/ diuretics, to control adult resp distress syndrome in amounts sufficient to maintain vital signs. Assists w/ rapid removal of excess extravascular fluid & maintains perfusion pressure during haemodialysis. As plasma exchange if patient's serum albumin level is not maintained on iso-oncotic albumin soln.

Albumex 5 Hypovolaemia/shock IV infusion of at least 1 L. Plasma exchange Adjust infusion rate to match rate of removal. Albumex 20 Hypoproteinaemia in acutely ill patient 50-75 g (250-375 mL) daily. Max infusion rate: 2 mL/min. Shock Initially 20 g (100 mL) infused at a rate of 2-4 mL/min, may be increased & repeated in 15-30 min if necessary. Burns 20-80 g (100-400 mL) daily infused at a rate of about 1 mL/min. Acute resp distress syndrome Initially 50 g (250 mL) over the 1st 24 hr together w/ diuretic therapy. Adjust dose to maintain vital signs thereafter. Haemodialysis 20-40 g (100-200 mL) at the end of dialysis procedure. Plasma exchange Replace albumin removed on a g-for-g basis either prediluted or followed by 4-5 vol of an appropriate crystalloid soln.

Hypersensitivity. Patients w/ cardiac failure, pulmonary oedema or severe anaemia. Albumex 20 Hypoproteinaemic states associated w/ chronic cirrhosis, malabsorption, protein-losing enteropathies, pancreatic insufficiency or undernutrition. Promptly excreted by the kidneys w/ no relief of chronic oedema in chronic nephrosis.

Hypersensitivity reactions occur rarely. Stop infusion if anaphylactic reaction develops. Monitor myocardial function eg, central venous pressure, arterial pressure & pulse rate; plasma electrolytes, prothrombin time, biochemistry & haematological status. Frequently monitor rate & vol of infusion to avoid circulatory overload. Patients w/ a history of cardiac failure or pulmonary oedema or who have renal insufficiency, severe/stabilised chronic anaemia or are on cardiopulmonary bypass are at special risk of developing circulatory overload. Stop infusion at the 1st clinical signs of circulatory overload (headache, dyspnoea, jugular vein congestion), or increased BP or raised venous pressure associated w/ pulmonary oedema. Not recommended for fluid resuscitation of patients w/ traumatic brain injury. Contains trace amounts of Al (≤200 mcg/L). Al accumulation in patients w/ chronic renal insufficiency has led to toxic manifestations eg, hypercalcaemia, vit D refractory osteodystrophy, anaemia & severe progressive encephalopathy. May contain infectious agents & still potentially transmit disease. Consider vaccination for patients in receipt of medicinal products from human plasma. Pregnancy & lactation. Childn. Elderly. Albumex 5 Associated w/ hypotension. May contain some bound bilirubin & result in elevated serum bilirubin in some patients. Albumex 20 BP monitoring is recommended during administration. Can aggravate myocardial depression when present in patients w/ shock. Reports of paradoxical effect of refractory oliguria in burns patients. Must be given w/ or followed by crystalloid soln in the presence of dehydration. Patients w/ Na-restricted diet.

Hypotension, chills, fever, allergic reactions including anaphylaxis, urticaria, skin rashes, nausea, vomiting & increased salivation.

Hypotension w/ ACE inhibitors. Do not mix w/ protein hydrolysates, amino acid soln, alcohol-containing soln, or soln containing drugs that bind to albumin eg, Ca channel blockers, antibiotics & benzodiazepines.

Intravenous & Other Sterile Solutions

B05AA01 - albumin ; Belongs to the class of blood substitutes and plasma protein fractions. Used as blood substitutes.

P₁S₁S₃