部分中文低分子右旋糖酐处方资料（仅供参考）

低分子右旋糖酐 【Dextran40】
【分类】血浆及血浆代用品

【别名】低分子糖酐；低分子右旋糖酐；通脉液，右旋糖酐40，低分子右旋糖酐-40

【外文名】Dextran40

【适应症】
临床用于：
1.各种休克：可用于失血、创伤、烧伤及中毒性休克，还可早期预防因休克引起的弥散性血管内凝血。体外循环时，还可代替部分血液予充心肺机。
2.血栓性疾病如脑血栓形成、心绞痛和心肌梗塞、血栓闭塞性脉管炎、视网膜动静脉血栓、皮肤缺血性溃疡等。
3.肢体再植和血管外科手术，可预防术后血栓形成。

【用量用法】
静滴：每次250～500ml，成人和儿童每日每千克体重不超过20ml。抗休克时滴注速度为每分钟20～40ml，在15～30分钟注入500ml。对冠心病和脑血栓应缓慢静滴。疗程视病情而定，通常每日或隔日1次，7～14次为1疗程。

【注意事项】
1.少数病人用药可出现皮肤瘙痒、荨麻疹、红色丘疹等皮肤过敏反应，也有引起哮喘发作。极少发生过敏性休克，多在首次输入本品数滴至数毫升时，立即出现胸闷、面色苍白，以至血压下降而发生休克，及时抢救一般可恢复。故初次滴注时，应严密观察5～10分钟一发现症状立即停注。
2.偶有发热反应。一类为热原反应，多在用药1～2次，见寒战高烧；另一类在多次用药或长期用药停药后，出现周期性高热或持续性低热，少数尚可见淋巴结肿大、关节痛。
3.用量过大可致出血，如鼻衄、牙龈出血、皮肤粘膜出血、创面渗血、血尿等。因此，每日用量不应超过1500ml。
4.充血性心力衰竭和有出血性疾病者禁用。肝肾疾病者慎用。
5.与双嘧达莫和维生素B12混合可发生变化，与卡那霉素、庆大霉素和巴龙霉素合用，可增加其肾毒性。

【规格】右旋糖酐-40葡萄糖(5%)注射液及右旋糖酐-40氯化钠(0.9%)注射液各有10%，6%的100ml，250ml，500ml。

Dextran
Dextran is a complex, branched glucan (polysaccharide made of many glucose molecules) composed of chains of varying lengths (from 3 to 2000 kilodaltons). It is used medicinally as an antithrombotic (anti-platelet), to reduce blood viscosity, and as a volume expander in anemia.

The straight chain consists of α-1,6 glycosidic linkages between glucose molecules, while branches begin from α-1,3 linkages. (For information on the numbering of carbon atoms in glucose, see the glucose article.) Dextran is synthesized from sucrose by certain lactic-acid bacteria, the best-known being Leuconostoc mesenteroides and Streptococcus mutans. Dental plaque is rich in dextrans. Dextran is also formed by the lactic acid bacterium Lactobacillus brevis to create the crystals of tibicos, a water kefir fermented beverage which supposedly has some health benefits.

Dextran was first discovered by Louis Pasteur as a microbial product in wine

Uses
Microsurgery uses
These agents are used commonly by microsurgeons to decrease vascular thrombosis. The antithrombotic effect of dextran is mediated through its binding of erythrocytes, platelets, and vascular endothelium, increasing their electronegativity and thus reducing erythrocyte aggregation and platelet adhesiveness. Dextrans also reduce factor VIII-Ag Von Willebrand factor, thereby decreasing platelet function. Clots formed after administration of dextrans are more easily lysed due to an altered thrombus structure (more evenly distributed platelets with coarser fibrin). By inhibiting α-2 antiplasmin, dextran serves as a plasminogen activator and therefore possesses thrombolytic features.

Outside from these features, larger dextrans, which do not pass out of the vessels, are potent osmotic agents, and thus have been used urgently to treat hypovolemia. The hemodilution caused by volume expansion with dextran use improves blood flow, thus further improving patency of microanastomoses and reducing thrombosis. Still, no difference has been detected in antithrombotic effectiveness in comparison of intraarterial and intravenous administration of dextran.

Dextrans are available in multiple molecular weights ranging from 3,000 Da to 2,000,000 Da. The larger dextrans (>60,000 Da) are excreted poorly from the kidney and therefore remain in the blood for as long as weeks until they are metabolized. Subsequently, they have prolonged antithrombotic and colloidal effects. In this family, dextran-40 (MW: 40,000 Da), has been the most popular member for anticoagulation therapy. Close to 70% of dextran-40 is excreted in urine within the first 24 hours after intravenous infusion while the remaining 30% will be retained for several more days.

Other medical usesIt is used in some eye drops as a lubricant, and in certain intravenous fluids to solubilise other factors, e.g. iron (=iron dextran).
Intravenous solutions with dextran function both as volume expanders and means of parenteral nutrition. Such a solution provides an osmotically neutral fluid that once in the body is digested by cells into glucose and free water. It is occasionally used to replace lost blood in emergency situations, when replacement blood is not available, but must be used with caution as it does not provide necessary electrolytes and can cause hyponatremia or other electrolyte disturbances.
It also increases blood sugar levels.

Laboratory usesDextran is used in the osmotic stress technique for applying osmotic pressure to biological molecules.
It is also used in some size-exclusion chromatography matrices; an example is Sephadex.
Dextran has also been used in bead form to aid in bioreactor applications.
Dextran has been used in immobilization in biosensors.
Dextran preferentially binds to early endosomes; fluorescently-labelled dextran can be used to visualize these endosomes under a fluorescent microscope.
Dextran can be used as a stabilising coating to protect metal nanoparticles from oxidation and improve biocompatibility.
Dextran coupled with a fluorescent molecule(such as FITC) can be used to create concentration gradients of diffusible molecules for imaging and allow subsequent characterization of gradient slope.
Dextran is used to make microcarriers for industrial cell culture
As one phase in Aqueous two-phase system

Side effects
Although there are relatively few side-effects associated with dextran use, these side-effects can be very serious. These include anaphylaxis, volume overload, pulmonary edema, cerebral edema, or platelet dysfunction. An uncommon but significant complication of dextran osmotic effect is acute renal failure. The pathogenesis of this renal failure is the subject of many debates with direct toxic effect on tubules and glomerulus versus intraluminal hyperviscosity being some of the proposed mechanisms. Patients with history of diabetes mellitus, renal insufficiency, or vascular disorders are most at risk. Brooks and others recommend the avoidance of dextran therapy in patients with chronic renal insufficiency and CrCl<40 cc per minute.
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原产地英文商品名:
DEXTRAN 40 10%/DSW IV SOLN 500MLS/BAG 12BAGS/CASE 10CASES/BOX
原产地英文药品名:
DEXTRAN 40 10%/DSW
中文参考商品译名:
右旋糖酐40 10%/DSW IV溶液 500毫升/袋 12袋/箱 10箱/盒
中文参考药品译名:
右旋糖酐40 10%/DSW
生产厂家中文参考译名:
HOSPIRA
生产厂家英文名:
HOSPIRA
---------------------------------------------------------------
原产地英文商品名:
DEXTRAN 40 10%/NS IV SOLN 500MLS/BAG 12BAGS/CASE 10CASES/BOX
原产地英文药品名:
DEXTRAN 40 10%/NS
中文参考商品译名:
右旋糖酐40 10%/NS IV溶液 500毫升/袋 12袋/箱 10箱/盒
中文参考药品译名:
右旋糖酐 40 10%/NS
生产厂家中文参考译名:
HOSPIRA
生产厂家英文名:
HOSPIRA