hetastarch (Hespan, hydroxyethyl starch)

From Aaushi
Jump to navigation Jump to search

Introduction

Tradename: Hespan.

Indications

* Caution:

  • hydroxyethyl starch increases risks for kidney damage & mortality in critically ill patients[4]

Contraindications

pregnancy category = c

safety in lactation = ?

Benefit/risk

Dosage

30-60 g IV as an infusion

500 to 1000 mL IV (6% solution).

500 mL packages.

Dosage adjustment in renal failure

Pharmacokinetics

  • degraded enzymatically to glucose
  • excreted in urine
  • effects can last for 24 hours, depending upon the dose, clinical state of patient & organ function

elimination via kidney

Adverse effects

Mechanism of action

More general terms

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  3. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  4. 4.0 4.1 4.2 4.3 4.4 4.5 The NNT: Hydroxyethyl Starch for Acute Volume Resuscitation. http://www.thennt.com/nnt/hydroxyethyl-starch-for-acute-volume-resuscitation/
    Zarychanski R et al Association of Hydroxyethyl Starch Administration With Mortality and Acute Kidney Injury in Critically Ill Patients Requiring Volume Resuscitation. A Systematic Review and Meta-analysis. JAMA. 2013;309(7):678-688 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23423413 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1653505
  5. 5.0 5.1 5.2 5.3 FDA MedWatch. June 20, 2013 Hydroxyethyl Starch Solutions: FDA Safety Communication - Boxed Warning on Increased Mortality and Severe Renal Injury and Risk of Bleeding
  6. Deprecated Reference
  7. 7.0 7.1 Mutter TC, Ruth CA, Dart AB. Hydroxyethyl starch (HES) versus other fluid therapies: effects on kidney function. Cochrane Database Syst Rev. 2013 Jul 23;7:CD007594. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23881659