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GENERIC NAME: Albumin (Human)

BRAND NAME: Buminate

CLASSIFICATION:

Pharmacologic: blood derivative

Therapeutic: plasma volume expander

MODE OF ACTION: It is osmotically equivalent to an equal volume of normal human plasma and willincrease circulating plasma volume by an amount approximately equal to the volumeinfused. It provides colloidal oncotic pressure, which serves to mobilize fluid fromextravascular tissues back into the intravascular space

INDICATION: Hypovolemia, Hypoalbuminemia, Hemolytic Disease of the Newborn; Nephrotic Syndrome

DOSAGE: Must be administered by IV inj. Max infusion rate: 1 mL/min.

Hypovolemic shock Adult 100-200 mL. Children 2.5-5 mL/kg body wt. May be repeated after 15-30 min if response is not adequate.

Hypoalbuminemia Max daily dose: 2 g/kg body wt.

Hemolytic disease of the newborn 1 g/kg body wt.

Nephrotic Syndrome Adults 12.5 50 g/dzay IV in 3 4 divided doses. Children and Infants 0.25 1 g/kg/dose IV.

CONTRAINDICATION: History of allergic reaction to albumin, severely anemic patients & patients w/cardiac failure.

SIDE EFFECTS: CNS: headache; CV: hypertension, hypotension, tachycardia; GI: increased salivation;nausea, vomiting; DERM: rash, urticaria; MS: back pain

ADVERSE REACTIONS: Fluid overload; Hypervolemia; Pulmonary edema; Anaphylaxis

DRUG INTERACTIONS: non-significant

NURSING RESPONSIBILITIES:

1. Buminate must not be diluted with sterile water for injection.(R) Diluting Buminate in sterile water may cause hemolysis in recipients and possible renal

failure.2. Do not mix albumin solutions with protein hydrolysates or solutions containing alcohol.

(R) This may cause proteins to precipitate.3. Administer slowly with caution.

(R) Rapid infusion may cause circulatory overload and interstitial dehydration in most vulnerable patients.

4. Do not begin administration more than 4 hours after the container has been entered.(R) Since this product does not contain antimicrobial preservatives, prolonged administrationmay predispose the client to risks of infection.

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5. Place the bottle containing the albumin solution at least three level above the patients heart. (R)Since albumin is a viscous fluid, by virtue of gravity, it will be easier for the drug to passthrough the IV tubing.

6. Watch out for allergic reactions such as rashes, urticaria, fever, etc.(R)Since Buminate comes from human albumin, incompatibilities may occur which may lead tohemolysis or anaphylaxis.

7. Monitor VS (esp. CR and BP).(R) If ever hypotension or tachycardia occurs as a result of the drugs side effects, the drugshould be withheld.

8. Monitor I/O.(R) This helps determine possibilities of hypervolemia.

9. Monitor for abnormal breath sounds e.g. rales/crackles.(R) Abnormal breath sounds may be due to obstruction of the airways, possibly caused by fluid overload within the lungs or pulmonary edema.

10. Monitor laboratory results especially coagulation factors, electrolytes, platelets, hemotacrit, anderythrocytes.(R) Care must be taken to ensure adequate substitution of other blood constituents and to

prevent fluid overload.

References:

Baxter, (2009). Buminate 5%, Albumin (Human), USP, 5% solution. California: Baxter HealthcareCorporation.

Venable, Samantha, (2008). Springhouse Nurses Drug Guide 2008. Philadelphia: Lippincott Williams andWilkins.

Yeo, Ben, (2009). Philippine Index of Medical Specialties. Australia: CMPMedica Drug ReferenceWorldwide.