Amino acids for parenteral nutrition + Other drugs [Multivitamins] - 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.10 Combined preparations for parenteral nutrition

Pharmacodynamics:Source of amino acids. Participation in the processes of metabolism and protein synthesis. Normalization of electrolyte balance, nitrogen balance. Replenishment of deficiency of proteins and microelements.

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%. Total and renal clearance of essential amino acids - 0.5 l in a minute and 1.5 ml in a minute, the majority of non-essential amino acids - 0,6 l in a minute and 3 ml in a minute. 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 trauma, burns, blood loss, renal and intestinal loss of proteins, in pre- and postoperatively(prevention and treatment of protein deficiency).

ICD-10

I.B15-B19.B19 Viral hepatitis, unspecified

IV.E70-E90.E72.2 Disorders of urea cycle exchange

IX.I80-I89.I85.0 Varicose veins of the esophagus with bleeding

XI.K70-K77.K72 Hepatic failure, not elsewhere classified

XI.K70-K77.K72.0 Acute and subacute liver failure

XI.K70-K77.K72.9 Hepatic failure, unspecified

XI.K70-K77.K73 Chronic hepatitis, not elsewhere classified

XI.K70-K77.K74 Fibrosis and cirrhosis of the liver

XVIII.R30-R39.R39.2 Extrarenal uremia

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

Contraindications:Severe renal and hepatic insufficiency, decompensatedheart failure, hyperkalemia, a violation of the metabolism of fructose, methanol poisoning.

Carefully:With lactacidosis (since the composition of the drug includes sorbitol).

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, at a rate of 20-40 drops per minute, the maximum daily dose - 30 ml / kg.

Side effects:Nausea, tachycardia, increased sweating, fever, allergic reactions.

Overdose:

Symptoms: nausea, vomiting, increased sweating, fever, tachycardia. With a high rate of administration, hypervolemia and a violation of the electrolyte composition of the blood plasma are possible. Symptoms of overdose are reversible.

Treatment: it is necessary to reduce the rate of administration or stop the injection of the drug; symptomatic therapy.

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

Special instructions:

In chronic kidney failure, hyperkalemia, shock should be used only after reaching a sufficient diuresis.A very high rate of drug administration can lead to hyperkalemia and ammonia intoxication in infants.

During the treatment it is necessary to control the water-electrolyte and acid-base balance, whey protein content, 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 (within a few weeks) administration, coagulation factors and the cellular composition of the blood should be monitored. In the presence of hypotonic dehydration, an adequate balance of water and electrolytes should be restored, 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 is shaken lightly.

Instructions

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