Amino acids for parenteral nutrition + Other drugs [Minerals] - instructions for use, doses, side effects, contraindications

Clinical and pharmacological group: & nbsp

Means for enteral and parenteral nutrition

Included in the formulation

АТХ:

B.05.B.A Solutions for parenteral nutrition

B.05.B.A.01 Amino acids

Pharmacodynamics:Source of amino acids. Participation in the processes of metabolism and protein synthesis. Normalization of the electrolyte balance.

Pharmacokinetics:

The drug is used intravenously, bioavailability is 100%. Amino acids are included in the pool of free amino acids of the body, distributed in the interstitial fluid and the intercellular space. Assimilation of essential amino acids - 99%, replaceable - 97%. The total and renal clearance of essential amino acids is 0.5 l / min and 1.5 ml / min, for most interchangeable amino acids - 0.6 l / min and 3 ml / min. Half-life depends on the age of the patient.

Biotransformation occurs in the liver by deamination of the α-amino group. Arginine almost completely reabsorbed in the renal tubules. Excretion of urea is carried out by the kidneys, 5% of amino acids - in unchanged form. Calcium and magnesium ions penetrate the placental barrier and into breast milk. Elimination is carried out by the kidneys (potassium ions - in the distal tubules in exchange for sodium or hydrogen ions), a small amount is excreted with sweat. 25-30% of magnesium binds to plasma proteins.

Indications:Parenteral nutrition in the inability or inferiority of oral and probe nutrition. Conditions accompanied by protein deficiency. Parenteral nutrition with protein deficiency, including in newborns and premature infants; replenishment of the volume of circulating blood with bleeding, burns, surgical interventions.

ICD-10

I.A30-A49.A40 Streptococcal septicemia

I.A30-A49.A41 Other septicemia

IV.E40-E46.E46 Protein-energy insufficiency, unspecified

XI.K50-K52.K50 Crohn's disease [regional enteritis]

XI.K50-K52.K51 Ulcerative colitis

XI.K65-K67.K65.0 Acute peritonitis

XIX.T08-T14.T14 Injury of unspecified site

XIX.T20-T32.T30 Thermal and chemical burns, unspecified

Contraindications:Hypersensitivityrenal insufficiency with hyperazotemia, liver failure, impaired metabolism of amino acids, fructose and sorbitol, fructose intolerance, methanol intoxication, hyperhydration, acute craniocerebral trauma, children's age up to 2 years.

Carefully:Chronic heart failure, acidosis, hyperkalemia.

Pregnancy and lactation:

The category of FDA recommendations is not defined.Adequate and well-controlled studies on humans and animals have not been conducted.

There is no information on the penetration into breast milk. Complications in humans are not found.

Dosing and Administration:Intravenously drip. Adults: daily dose - at the rate of 0.6-1 g of amino acids per kg; at catabolic states - at the rate of 1.3-2 g of amino acids per kg. Children: daily dose - at the rate of 1.5-2.5 g of amino acids per kg. If the body needs more liquid and calories, you can additionally use an electrolyte solution "75", a solution of dextrose, inverted sugar, sorbitol, etc., alternating them or injecting simultaneously.

Side effects:Nausea, vomiting, chills, phlebitis, allergic reactions, hyperbilirubinemiaincrease in transaminase activity in the liver.

Overdose:

Overdose or too rapid administration of the drug can cause chills, nausea, vomiting and increased excretion of amino acids by the kidneys.

Treatment: the drug infusion should be discontinued and restarted at a slower rate.

Interaction:The solution should not be mixed with other drugs.

Special instructions:

With chronic kidney failure, hyperkalemia, shock before the drug should be restored to a sufficient level of diuresis.

Too high rate of drug administration can lead to hyperkalemia and ammonia intoxication in infants.

During treatment, it is necessary to monitor the water-electrolyte and acid-base balance, serum protein level, serum osmolarity, blood glucose concentration and liver function.

For patients with hepatic, renal, cardiac, pulmonary insufficiency, it is necessary to select an individual dosing regimen.

With prolonged administration (within a few weeks), coagulation factors and the cellular composition of the blood should be monitored. In the case of hypotonic dehydration, an adequate balance of water and electrolytes should be restored first, and then parenteral nutrition should be started.

Storage at temperatures below 15 ° C can cause the formation of crystals that dissolve when the solution is heated to 25 ° C and shaken lightly.

Instructions

Amino acids for parenteral nutrition + Other drugs [Minerals] (Aminoacids for parenteral nutrition + Other medicines [Multimineral])