Pentastarch

Infusion premixed in 0.9% sodium chloride.

Patients with severe heart failure, bleeding disorders such as hypofibrinogenaemia or thrombocytopenia or renal failure.

Caution in patients with haemorrhage, cardiac disease, liver disease or renal impairment. Patients at risk of developing pulmonary oedema or heart failure. Monitor urine output. Monitor central venous pressure during the initial period of infusion to detect fluid overload. Avoid haematocrit concentration from falling <25-30%. Monitor patient for signs of hypersensitivity reactions. To stop infusion if there are signs of oliguria or renal failure. Monitor for early signs of bleeding complications. Monitor electrolytes. Should only be used in children under expert supervision.

Transient increase in bleeding time may occur. Pruritus. May raise serum amylase. Fluid overload.
Potentially Fatal: Severe anaphylactic reactions.

Description:
Mechanism of Action: Pentastarch is a macromolecule that is used to expand and maintain blood volume in shock arising from conditions such as burns or septicaemia.
Duration: For 6%: 24-36 hr.
Pharmacokinetics:
Distribution: Distributes into tissues; some may persist in body for several years.
Metabolism: Molecules with molecular wt <50000, excreted unchanged by kidney. Molecules with molecular wt >50000 are metabolised and excreted more slowly. Metabolism rate depends on size of molecule.
Excretion: Approx 33% of high molecular wt and approx 70% of medium molecular wt molecules are excreted via urine within 24 hr.

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