Serum albumin

Serum albumin
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alberto Plate [2]

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Overview

Serum albumin is a volume expander that is FDA approved for the treatment of burn therapy, Cardiopulmonary bypass, hypovolemic shock, acute liver failure and sequestration of protein rich fluids. Common adverse reactions include {{{adverseReactions}}}.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Emergency Treatment of Hypovolemic Shock

Albuked 5 is iso-oncotic with normal plasma and on intravenous infusion will expand the circulating blood volume by an amount approximately equal to the volume infused. In conditions associated mainly with a volume deficit, albumin is best administered as a 5% solution (Albuked 5); but where there is an oncotic deficit, Albumin (Human) 25%, USP (Albuked™ 25) may be preferred. This is also an important consideration where the treatment of the shock state has been delayed. If Albuked 25 is used, appropriate additional crystalloid should be administered.(1)

Crystalloid solutions in volumes several times greater than that of Albuked 5 may be effective in treating shock in younger individuals who have no preexisting illness at the time of the incident. Older patients, especially those with preexisting debilitating conditions, or those in whom the shock is caused by a medical disorder, or where the state of shock has existed for some time before active therapy could be instituted, may not tolerate hypoalbuminemia as well.(1)

Removal of ascitic fluid from a patient with cirrhosis may cause changes in cardiovascular function and even result in hypovolemic shock. In such circumstances, the use of albumin infusion may be required to support the blood volume.

Burn Therapy

An optimal therapeutic regimen with respect to the administration of colloids, crystalloids, and water following extensive burns has not been established. During the first 24 hours after sustaining thermal injury, large volumes of crystalloids are infused to restore the depleted extracellular fluid volume. Beyond 24 hours, albumin can be used to maintain plasma colloid osmotic pressure. Albuked 25 may be preferred for this purpose.

Cardiopulmonary Bypass

With the relatively small priming volume required with modern pumps, preoperative dilution of the blood using albumin and crystalloid has been shown to be safe and well-tolerated. Although the limit to which the hematocrit and plasma protein concentration can be safely lowered has not been defined, it is common practice to adjust the albumin and crystalloid pump prime to achieve a hematocrit of 20% and a plasma albumin concentration of 2.5 g per 100 mL in the patient.

Acute Liver Failure

In the uncommon situation of rapid loss of liver function, with or without coma, administration of albumin may serve the double purpose of supporting the colloid osmotic pressure of the plasma as well as binding excess plasma bilirubin.

Sequestration of Protein Rich Fluids

This occurs in such conditions as acute peritonitis, pancreatitis, mediastinitis, and extensive cellulitis. The magnitude of loss into the third space may require treatment of reduced volume or oncotic activity with an infusion of albumin.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Serum albumin in adult patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Serum albumin in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

There is limited information regarding Serum albumin FDA-Labeled Indications and Dosage (Pediatric) in the drug label.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Serum albumin in pediatric patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Serum albumin in pediatric patients.

Contraindications

There is limited information regarding Serum albumin Contraindications in the drug label.

Warnings

There is limited information regarding Serum albumin Warnings' in the drug label.

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Serum albumin Clinical Trials Experience in the drug label.

Postmarketing Experience

There is limited information regarding Serum albumin Postmarketing Experience in the drug label.

Drug Interactions

There is limited information regarding Serum albumin Drug Interactions in the drug label.

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): There is no FDA guidance on usage of Serum albumin in women who are pregnant.
Pregnancy Category (AUS): There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Serum albumin in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Serum albumin during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Serum albumin in women who are nursing.

Pediatric Use

There is no FDA guidance on the use of Serum albumin in pediatric settings.

Geriatic Use

There is no FDA guidance on the use of Serum albumin in geriatric settings.

Gender

There is no FDA guidance on the use of Serum albumin with respect to specific gender populations.

Race

There is no FDA guidance on the use of Serum albumin with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Serum albumin in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Serum albumin in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Serum albumin in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Serum albumin in patients who are immunocompromised.

Administration and Monitoring

Administration

There is limited information regarding Serum albumin Administration in the drug label.

Monitoring

There is limited information regarding Serum albumin Monitoring in the drug label.

IV Compatibility

There is limited information regarding the compatibility of Serum albumin and IV administrations.

Overdosage

There is limited information regarding Serum albumin overdosage. If you suspect drug poisoning or overdose, please contact the National Poison Help hotline (1-800-222-1222) immediately.

Pharmacology

There is limited information regarding Serum albumin Pharmacology in the drug label.

Mechanism of Action

There is limited information regarding Serum albumin Mechanism of Action in the drug label.

Structure

There is limited information regarding Serum albumin Structure in the drug label.

Pharmacodynamics

There is limited information regarding Serum albumin Pharmacodynamics in the drug label.

Pharmacokinetics

There is limited information regarding Serum albumin Pharmacokinetics in the drug label.

Nonclinical Toxicology

There is limited information regarding Serum albumin Nonclinical Toxicology in the drug label.

Clinical Studies

There is limited information regarding Serum albumin Clinical Studies in the drug label.

How Supplied

There is limited information regarding Serum albumin How Supplied in the drug label.

Storage

There is limited information regarding Serum albumin Storage in the drug label.

Images

Drug Images

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Package and Label Display Panel

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Patient Counseling Information

There is limited information regarding Serum albumin Patient Counseling Information in the drug label.

Precautions with Alcohol

Alcohol-Serum albumin interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

There is limited information regarding Serum albumin Brand Names in the drug label.

Look-Alike Drug Names

There is limited information regarding Serum albumin Look-Alike Drug Names in the drug label.

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

WikiDoc Resources for Serum albumin
Articles
Most recent articles on Serum albumin Most cited articles on Serum albumin Review articles on Serum albumin Articles on Serum albumin in N Eng J Med, Lancet, BMJ
Media
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Evidence Based Medicine
Cochrane Collaboration on Serum albumin Bandolier on Serum albumin TRIP on Serum albumin
Clinical Trials
Ongoing Trials on Serum albumin at Clinical Trials.gov Trial results on Serum albumin Clinical Trials on Serum albumin at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Serum albumin NICE Guidance on Serum albumin NHS PRODIGY Guidance FDA on Serum albumin CDC on Serum albumin
Books
Books on Serum albumin
News
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Commentary
Blogs on Serum albumin
Definitions
Definitions of Serum albumin
Patient Resources / Community
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Healthcare Provider Resources
Symptoms of Serum albumin Causes & Risk Factors for Serum albumin Diagnostic studies for Serum albumin Treatment of Serum albumin
Continuing Medical Education (CME)
CME Programs on Serum albumin
International
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Business
Serum albumin in the Marketplace Patents on Serum albumin
Experimental / Informatics
List of terms related to Serum albumin

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]

Overview

Serum albumin, often referred to simply as albumin, is the most abundant plasma protein in humans and other mammals. Albumin is essential for maintaining the osmotic pressure needed for proper distribution of body fluids between intravascular compartments and body tissues. It also acts as a plasma carrier by non-specifically binding several hydrophobic steroid hormones and as a transport protein for hemin and fatty acids.

Classification

• The human version is human serum albumin.
• Bovine serum albumin, or BSA, is commonly used in immunodiagnostic procedures, clinical chemistry reagents, cell culture media, protein chemistry research and molecular biology laboratories.

Pathophysiology

Albumin is negatively charged. The glomerular basement membrane is also negatively charged; some studies suggest that this prevents the filtration of albumin in the urine. According to this theory, that charge plays a major role in the selective exclusion of albumin from the glomerular filtrate, a defect in this property results in nephrotic syndrome. Thus, there is more albumin loss in the urine. Nephrotic syndrome patients are sometimes given albumin to replace the lost albumin.

Because smaller animals (for example rats) function at a lower blood pressure, they need less oncotic pressure to balance this, and thus need less albumin to maintain proper fluid distribution.

Serum albumin contains eleven distinct binding domains for hydrophobic compounds. One hemin and six long-chain fatty acids can bind to serum albumin at the same time .

References

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