List uses.
Hypovolemia
Hermorrhagic shock
Nephrosis/Nephrotic syndrome
cirrhotic ascites and paracentesis (> 5L)
Hypoproteinemias
List contraindications.
Hypersensitivity to albumin, any ingredient in the formulation, [ref] or component of the container. [ref](See Sensitivity Reactions under Cautions.)
Severe anemia.
Cardiac failure [ref] in the presence of normal or increased intravascular volume.
Consider that certain individuals are at particular risk of circulatory overload, including those with stabilized chronic anemia, CHF, or renal insufficiency. [ref](See Renal Impairment under Cautions.)
Buminate® 25%: Contraindicated in patients with chronic renal impairment because of risk of aluminum accumulation.
Dilution with sterile water for injection contraindicated because of risk of potentially life-threatening hemolysis and acute renal failure.
List common adverse effects.
Anaphylactoid reactions, fever, chills, rash, nausea, vomiting, tachycardia, hypotension.
Is there any specific drug interaction?
Drug
Interaction
Comments
ACE inhibitors
Increased risk of atypical reactions (e.g., flushing, hypotension) to ACE inhibitors in patients undergoing therapeutic plasma exchange with albumin human replacement
Withhold ACE inhibitors ≥ 24 hours prior to plasma exchange in which large volumes of albumin human are given
Describe the actions of albumin.
Albumin is an important factor in regulation of plasma volume and tissue fluid balance through its contribution to the colloid oncotic pressure of plasma.
Albumin is a highly soluble globular protein with a relatively low molecular weight (66,500) and exerts 70–80% of the colloid oncotic pressure of normal plasma.
IV administration of concentrated albumin human solution causes a shift of fluid from the interstitial spaces into the circulation and a slight increase in the concentration of plasma proteins.
In the US, albumin human is commercially available as 5, 20, or 25% solutions; [ref] other concentrations (e.g., 4% solutions) are available in other countries.
Albumin human 5% solution is iso-oncotic with normal human plasma and will expand circulating blood volume by an amount approximately equal to the volume infused.
When administered IV in well-hydrated patients, each volume of albumin human 20 or 25% solution draws about 2.5 or 3.5 volumes, respectively, of additional fluid into the circulation within 15 minutes, reducing hemoconcentration and blood viscosity.
In patients with reduced circulating blood volumes (e.g., from hemorrhage or loss of fluid through exudates or into extravascular spaces), hemodilution persists for many hours. In patients with normal blood volume, excess fluid and protein are lost from the circulation within a few hours.
When used for treatment of hypovolemia, most effective in well-hydrated patients.
Not considered and not used as an IV nutrition source.
Binds and functions as a carrier of intermediate metabolites (including bilirubin), trace metals, some drugs, dyes, fatty acids, hormones, and enzymes, thus affecting the transport, inactivation, and/or exchange of tissue products.
Last changed2 years ago