Albumin is an important and vital protein in human blood serum that plays a role in transporting nutrients, hormones and other substances in the body. Also, albumin has a fundamental function to maintain the balance of body fluids and maintain blood pressure. This drug has important features such as carrying nutrients, maintaining fluid balance, preventing pressure increase in the central nervous system, role in drug absorption and transfer, etc.
It is not used as a medicine directly to treat diseases. However, in some special cases, researchers use albumin as a carrier material for other drugs to increase the effectiveness of the drugs.
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Pharmaceutical forms of albumin
Albumin drug is produced in the form of injectable solution of 50 mg/ml (5%) and 250 mg/ml (25%). This drug is produced by domestic and foreign companies and sold in the country’s market.
Uses of albumin medicine
Albumin medicine is used for immediate treatment of low blood volume with or without shock, low blood protein, severe burns, etc. Albumin (human) injections are also used to treat hypoalbuminemia in patients with severe injury, infection, or pancreatitis (swelling of the pancreas) that is not quickly reversible, and when nutritional supplements have been given but are not working well.
Some of the most important uses of this drug include acute liver failure, adult respiratory distress syndrome, hypoalbuminemia, hemodialysis, hypovolemia, ovarian hyperstimulation syndrome, etc.
Uses of albumin in adults
- Acute liver failure
- Adult respiratory distress syndrome
- Ovarian hyperstimulation syndrome
- Cardiopulmonary bypass
Uses of albumin in children
- Hemolytic disease of the newborn
- Ascites with hypoalbuminemia
Pharmacological effects and mechanism of action of albumin drug
plasma protein replacement; It increases the intravascular oncotic pressure and moves fluids from the interstitial space into the vessels. Distribution in the plasma area is 30-40% and metabolism is minimal in the liver. The elimination half-life is 15-20 days and the drug is eliminated not through the kidney but through the intestinal mucosa.
The amount of albumin used
Albumin is injected intravenously into the vein. While receiving albumin, the patient’s breathing, pulse, blood pressure, electrolyte levels, kidney function and other vital signs will be closely monitored. The patient’s blood should also be tested regularly during treatment. Note that you should drink a lot of fluids during the treatment. Consult with your doctor about how to use and tips after using the medicine.
Albumin intake in adults
- Acute liver failure: This drug is used to maintain cardiovascular function after paracentesis caused by cirrhotic ascites. The recommended dose is 6-8 grams per 1000 ml of ascitic fluid removed.
- Adult respiratory distress syndrome: Indicated for adult respiratory distress syndrome (ARDS) in combination with diuretics to correct fluid volume overload associated with ARDS. The recommended dose is 25 grams per 30 minutes.
- Burns: After 24 hours of burn, it is indicated in case of severe reduction of albumin to help reabsorb edema. The amount of albumin required to achieve adequate plasma volume and protein content should be determined by direct observation of vital signs or measurement of plasma oncotic pressure and protein content.
- Cardiopulmonary bypass: The required dose can be calculated from the difference between the total serum protein concentration and the actual value multiplied by the estimated plasma volume (~40 mL/kg) times 2 (to account for the extravascular deficit that absorbs about half of the prescribed dose He estimated.
- Hypoalbuminemia: It is prescribed to restore and maintain the lack of circulating blood volume caused by disease or active bleeding. When albumin deficiency is caused by excessive protein loss, the effect of albumin administration will be temporary unless the underlying disorder is reversed.
- Hemodialysis: This drug is recommended for patients undergoing long-term hemodialysis or for those who are fluid overloaded and cannot tolerate significant volumes of sodium to treat shock or hypotension.
- Hypovolemia: The recommended dose is 25 grams to start with and adjust according to the required volume.
- Ovarian Hyperstimulation Syndrome: It is prescribed as a plasma expander in the fluid management of severe forms of Ovarian Hyperstimulation Syndrome (OHSS). The dosage is 50-100 grams infused over 4 hours, and it is possible to repeat the dosage according to the doctor’s opinion.
Albumin intake in children
- Hemolytic disease of newborns: the recommended dose for this disease is 25% albumin, 1 g/kg before or during plasma exchange. Due to the risk of intraventricular bleeding due to the rapid increase in intravascular volume, the concentration of 25% should be used with extreme caution in infants.
- Hypovolemia: To treat albumin 5%, 1-5 gm infusion over 1 hour, which may be given more rapidly for hypovolemic shock.
- Ascites with hypoalbuminemia: treatment with 25% albumin in the amount of 1 g/kg injected over 2-3 hours, which may be repeated until serum albumin is above 2.5 g.
Time to use albumin
Albumin is made from human plasma (part of blood) and may contain viruses and other infectious agents. Donated plasma is tested and treated to reduce the risk of infectious agents, but there is still a small chance that it can transmit disease. Talk to your doctor about the risks and benefits of using this medication. The exact time of use is determined by the doctor according to the type of disease or inflammation, the patient’s age (adults, elderly or children), physical condition, medical records, etc.
Before taking albumin, if you are allergic to it or the size of the ingredients in it, avoid taking the medicine. This medicine may contain inactive substances that cause side effects and allergies in patients after use.
People with medical records such as cardiovascular problems, digestive problems, liver or kidney disorders, arterial hypertension, esophageal varices, pulmonary edema, hemorrhagic diathesis, severe anemia, severe burns, hypersensitivity, sensitivity to Albumin, etc. should use with caution. Pregnant women should consult a doctor about the risks and side effects of this medicine before using it.
- Hypersensitivity reactions have been reported. Monitor the patient during the infusion in a hospital capable of responding to anaphylaxis.
- Use caution in situations where hypervolemia and its consequences or hemodilution can be a particular risk (such as heart failure, arterial hypertension, esophageal varices, pulmonary edema, hemorrhagic diathesis, severe anemia, renal and postrenal anuria).
- Do not dilute with sterile water for injection, as this may cause hemolysis. For dilution use D5W or 0.9% NaCl.
- When replacing a large volume of albumin, control of coagulation and hematocrit is necessary. (Ensuring adequate replacement of other blood components, eg coagulation factors, electrolytes, platelets, red blood cells)
- The osmotic effect of colloid is 4 times that of human blood. Therefore, when administering concentrated albumin, ensure adequate hydration of the patient. Protect against circulatory overload by assessing arterial blood pressure and pulse rate, central venous pressure, pulmonary artery occlusion pressure, electrolyte levels, and hematocrit or hemoglobin.
- Albumin is a blood product. There is a very remote risk of transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD).
Contraindications for albumin use
- Allergy to commercially available albumin products; Suspected hypersensitivity to perflutran, blood, blood products, or albumin
- Severe anemia, heart failure
Side effects of albumin
Hot flashes, hives, fever, chills, nausea, vomiting, tachycardia, high blood pressure, etc. are some of the side effects of albumin. If any of these symptoms persist or worsen, stop taking the drug and consult a doctor. Some of the reported allergies of this drug include hives; Cough, difficulty breathing, swelling of the face, lips, tongue or throat.
Solutions containing albumin can be injected to patients regardless of blood group. But the disease must first be checked by a doctor to prescribe other drugs along with it if needed.
- hot flashes
- high blood pressure
Drug interaction of albumin
No specific drug interaction of albumin has been reported.
Taking albumin during pregnancy and breastfeeding
No human or animal data are available to demonstrate the presence or absence of risk associated with the drug. Albumin levels can be affected by various factors during pregnancy, including poor nutrition, liver disease, and kidney dysfunction. It is important for pregnant women to maintain a healthy diet and receive regular prenatal care to monitor their albumin levels and overall health. Albumin levels can be determined through a simple blood test, usually done during routine prenatal care visits.
Albumin storage conditions
Consult your doctor regarding the storage conditions of the albumin solution with the pharmacist. This drug can be stored at a temperature of 2 to 25 degrees Celsius for up to 36 months (depending on the manufacturer’s brand). Albumin or other chemical and herbal medicines should be kept out of the reach of animals and children.
A final word about albumin medicine
In this article from Positive Green Online Pharmacy magazine, we reviewed the drug albumin and its key and important points. Albumin is also used in medical treatments such as patients suffering from severe burns or liver failure. This medication can be administered intravenously to help restore fluid balance and provide essential nutrients to the body.
It is important to note, however, that Albumin should only be used under the guidance of a healthcare professional. Because it has important side effects such as hot flashes, hives, chills, fever, vomiting, nausea, high blood pressure, etc.
Site source: Medscape