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Maltofer - the preparation of iron. After the / m introduction of iron hydroxide polymaltozate enters the bloodstream through the lymphatic system. From the plasma macromolecular complex enters the reticulo-endothelial system, where it is split into iron hydroxide and polymaltose. The slow release of iron is the reason for its good tolerability. In the liver is included in the composition of hemoglobin, myoglobin and iron-containing enzymes, and is also deposited in the body in the form of ferritin. In the blood, iron binds to transferrin, in the bone marrow is included in the hemoglobin and used in the process of erythropoiesis.
It is well known that the inclusion of iron in protoporphyrin depends on the severity of iron deficiency anemia. It is intense in the case of a low level of hemoglobin and decreases as the hemoglobin level normalizes.
The response from the blood indicators for parenteral administration of iron occurs no faster than with the oral administration of iron salts in patients in whom they are effective.
The degree of iron utilization can not be higher than the iron-binding capacity of transport proteins.
The effect of renal and hepatic insufficiency on the pharmacological properties of iron (III) polymethyltosate hydroxide is not known.
Like other iron preparations, Maltofer has no effect on erythropoiesis and is ineffective in anemia not associated with iron deficiency.
The toxicity of the drug is very low. With IV injection of the preparation Maltofer LD50y white mice was> 2500 mg iron per kg body weight, which is 100 times lower than for simple iron salts.
Treatment of iron deficiency in case of insufficient efficiency, inefficiency or impossibility of oral intake of iron-containing preparations, including:
Maltofer for injection is used only if the iron deficiency state is confirmed by appropriate studies (for example, serum ferritin, hemoglobin, hematocrit, or erythrocyte count, as well as their mean erythrocyte volume, mean hemoglobin content in erythrocyte).
On the part of the body as a whole: rarely - joint pain, enlarged lymph nodes, fever, headaches, malaise; very rarely - allergic or anaphylactic reactions.
From the digestive system: rarely - nausea, vomiting (stop with symptomatic therapy).
Local reactions: violation of the technique of drug administration can lead to skin staining, the appearance of soreness and inflammation at the injection site.
Parenteral iron preparations can cause allergic and anaphylactic reactions. In the case of moderate allergic reactions, antihistamines should be prescribed; with the development of severe anaphylactic reaction requires the immediate introduction of epinephrine (adrenaline). With the introduction it is necessary to ensure the availability of cardiopulmonary resuscitation.
With caution, the drug should be administered to patients with allergies, as well as hepatic and renal insufficiency.
Side effects, which occur in patients with cardiovascular diseases, can aggravate the course of the underlying disease.
Patients with bronchial asthma or having a low iron-binding capacity of serum and / or deficiency of folic acid belong to a group at high risk of developing allergic or anaphylactic reactions.
Before using the drug, the ampoule should be inspected for sediment and damage. Use only ampoules without sediment and damage. After opening the ampoule, the injection solution should be administered immediately.
Maltofer for injection should not be mixed with other therapeutic agents.
Use in Pediatrics
In children, the parenteral use of iron preparations can adversely affect the course of the infection process.
It is not recommended to prescribe the drug to children under 4 months due to lack of experience in this category of patients.
Impact on the ability to drive vehicles and manage mechanisms
Influence on the ability to drive vehicles or work with mechanisms is unlikely.
The drug is given in / m.
Before the first administration of the therapeutic dose, an IM test should be performed: adults are injected from 1/4 to 1/2 of the drug dose (25 to 50 mg of iron (0.5-1 ml)), children from 4 months - half the daily dose. In the absence of adverse reactions within 15 minutes after administration, the remainder of the initial dose of the drug can be administered.
During the injection, it is necessary to ensure the availability of funds for the provision of emergency care in the development of anaphylactic shock.
The dose of the drug is calculated individually and adapted to the overall iron deficiency according to the following formula:
Total iron deficiency (mg) = body weight (kg) × (normal Hb level - patient Hb level) (g / l) × 0.24 * + iron stocks (mg)
With a body weight of less than 35 kg: normal Hb = 130 g / l, which corresponds to the deposited iron = 15 mg / kg body weight
At a body weight of more than 35 kg: a normal level of Hb = 150 g / l, which corresponds to the deposited iron = 500 mg
* Factor 0.24 = 0.0034 × 0.07 × 1000 (iron content in hemoglobin = 0.34% / blood volume = 7% of body weight / factor 1000 = conversion from g to mg)
Total number of ampoules for administration = total iron deficiency (mg) / 100 mg.
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