Amino Acid + Glucose + Electrolytes
Composition
Each 100 ml contains-
Essential Amino Acids:
Essential Amino Acids:
- L-Isoleucine 0.390 gm
- L-Leucine 0.530 gm
- L-Lysine Hydrochloride 0.390 gm
- L-Methionine 0.190 gm
- L-Phenylalanine 0.550 gm
- L-Threonine 0.300 gm
- L-Tryptophan 0.100 gm
- L-Valine 0.430 gm
- L-Histidine 0.240 gm
- L-Tyrosine 0.050 gm
- L-Arginine 0.330 gm
- L-Aspartic Acid 0.410 gm
- L-Glutamic Acid 0.900 gm
- L-Alanine 0.300 gm
- L-Cystine 0.140 gm
- Glycine (Aminoacetic Acid) 0.210 gm
- L-Proline 0.810 gm
- L-Serine 0.750 gm
- Anhydrous Glucose 10.00 gm
- Sodium (Na+) 50.0 mmol/L
- Potassium (K+) 20.0 mmol/L
- Calcium (Ca++) 2.5 mmol/L
- Magnesium (Mg++) 1.5 mmol/L
- Chloride (Cl-) 32.0 mmol/L
Indications
This is indicated as a source of amino
acids, glucose and electrolytes in adult and pediatric patients needing
IV nutrition. This is particularly suitable for patients with basal
amino acid requirements.
Pharmacology
A crystalline amino acid solution provides
crystalline amino acids to promote protein synthesis and wound healing,
and to reduce the rate of endogenous protein catabolism. Amino Acids
given by central venous infusion in combination with concentrated
dextrose, electrolytes, vitamins, trace metals, and ancillary fat
supplements, constitutes total parenteral nutrition (TPN). Amino Acids
can also be administered by peripheral vein with dextrose and
maintenance electrolytes.
Dosage & Administration
Adults: The nitrogen
requirement for maintenance of body protein mass depends on the
condition of the patient (nutritional state and degree of metabolic
stress). The requirements are 0.1-0.15 g nitrogen/kg body weight/day (no
or minor metabolic stress and normal nutritional state), 0.15-0.2 g
nitrogen/kg body weight/day (moderate metabolic stress with or without
malnutrition) and up to 0.2-0.25 g nitrogen/kg body weight/day (severe
catabolism as in burns, sepsis and trauma). The dosage range 0.1-0.25 g
nitrogen/kg body weight/day corresponds to 11-27 mL Amino Acid IV
Infusion with 10% Glucose and Electrolytes /kg body weight/day,
respectively.
Obese patient: In obese patients, the dose should be based on the estimated ideal weight. Depending upon patient requirements, up to 1000-2000 mL of Amino Acid IV Infusion with 10% Glucose and Electrolytes may be infused IV per 24 hrs. Amino Acid IV Infusion with 10% Glucose and Electrolytes should be infused slowly, at a rate not exceeding 1000 mL in 6 hrs corresponding to approximately 2.8 mL/min. In patients with basal amino acids requirements, the less concentrated Amino Acid IV Infusion with 10% Glucose and Electrolytes may be used.
Infants and Children: In children and infants, a maximal rate of infusion of 30 mL Amino Acid IV Infusion with 10% Glucose and Electrolytes/kg body weight/day is recommended, with a stepwise increase in the rate of administration during the 1st week of treatment.
Obese patient: In obese patients, the dose should be based on the estimated ideal weight. Depending upon patient requirements, up to 1000-2000 mL of Amino Acid IV Infusion with 10% Glucose and Electrolytes may be infused IV per 24 hrs. Amino Acid IV Infusion with 10% Glucose and Electrolytes should be infused slowly, at a rate not exceeding 1000 mL in 6 hrs corresponding to approximately 2.8 mL/min. In patients with basal amino acids requirements, the less concentrated Amino Acid IV Infusion with 10% Glucose and Electrolytes may be used.
Infants and Children: In children and infants, a maximal rate of infusion of 30 mL Amino Acid IV Infusion with 10% Glucose and Electrolytes/kg body weight/day is recommended, with a stepwise increase in the rate of administration during the 1st week of treatment.
Interaction
At the recommended dosage the amino acid have no pharmacological effects and is not expected to interact with other medicaments.
Contraindications
Patients with inborn errors of amino acid
metabolism, severe liverdysfunction and in severe uremia when dialysis
facilities are not available. Due to the content of glucose,this drug is
contraindicated in patients with hyperosmolar nonketotic diabetic coma.
Side Effects
Nausea occurs rarely. Transient increases
in liver tests during IV nutrition have been reported. Hypersensitivity
reactions have been reported with amino acid solutions. As with all
hypertonic infusion solutions, thrombophlebitis may occur when
peripheral veins are used. Hyperphenylalaninemia may occur in severely
ill, premature infants.
Pregnancy & Lactation
No specific studies have been performed to
assess the safety of Amino Acids + Electrolytes + Glucose in pregnancy
and lactation. The prescriber should consider the benefit/risk
relationship before administering this combination to pregnant or
breastfeeding women.
Precautions & Warnings
This IV infusion is accompanied by
increased urinary excretion of the trace elements copper and, in
particular zinc, which should be taken into account in the dosing of
trace elements, particularly during long-term IV nutrition.
Hyperphenylalaninemia has been noted in severely ill premature infants.
In these patients, monitoring of the phenylalanine level is recommended
and the infusion rate adjusted as needed. This should be used with
caution in patients with diabetes mellitus, severe heart failure or with
renal function in combination with fluid restrictions or oliguria /
anuria of other origin. In patients with hyperglycemia, administration
of exogenous insulin might be necessary.
Overdose Effects
If Amino Acid, Glucose & Electrolytes
combination is administered at a higher rate than recommended, there is
an augmented risk for nausea, vomiting and sweating. When peripheral
veins are used thrombophlebitis may occur. Osmotic diuresis with
dehydration may occur if the dosage recommendations are exceeded. There
is also a risk of symptoms related to hyperglycemia. In case of symptoms
due to overdose, the infusion should be slowed down or discontinued.
Therapeutic Class
Parenteral nutritional preparations
Storage Conditions
Protect from light and store between 15° C to 25° C temperature. Avoid freezing.
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