2010/09/20

Aminosol

Composition, structure and packing

Solution for infusion 1 L (600 kcal) 1 l (800 kcal):
L-Valine 1.6 g 3.2 g;
L-isoleucine 1.4 g/2.8 g;
L-leucine 2.2 g / 4.4 g;
L-Lysine-chloride, 2 g / 4 g;
L-methionine 2.2 g / 4.4 g;
L-threonine, 1 g / 2 g;
L-tryptophan 500 mg / 1 g;
L-phenylalanine 2.2 mg / 4.4 mg;
L-arginine 5 g/10 g;
L-histidine-chloride monohydrate g/3.24 1.62 g;
L-alanine 17.1 g/34.2 g;
glycine 10 g/20 g;
L-ornithine;
L-Aspartate 500 mg / 1 g;
L-proline, 3.5 g / 7 g;
sorbitol 100 g/100 g;
L-malic acid g/6.79 3,395 g;
Na 30 mmol/30 mmol;
K 25 mmol/30 mmol;
Cl 55 mmol/60 mmol;
riboflavin-5-sodium phosphate, 2 mg / 2 mg;
Panthenol 10 mg/10 mg;
pyridoxine hydrochloride 2 mg / 2 mg;
nicotinamide 15 mg/15 mg;
common amino g/100.64 50.82 g;
total nitrogen 8.46 g/16.92 g;
osmolarity of 1250 mOsm mosm/1695;
Energy value 600 kcal kkal/800.

Clinico-pharmacological group: The preparation for parenteral nutrition - a solution of amino acids, electrolytes and vitamins.

Pharmacological action

Combined preparation for parenteral nutrition. Has an optimal ratio of essential amino acids and 1:1.

All amino acids are L-form that allows their direct involvement in the biosynthesis of proteins. Contains all eight essential amino acids, as well as conventionally interchangeable L-arginine and L-histidine. L-arginine at converting ammonia into urea, binds toxic ammonium ions, which are formed during the catabolism of proteins in the liver. L-malic acid is a source of energy for the synthesis of urea. The main source of energy is sorbitol, which is phosphorylated in the liver of fructose-6-phosphate.

Sorbitol and fructose are insulin-dependent sources of energy, the use of which there is no danger of hyperglycemic acidosis.

Ion sodium - the main extracellular cation of the liquid, which, together with the anion chloride is a key element for the maintenance of homeostasis.

Ion potassium - the main cation in intracellular fluid, adding that in the infusion solution with a total parenteral nutrition promotes a positive nitrogen balance in the body. Nicotinamide has an important role in oxidative processes involved in the processes of intermediate metabolism and protein synthesis, has a positive effect on blood lipid profile.

Panthenol is involved in the metabolism of carbohydrates, gluconeogenesis, catabolism of fatty acids, as well as in the synthesis of sterols, steroid hormones and porphin. Pyridoxine is an integral part of many enzymes and coenzymes. It plays a significant role in metabolism of carbohydrates and fats, essential in the synthesis of porphyrin, hemoglobin and myoglobin.

Pharmacokinetics

Input parenteral amino acids used in the body in the process of protein synthesis. Not used in this process, amino acids are dezaminatsii with the formation of urea, which is then excreted in the urine.

T1 / 2 amino acids (in healthy people) is 5-15 min. With the rapid increase in the concentration of amino acids in the blood, they can be excreted in the urine in unchanged form, not having enough time to biotransformirovatsya. Riboflavin in the body biotransformiruetsya in the enzyme flavin mononucleotide, and then in flavinadenindinukleotid. Metabolites of riboflavin by 60% bound to plasma proteins. Riboflavin is excreted in the urine, partly in the form of metabolites. At high concentrations of riboflavin in the blood plasma of most of it is excreted unchanged in. Nicotinamide biotransformiruetsya in the liver with the formation of N-metilnikotinamida. Nicotinamide and its metabolites are excreted in the urine.

Pyridoxine biotransformiruetsya in the liver into active metabolites of pyridoxal phosphate and piridoksaminofosfat that stand out in the urine. About 2% of the administered dose of pyridoxine is excreted in the bile. Sorbitol initially metabolized in the liver to fructose, but may be metabolized directly to glucose.

Statement

Parenteral nutrition (partial or complete with the addition of fat emulsion):
the impossibility of enteral nutrition;
with severe diseases of the digestive system (gastrointestinal obstruction, malabsorption syndrome, inflammatory bowel disease, pancreatitis, intestinal fistulas);
with injuries;
for burns;
sepsis;
malignant tumors;
in pre-and postoperative period.

Dosage regimen

Install individually, taking into account the patient's condition. Adult drug use in the form of a slow i / v infusion (rate of introduction of 20-30 drops / min) at a dose of 30 ml / kg body weight / day, which corresponds to 3 g sorbitol / kg / day. Infusion should be done slowly, because rapid introduction of amino acids leads to a rapid excretion of unchanged from the body.

Side effect

On the part of the digestive system: increased activity of liver enzymes. Local reactions: skin irritation at the injection of the drug, thrombophlebitis. Amino acids may cause changes in the composition and blood ammonia content in the blood.

During the in / infusion: may cause nausea, vomiting, abdominal pain, fatigue, rash, hypertension, tachycardia, paresthesia, respiratory failure, increased sweating and body temperature, cyanosis.

Contraindications
violation of the synthesis of proteins;
pronounced renal dysfunction;
marked disturbances of liver function;
severe heart failure;
fructosemia;
methanol poisoning;
hyperkalaemia;
acidosis.

Pregnancy and lactation

Data on the possible use of the drug Aminosol during pregnancy and lactation are not available.

Application for violations of liver function

Precautions should be prescribed the drug to treat liver diseases.

Cautions

Precautions should be prescribed the drug for sepsis, in arterial hypertension of unknown origin, liver diseases, as well as patients who need to limit the introduction of the liquid. In the appointment of the drug should be taken into account that part of the preparation arginine may cause a decrease of phosphorus concentration and increasing concentration of potassium in the blood plasma, especially in patients with diabetes mellitus. Therefore, the appointment Aminosola patients with diabetes of any type is possible only on the background of insulin. Overdose data on drug overdose Aminosol not available.

Drug Interactions

Simultaneous injection of arginine with thiazide diuretics and aminophylline increases levels of insulin in the blood.

With simultaneous application of arginine with spironolactone the possibility of severe hyperkalemia. When combined isoniazid, penicillamine, oral contraceptives reduce the metabolism of pyridoxine.

With simultaneous application of riboflavin significantly reduces the activity of doxycycline, tetracycline, oxytetracycline, erythromycin and lincomycin.

Pharmaceutical interactions

With the introduction of the drug should be aware that arginine is not compatible with thiopental, and riboflavin is not compatible with streptomycin. In the solution, you can add Aminosola amikacin, ampicillin, cefotaxime, ceftriaxone, chloramphenicol, clindamycin, doxycycline, erythromycin as glyutseptata or lactobionate, gentamicin, netilmitsin, penicillin, piperatsilin, tetracycline, tobramitsin, vancomycin. These solutions remain stable at room temperature up to 6-24 hours

Also in the solution can be added Aminosola aminofilin, calcium gluconate, chlorpromazine, cimetidine, nizatidin, famotidine, ranitidine, cyclophosphamide, cytarabine, digoxin, dopamine, fluorouracil, folic acid, furosemide, heparin, insulin, propranolol, noradrenaline, lidocaine, morphine, methotrexate, methyldopa, methylprednisolone, metoklopamid, fitomenadion, riboflavin. The stability of these solutions at room temperature - up to 24 hours

Terms and Conditions of storage

The drug should be stored in a dark place at a temperature of 15 ° to 25 ° C. Shelf life - 2 years.