Included in the formulation
АТХ:B.05.B.A Solutions for parenteral nutrition
Pharmacodynamics:Source of amino acids. Participation in the processes of metabolism and protein synthesis. It is necessary to have eight essential amino acids (L-valine, L-isoleucine, L-leucine, L-lysine, L-methionine, L-threonine, L-phenylalanine, L-tryptophan) and conditionally-replaceable amino acids (in some pathophysiological states synthesized in insufficient amounts) - L-arginine and L-histidine. L-form of amino acids provides the possibility of their direct participation in protein biosynthesis. L-arginine promotes the conversion of ammonia into urea, binds toxic ammonium ions produced by the catabolism of proteins in the liver. L-alanine and L-proline reduce the body's need for glycine. L-isoleucine, L-leucine, L-valine (irreplaceable amino acids with branched side chains) are directly absorbed by peripheral tissues (their metabolism does not depend on the degree of liver damage), reduces the assimilation and intake of aromatic amino acids in the central nervous system, reducing the signs of hepatic encephalopathy, normalize the energy and nitrogen balance in the body.
Pharmacokinetics: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.
The elimination half-life depends on the age. Biotransformation in the liver by deamination of α-amino groups. Arginine almost completely reabsorbed in the renal tubules. Elimination in the form of urea is carried out by the kidneys (5% of amino acids - unchanged).
Indications:Partial or complete parenteral nutrition in conjunction with solutions of carbohydrates, fat emulsions, as well as preparations of vitamins, electrolytes and trace elements, when enteral nutrition is impossible or insufficient; partial replacement of protein deficiency in diseases or conditions accompanied by protein deficiency (disorders of digestion or absorption of proteins due to gastrointestinaldiseases, burns, injuries, postoperativeth period, cirrhosis, nephrosis, febrile conditions, acute infectious diseases, anorexia).
IV.E40-E46.E46 Protein-energy insufficiency, unspecified
Contraindications:Violation of amino acid metabolism, metabolic acidosis, hyperhydration, hypokalemia, children's age (up to 6 years).
Carefully:Renal / hepatic insufficiency.
Pregnancy and lactation:The category of FDA recommendations is not defined. Adequate and well-controlled studies on humans and animals have not been conducted.
Use during pregnancy is only possible in situations where the potential benefit of using the drug for the mother exceeds the possible risk to the fetus. During breastfeeding with the drug should stop breastfeeding.
Dosing and Administration:Intravenous drip, mainly in the central veins, at a rate of 2 ml per minute (maximum 40 drops per minute).
With parenteral nutrition, the maximum daily dose: children over 6 years and adults - 2.5 grams of amino acids per 1 kg of body weight.
The drug is used as long as there is a need for parenteral nutrition.
In diseases or conditions accompanied by protein deficiency daily dose for children over 6 years and adults - 1.3-2 grams of amino acids per kg.
Side effects:Locally - redness at the injection site, phlebitis, thrombosis; allergic reactions, including bronchospasm. If the speed of injection is exceeded, chills, nausea, vomiting, renal amino acidosis are possible.
Overdose:Symptoms: signs of acute circulatory disturbance.
Treatment: the drug should be discontinued immediately.
Interaction:Do not mix with medicines not intended for parenteral nutrition.
Special instructions:A daily examination of the puncture area is recommended.
The amino acids contained in the preparation can become a nutrient medium for microorganisms, and therefore the equipment for intravenous infusion should be carefully sterilized.
When cardiac activity is decompensated, the dose of the drug should be reduced, with a cerebral hemorrhage, the total volume of the injected liquid is no more than 2 liters per day. With thrombophlebitis, drugs are injected through the central veins.