DrugindexOnline^{2nd edition}

( Normal Serum Albumin ) Pronouncation: (al-BYOO-MIN human)
Class: Plasma protein fraction

Trade Names:
Albuminar-5
- Injection 5%

Trade Names:
Albuminar-25
- Injection 25%

Trade Names:
Albunex
- Injection 5%

Trade Names:
Albutein 5%
- Injection 5%

Trade Names:
Albutein 25%
- Injection 25%

Trade Names:
Buminate 5%
- Injection 5%

Trade Names:
Buminate 25%
- Injection 25%

Trade Names:
Human Albumin Grifols
- Injection 25%

Trade Names:
Plasbumin-5
- Injection 5%

Trade Names:
Plasbumin-25
- Injection 25%

Mechanism of Action

Pharmacology

Maintains plasma colloid osmotic pressure and serves as carrier of intermediate metabolites in transport and exchange of tissue products.

Indications and Usage

Symptomatic relief and supportive treatment in management of shock, burns, hypoprothrombinemia, adult respiratory distress syndrome, cardiopulmonary bypass, acute liver failure, acute nephrosis, sequestration of protein-rich fluids, erythrocyte resuspension, hypotension or shock during renal dialysis, hyperbilirubinemia and erythroblastosis fetalis.

Contraindications

Severe anemia; cardiac failure; renal insufficiency; presence of normal or increased intravascular volume; chronic nephrosis; hypoprothrombinemic states associated with chronic cirrhosis; malabsorption; protein-losing enteropathies, pancreatic insufficiency; undernutrition.

Dosage and Administration

Burns

Initial treatment usually consists of large amounts of crystalloid infusions (eg, normal saline, Lactated Ringer solution) with lesser amounts of 5% albumin to maintain adequate plasma volume. After first 24 h, ratio of albumin and crystalloid should maintain plasma albumin level of about 2.5 g ± 0.5 g/100 mL or total plasma protein level about 5.2 g/100 mL. This is best achieved with albumin 25% solution.

Normal Serum Albumin, 5%
Shock

Give as rapidly as necessary to improve patient's condition and restore normal blood volume.

Adults

IV Initial dose is 500 mL of 5% albumin given as rapidly as tolerated. If response in 30 min is inadequate, give additional 500 mL. In patients with slightly low or normal blood volume, rate is 2 to 4 mL/min.

Children

IV Rate of administration is 25% to 50% adult rate.

Newborns and infants

IV 10 to 20 mL/kg 5% albumin based on clinical response, BP, and assessment of anemia.

Hypoproteinemia

To replace protein loss, 5% albumin may be given.

Albumin Human, 25%
Shock Adults and children

IV Initial dose is determined by patient's condition and response to treatment. Therapy is guided by degree of venous or pulmonary congestion or Hct measurements.

Hypoproteinemia Adults

IV 50 to 75 g/day at rate not exceeding 2 mL/min.

Children

IV 25 g/day at rate not exceeding 2 mL/min.

Acute Nephrosis Adults

IV 100 mL 25% albumin in combination with loop diuretic repeated daily for 7 to 10 days.

Renal Dialysis Adults

IV Approximately 100 mL 25% albumin.

Hyperbilirubinemia and Erythroblastosis Fetalis Newborns and infants

IV 1 g/kg 1 to 2 h before transfusion.

General Advice

• Administer by IV infusion only, using accompanying administration set and large-gauge needle or catheter.
• Give medication as supplied; do not dilute.
• Do not administer if solution is cloudy or sediment is present.

Storage/Stability

Store at room temperature. Do not freeze.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Hypotension after rapid infusion (above 10 mL/min) or intra-arterial administration to patients undergoing cardiopulmonary bypass; rapid administration may cause vascular overload, dyspnea or pulmonary edema.

Miscellaneous

Allergic or pyogenic reactions (characterized by fever and chills).

Precautions

Monitor Allergic reactions Monitor for allergic or pyogenic reactions characterized by fever and chills. If these symptoms occur, discontinue treatment and notify health care provider. Hct Assess baseline Hct before infusion. I&O Monitor I&O. Monitoring levels Monitor liver and kidney function, Hct, electrolytes, plasma albumin, and total serum protein before and during therapy. Pulse/BP Take pulse and BP before and during infusion. Venous or pulmonary congestion/Hypotension If venous or pulmonary congestion worsens or if hypotension occurs, slow or discontinue infusion and notify health care provider.

Pregnancy

Category C .

Lactation

Undetermined.

Renal Function

Caution is needed because of added protein load.

Hepatic Function

Caution is needed because of added protein load.

Special Risk Patients

Circulatory overload may develop in patients with CHF, renal insufficiency, or stabilized chronic anemia.

Blood coadministration

Relative anemia can be avoided by supplementing or replacing large quantities of albumin with whole blood.

Patient Information

• Explain rationale for infusion of drug and need for frequent monitoring.
• Instruct patient to report the following symptoms to health care provider: fever, chills, headache, back pain.