Download plasma protein fraction (plaz-maproe-teenfrak-shun)

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02/17/2014 09:14AM
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plasma protein fraction (plaz-maproe -teen frak-shun)
Plasmanate, Plasma-Plex, Plasmatein, Protenate
Classification
Therapeutic: volume expanders
Pharmacologic: blood products
Pregnancy Category C
Plate # 0-Composite
Adverse Reactions/Side Effects
CNS: headache. CV: hypotension, tachycardia, vascular overload. GI: excess salivation, nausea, vomiting. Derm: erythema, urticaria. MS: back pain. Misc: infection,
chills, fever, flushing.
Interactions
Drug-Drug: None significant.
Route/Dosage
Indications
Expansion of plasma volume and maintenance of cardiac output in situations associated with deficiencies in circulatory volume, including: Shock, Hemorrhage, Burns.
Temporary replacement therapy in edema associated with low plasma proteins, such
as the nephrotic syndrome and end-stage liver disease.
Action
Provides colloidal osmotic pressure (in the form of albumin and globulins) within
the intravascular space, causing the shift of water from extravascular tissues back into
the intravascular space. Therapeutic Effects: Mobilization of fluid from extravascular tissue into intravascular space.
Pharmacokinetics
Absorption: Administered IV only, resulting in complete bioavailability.
Distribution: Stays mainly in the intravascular space.
Metabolism and Excretion: Unknown.
Half-life: Unknown.
TIME/ACTION PROFILE (intravascular volume expansion)
Dose is highly individualized and depends on condition being treated. Contains 130–
160 mEq sodium/liter. Not to exceed 250 g/24 hr.
IV (Adults): Hypovolemia— 250– 500 mL (12.5– 25 g protein). Hypoproteinemia— 1000– 1500 mL (50– 75 g protein).
IV (Infants and Young Children): Hypovolemia— 10– 30 mL/kg (0.5– 1.5 g
protein/kg).
NURSING IMPLICATIONS
Assessment
● Monitor vital signs, CVP, pulmonary capillary wedge pressure (PCWP), and intake
and output before and frequently throughout therapy. Hypotension may result
from too rapid infusion. If hypotension occurs, decrease rate or discontinue infusion.
● Assess for signs of vascular overload (qCVP,qPCWP, rales/crackles, dyspnea, hypertension, jugular venous distention) during and after administration.
● Assess surgical patients for increased bleeding after administration caused by increased BP and circulating blood volume. Plasma protein fraction does not contain clotting factors.
● Lab Test Considerations: Monitor hemoglobin, hematocrit, serum protein,
and electrolytes throughout therapy.
ROUTE
ONSET
PEAK
DURATION
Potential Nursing Diagnoses
IV
15–30 min
unknown
unknown
Decreased cardiac output (Indications)
Deficient fluid volume (Indications)
Excess fluid volume (Side Effects)
Contraindications/Precautions
Contraindicated in: Allergic reactions to albumin; Severe anemia; HF; Normal or
increased intravascular volume; Cardiopulmonary bypass procedures.
Use Cautiously in: Severe hepatic or renal disease; Rapid infusion (may cause hypotension or hypertension); Dehydration (additional fluids may be required); Large
doses (may cause anemia, requiring transfusion).
⫽ Canadian drug name.
⫽ Genetic Implication.
pg 1 # 1
Implementation
IV Administration
● Administer through a large-gauge (at least 20-gauge) needle. Use administration
set provided by manufacturer.
CAPITALS indicate life-threatening, underlines indicate most frequent.
Strikethrough ⫽ Discontinued.
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Name /bks_53161_deglins_md_disk/plasmaproteinfraction
02/17/2014 09:14AM
Plate # 0-Composite
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● Solution may vary from nearly colorless to straw to brownish. Do not use cloudy
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solution. Store at room temperature. Do not administer more than 250 g (5000
mL 5%) in 24 hr.
There is no danger of serum hepatitis from plasma protein fraction. Crossmatching is not required.
Dehydration should be corrected by additional IV fluids.
Intermittent Infusion: Administer plasma protein fraction undiluted by IV infusion. Infusion must be completed within 4 hr. Rate: Rate of administration is
determined by blood volume, indication, and patient response but should not exceed 10 mL/min, to minimize the possibility of hypotension. As the plasma volume
approaches normal, the rate of administration should not exceed 5– 8 mL/min.
The rate for infants and children should not exceed 5– 10 mL/min. Monitor the
patient for signs of hypervolemia.
Additive Compatibility: calcium gluconate, chloramphenicol, packed red
blood cells , whole blood.
Additive Incompatibility: alcohol, amino acids, norepinephrine, solutions
containing protein hydrolysates.
Patient/Family Teaching
● Explain the rationale for use of this solution to the patient.
Evaluation/Desired Outcomes
● Increase in BP and blood volume.
● Elevated serum plasma protein in patients with hypoproteinemia.
Why was this drug prescribed for your patient?
䉷 2015 F.A. Davis Company