Urea is a diuretic and dehydrating drug used to prevent and reduce toxic pulmonary edema and brain edema.
Release form and composition
Urea is produced in the form of a substance-powder (in dark glass jars of 100, 250 or 500 g; in plastic bags of 1, 5, 10, 25, 30 or 50 kg).
Indications for use
- Neurosurgical practice: mainly, early stages of brain edema;
- Ophthalmology: glaucoma, especially during acute attacks.
Urea is also prescribed for the treatment of onychomycosis, ichthyosis, hyperkeratosis and purulent wounds.
- Cerebral edema on the background of hemorrhagic stroke (due to the possibility of re-bleeding);
- Severe renal / hepatic failure;
- Hypersensitivity to the drug.
With caution, Urea is used in cases of hypovolemia, renal / hepatic failure, chronic heart failure.
Dosing and Administration
The solution prepared from a substance powder is administered intravenously. It is prepared immediately before use, following the rules of asepsis. It should be borne in mind that using pre-prepared solutions may develop hemolysis.
As a rule, a 30% solution prepared on a 10% glucose solution is used. The dissolution of the substance-powder occurs with the absorption of heat. Before use, the solution must be maintained until its temperature rises to room temperature.
The drug is administered intravenously at a rate of 40-60-80 drops per minute. If it is necessary to obtain the maximum and rapid effect, the introduction rate is increased to 80-120 drops per minute.
Urea dose can vary from 0.5 to 1.5 g (on average - 1 g) per 1 kg of patient's body weight. Usually the effect occurs in 15-30 minutes and lasts 5-6 hours or more (up to 14 hours). If the effect is insufficient, it is possible to re-introduce Urea with a break of 12-24 hours (no more than 2-3 injections).
With glaucoma, there is a decrease in intraocular pressure, with brain edema — a decrease in intracranial pressure, a decrease in the tension of the dura mater, and the appearance of a pulsation.
Inside Urea is prescribed in the form of a 30% or 50% solution in sugar syrup at a dose of 0.75-1.5 g / kg. There is evidence that in the treatment of glaucoma, the hypotensive effect after oral administration of the drug occurs at the same time (in 30-45 minutes) as with intravenous drip. The effect on brain tissue during cerebral edema is manifested only a few hours after taking the drug inside.
To prevent the development of water imbalance in the first 24 hours after using the drug, 500-800 ml of isotonic glucose or sodium chloride solution with the addition of 0.2-0.3 g of ascorbic acid and 0.1-0.15 g of thiamine must be injected intravenously. The appointment of other diuretics simultaneously with urea is unacceptable.
With the introduction of the drug to patients who are unconscious or under anesthesia, a catheter should be inserted into the bladder for urinary diversion.
To avoid irritation and tissue necrosis, do not allow the solution to get under the skin.
In the treatment of onychomycosis, 30% urea ointment, hyperkeratosis and ichthyosis - 10% cream are used as a keratolytic agent.
When purulent wounds (for cleaning from necrotic masses) apply wet dressings and irrigation with a 10% solution of the drug.
During urea therapy, heartburn, nausea, and vomiting may occur.
When administered parenterally - phlebitis at the injection site, vein thrombosis, subdural or subarachnoid hemorrhage, electrolyte imbalance, fever, palpitations, confusion, drowsiness, weakness, dizziness, headache, high blood pressure, dry mouth, thirst.
In the first hours after administration, a brief increase in the concentration of residual nitrogen in the blood.
In combination with loop diuretics, it is possible to use Urea for heart failure and hypertensive crisis with encephalopathy.
During therapy, it is necessary to control blood pressure, kidney function, electrolytes, and urea nitrogen concentration.
The drug increases the excretion of kidney lithium. Other diuretics (including carbonic anhydrase inhibitors) can reduce the effect of Urea.
Terms and conditions of storage
Store in a sealed container out of the reach of children at a temperature up to 25 ° C.
Shelf life - 4 years.