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CAPD/DPCA is a brand name for Calcium Chloride. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: End-stage (decompensated) chronic renal failure of any origin which can be treated with peritoneal dialysis.
Verbatim from this product's MHRA label. Tap a section to expand.
Posology CAPD/DPCA 17 is exclusively indicated for intraperitoneal use. The mode of therapy, frequency of administration, and dwell time required will be specified by the attending physician.
Continuous ambulatory peritoneal dialysis (CAPD) Adults:
Unless otherwise prescribed, patients will receive an infusion of 2000 ml solution per exchange four times a day. After a dwell time between 2 and 10 hours the solution will be drained. Adjustment of dosage, volume and number of exchanges will be necessary for individual patients.
If dilation pain occurs at the commencement of peritoneal dialysis treatment, the solution volume per exchange should be temporarily reduced to 500-1500 ml. In large patients and if residual renal function is lost, an increased volume of dialysis solution will be necessary.
In these patients, or patients who tolerate larger volumes, a dose of 2500 – 3000 ml solution per exchange may be given.
Paediatric population:
In children the solution volume per exchange should be prescribed according to age and body surface area (BSA). For initial prescription, the volume per exchange should be 600-800 ml/m2 BSA with 4 (sometimes 3 or 5) exchanges per day.
It can be increased up to 1000-1200 ml/m2 BSA depending on tolerance, age and residual renal function. Automated peritoneal dialysis (APD) A machine (cycler) is used for intermittent or continuous cyclic peritoneal dialysis. g. 5000 ml) providing more than one solution exchange are used.
The cycler performs the solution exchanges according to the medical prescription stored in the cycler.
Adults:
Typically, patients spend 8-10 hours a night cycling. Dwell volumes range from 1500 to 3000 ml and the number of cycles usually varies from 3 to 10 per night. The amount of fluid used is typically between 10 and 18 l but can range from 6 to 30 l.
The cycler therapy at night is usually combined with 1 or 2 exchanges during the daytime.
Paediatric population:
The volume per exchange should be 800-1000 ml/m2 BSA with 5-10 exchanges overnight. It can be increased up to 1400 ml/m2 BSA depending on tolerance, age and residual renal function. There are no special dosage recommendations for elderly patients.
Possible adverse reactions may result from the peritoneal dialysis treatment itself or may be induced by the dialysis solution. g. hypokalaemia (very common) - Hypocalcaemia (uncommon) General disorders and administration site conditions - Dizziness (uncommon) - Oedema (uncommon) - Disturbances in fluid balance (uncommon) indicated either by a rapid decrease (dehydration) or increase (overhydration) in body weight.
Severe dehydration might occur when using solutions of higher glucose concentration. Potential adverse reactions of the treatment mode Infections and infestations - Peritonitis (very common) indicated by a cloudy effluent. Later abdominal pain, fever, and general malaise may develop or, in very rare cases, sepsis.
The patient should seek medical advice immediately. The bag with the cloudy effluent should be closed with a sterile cap and assessed for microbiological contamination and white blood cell count. - Skin exit site and tunnel infections (very common) indicated by redness, oedema, exudations, crusts and pain at the catheter exit site.
In case of skin exit site and tunnel infections the attending physician should be consulted as soon as possible. Respiratory, thoracic and mediastinal disorders - Dyspnoea caused by the elevated diaphragm (not known) Gastrointestinal disorders - Hernia (very common) - Abdominal distension and sensation of fullness (common) - Diarrhoea (uncommon) - Constipation (uncommon) - Encapsulating peritoneal sclerosis (not known) Injury, poisoning and procedural complications - In- and outflow disturbances of the dialysis solution (common) - Shoulder pain (common) Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.
It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
The solution for peritoneal dialysis must not be used for intravenous infusion. CAPD/DPCA 17 should only be administered after careful benefit-risk assessment in: - loss of electrolytes due to vomiting and/or diarrhoea (a temporary change to a peritoneal dialysis solution containing potassium might then become necessary).
- hyperparathyroidism: The therapy should comprise the administration of calcium-containing phosphate binders and/or vitamin D to ensure adequate enteral calcium supply. - hypocalcaemia: It may be necessary to use a peritoneal dialysis solution with a higher calcium concentration either temporarily or permanently, in case an adequate enteral supply with calcium by calcium-containing phosphate binders and/or vitamin D is not possible.
- patients receiving digitalis therapy: Regular monitoring of the serum potassium level is mandatory. Severe hypokalaemia may necessitate the use of a potassium-containing dialysis solution together with dietary counselling. 25 %) should be used cautiously to protect the peritoneal membrane, to prevent dehydration and to reduce the glucose load.
A loss of proteins, amino acids, and water-soluble vitamins occurs during peritoneal dialysis. To avoid deficiencies an adequate diet or supplementation should be ensured. The transport characteristics of the peritoneal membrane may change during long-term peritoneal dialysis primarily indicated by a loss of ultrafiltration.
In severe cases peritoneal dialysis must be stopped and haemodialysis commenced. Regular monitoring of the following parameters is recommended: - body weight for the early recognition of over- and dehydration, - serum sodium, potassium, calcium, magnesium, phosphate, acid base balance and blood proteins, - serum creatinine and urea, - blood sugar, - parathormone and other indicators of bone metabolism, - residual renal function in order to adapt the peritoneal dialysis treatment.
For this specific peritoneal dialysis solution CAPD/DPCA 17 must not be used in patients with lactic acidosis, severe hypokalaemia, severe hypocalcaemia, hypovolaemia and arterial hypotension. Due to the content of fructose, this medicinal product is not suitable for patients with fructose intolerance (hereditary fructose intolerance).
A non-recognised hereditary fructose intolerance must be excluded prior to administration to babies and infants. For peritoneal dialysis treatment in general A peritoneal dialysis treatment should not be commenced in case of: - recent abdominal surgery or injury, a history of abdominal operations with fibrous adhesions, severe abdominal burns, bowel perforation - extensive inflammatory conditions of the abdominal skin (dermatitis), - inflammatory bowel diseases (Crohn's disease, ulcerative colitis, diverticulitis), - peritonitis, - internal or external abdominal fistula, - umbilical, inguinal or other abdominal hernia, - intra-abdominal tumours, - ileus, - pulmonary disease (especially pneumonia), - sepsis, - extreme hyperlipidaemia, - in rare cases of uraemia, which cannot be managed by peritoneal dialysis, - cachexia and severe weight loss, particularly in cases in which the ingestion of adequate protein is not guaranteed, - patients who are physically or mentally incapable of performing peritoneal dialysis as instructed by the physician.
If any of the above-mentioned disorders develop during the peritoneal dialysis treatment, the attending physician has to decide on how to proceed.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Peritoneal dialysis is a long-term therapy involving repeated administrations of single solutions. Method of administration Patients must be trained appropriately, must practise the technique and be shown to be proficient at performing peritoneal dialysis before performing it at home.
The training should be performed by qualified personnel. The attending physician must ensure that the patient masters the handling techniques sufficiently before the patient performs peritoneal dialysis at home. In case of any problems or uncertainty the attending physician should be contacted.
Dialysis using the prescribed doses should be performed daily and should be continued for as long as renal function substitution therapy is required. Continuous ambulatory peritoneal dialysis (CAPD): stay•safe bag The solution bag is first warmed to body temperature.
6. The appropriate dose is infused in the peritoneal cavity using a peritoneal catheter over 5 - 20 minutes. Depending on physician's instructions, the dose should dwell in the peritoneal cavity for 2 - 10 hours (equilibrium time), and then be drained.
Automated peritoneal dialysis (APD): sleep•safe bag The connectors of the prescribed sleep•safe solution bags are inserted in the free tray ports and then automatically connected to the tubing set by the cycler. The cycler checks the bar codes of the solution bags and gives an alarm when the bags do not comply with the prescription stored in the cycler.
After this check the tubing set can be connected to the patient’s catheter extension and the treatment be started. The sleep•safe solution is automatically warmed up to body temperature by the cycler during the inflow into the abdominal cavity.
Dwell times and selection of glucose concentrations are carried out according to the medical prescription stored in the cycler (for more details please refer to the operating instructions of the cycler). e. with lower osmolarity).
CAPD/DPCA 17 contains 15 g glucose in 1000 ml solution. Depending on the dosage instructions and the pack size used up to 45 g glucose (CAPD 3000 ml stay•safe) or up to 75 g glucose (APD, 5000 ml sleep•safe) are supplied to the body with each bag.
This should be taken into account in patients with diabetes mellitus. The effluent should be checked for clarity and volume. Turbidity and/or abdominal pain are indicators of peritonitis. Encapsulating peritoneal sclerosis is considered to be a known, rare complication of peritoneal dialysis therapy which can infrequently lead to fatal outcome.
Elderly patients The increased incidence of hernia should be considered in elderly patients prior to the start of peritoneal dialysis.