Hyaluronidase protocol pdf

Medically reviewed by Drugs. Written by Cerner Multum.

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Hyaluronidase is used together with fluids injected into the body to treat dehydration. Hyaluronidase can also be used as an aid in helping your body absorb other injected medications. Hyaluronidase is also used to help contrast dyes in your body show more clearly on certain types of x-rays or scans.

Serious drug interactions can occur when certain medicines are used together with hyaluronidase. Tell your doctor about all your current medicines. Your doctor may perform a skin test to see if you are allergic to hyaluronidase before you receive the medication.

Some medicines can cause unwanted or dangerous effects when used with hyaluronidase. Your doctor may change your treatment plan if you also use:. Get emergency medical help if you have signs of an allergic reaction: hives ; difficulty breathing; swelling of your face, lips, tongue, or throat. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. Other drugs may affect hyaluronidase, including prescription and over-the-counter medicines, vitaminsand herbal products.

Tell your doctor about all your current medicines and any medicine you start or stop using. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Skip to Content. Detailed Hyaluronidase dosage information. Hyaluronidase side effects more detail. Hyaluronidase drug interactions more detail. Drug Status Availability Prescription only Rx. Drug Class. Miscellaneous uncategorized agents. Related Drugs. Subscribe to our newsletters. FDA Safety Alerts for all medications. Daily MedNews. Weekly Drug News Roundup. Monthly Newsletter.

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Hyalase Tutorial pt.2

Research Feed. Hyaluronic Acid Filler Emergency Kit.J Clin Aesthet Dermatol. Hyaluronic acid HA -based dermal fillers are the most commonly used fillers in the aesthetics market. HA is a linear polysaccharide chain with the alternating monosaccharides d-glucuronic acid and N-acetyl-d-glucosamine.

There are several sources of hyaluronidase, and they are generally divided into three subgroups: mammalian obtained from the testes ; hookworm or leech; and microbes. Hyaluronidase has immediate effect and a half-life of two minutes with duration of action of 24 to 48 hours. This might be due to the low number units required to have a clinically significant effect; thus, even when the hyaluronidase has mostly degraded, its action continues. Additionally, the initial action of hyaluronidase might break cross-links in the HA dermal filler so that it behaves like native HA in the skin, which has a half-life of 24 to 48 hours.

Vascular occlusion. The incidence of impending necrosis following dermal filler treatment has been estimated at 0. Normal skin should be non-discolored and warm, with a capillary refill time of 1 to 2 seconds, whereas arterial compromise will have a slow capillary refill time and dusky or blue-grey-black appearance, and venous insufficiency will have a fast capillary time and bluish discoloration.

Hyaluronidase should be administered as soon as this complication occurs within 4 hours. Blindness due to periocular embolism of HA is instant and associated with excruciating ocular pain. The retinal circulation needs to be restored within 60 to 90 minutes if the retina is to survive. Blindness is a medical emergency and the patient should be transferred immediately to the nearest hospital eye department Refer to the ACE Group guidance on blindness Treatment of blindness is rarely successful.

Tyndall effect. The Tyndall effect refers to the scattering of light that may be seen in some patients after injection of HA resulting in a bluish hue of the skin and most commonly seen in the sub ocular region.

Unacceptable cosmetic outcome. Overcorrection or misplacement of HA filler can be successfully treated with hyaluronidase, although this is often caused by poor injection technique or poor choice of product for a particular indication. If HA is present, then hyaluronidase is effective, and HA gel has been successfully removed 63 months post-treatment. Delayed onset nodules. It is important to remember that hyaluronidase is used to help diffuse fluids intradermally and for hypodermoclysis.

To prevent potential dissemination of infection in inflammed nodules, it is important to prescribe antibiotics for one week before administering hyaluronidase. Allergic or immunogenic reaction to the HA dermal filler.Send the page " " to a friend, relative, colleague or yourself. We do not record any personal information entered above. Hydrolyzes hyaluronic acid in connective tissue, which enhances connective tissue permeability For increasing the absorption and dispersion of other injected drugs, for hypodermoclysis rehydration, and for improving resorption of radiopaque agents in subcutaneous urography Hypersensitivity may occur; skin testing can be performed.

Clinical trial data documenting dosages used in practice are limited, although use clinically is common; it is estimated that the most common use of hyaluronidase is as a spreading agent for anesthetics in ophthalmologic surgery. Doses of 15 to units of hyaluronidase administered intravitreally in conjunction with various parenteral anesthetics have been reported in the literature.

In a Phase III trial for the treatment of vitreous bleeding, an increased incidence of adverse events was noted with an intravitreal dosage of hyaluronidase 75 units, the highest dose evaluated in this study. Consult appropriate references to determine the usual precautions for the use of any other drug with hyaluronidase. Rate and volume of administration should not exceed those employed for intravenous infusion. Do not exceed a maximum fluid volume of mL per single clysis.

Although a specific neonatal dosage is not provided in the product labeling, a dosage of 20 units per mL of administered fluid may be considered based on the recommended dosage for older patients i.

The dosage of subcutaneous fluids administered is dependent on the age, weight, and clinical condition of the patient. Although a specific neonatal dosage is not provided in the product labeling, a dosage of 15 units per mL of administered fluid may be considered based on the recommended dosage for older patients i.

Total doses of to units have been used; divide the total dose and inject subcutaneously or intradermally between 5 to 10 sites along the leading edge of the extravasation. If a single syringe is used change the needle after each injection.

Larger doses have been used and may be appropriate for large extravasations, for example. Adjunctive medical therapy for extravasation should also be considered, including hot or cold compresses extravasating agent dependentelevation of the affected limb, surgical debridement, and wound care.

Examples of drugs where hyaluronidase may be effective in treating extravasation include: antineoplastic agents e. Inject 55 units intravitreally. A dose of 7. An increased incidence of adverse events has been noted with an intravitreal dosage of 75 units. Pooled data from 2 Phase III clinical trials evaluating the efficacy of a single 55 unit injection resulted in a statistically significant effect on the primary efficacy endpoint i.

These results were supported by significant improvements in 3 secondary endpoints i. A single dose of Vitrase is used to cause a detachment of the vitreous humor from the retina; data indicate the drug may delay diabetic retinopathy. Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. The solutions should be clear and colorless. Hypersensitivity Test Dose Vitrase, Amphadase, Hylenex, Hydase A preliminary skin test for hypersensitivity can be performed with any formulation of hyaluronidase prior to the full-dose administration.

Inject approximately 0. A positive reaction consists of a wheal with pseudopods appearing within 5 minutes and persisting for 20 to 30 minutes and accompanied by localized itching. Transient vasodilation i. Discontinue if sensitization occurs. Administration for Absorption and Dispersion of other Drugs Absorption and dispersion of other injected drugs may be enhanced by adding 50 to units, most typically units of hyaluronidase, to the injection solution prior to infiltration use, interstitial use, intramuscular use, intraocular use, retrobulbar use, soft tissue use, or subcutaneous use.

Consult appropriate references regarding physical or chemical incompatibilities before adding hyaluronidase to a solution containing another drug.

Hyaluronidase (injection)

Storage Vitrase only : If Vitrase is mixed with other drugs, the solution should be stored at 15 to 25 degrees C 59 to 77 degrees F and used within 6 hours. Alternatively, hyaluronidase may be added to small volumes of fluid replacement solutions. For infants and children less than 3 years, the volume of a single clysis should be limited to mL. As with all parenteral fluid therapy, closely observe the effect on the patient and use the same precautions for restoring fluid and electrolyte balance as when administering intravenous injections.

For older patients, do not exceed a rate and volume of administration greater than those employed for intravenous infusion.Drug information provided by: IBM Micromedex.

Hyaluronidase is a natural substance found in the body, which is collected from either cows or pigs. It is cleaned up to remove animal substances. It may also be produced in a laboratory that recreates it from human albumin sources. Hyaluronidase injection is a spreading substance.

It is used with other medicines given under the skin to improve their uptake by the body. This method of drug delivery is only used when the drug cannot be given by injection into a vein.

hyaluronidase protocol pdf

Hyaluronidase injection is also used to increase absorption of fluids or medicines that are injected into your skin. It also used to help improve absorption of radioactive substances during a procedure called subcutaneous urography. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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hyaluronidase protocol pdf

Products and services. Free E-newsletter Subscribe to Housecall Our general interest e-newsletter keeps you up to date on a wide variety of health topics. Sign up now. Mayo Clinic Marketplace Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.Individual trees in the boosted trees differ from trees in bagged or random forest ensembles. Primarily the difference is that boosted trees do not try to predict the objective field directly. Instead, they try to fit a gradient (correcting for mistakes made in previous iterations), and this will be stored under a new field, named gradient.

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hyaluronidase protocol pdf

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