Aminosol-Neo-E

General characteristics. Structure:

Solution for infusions of 10%	1000 ml
L-L-izoleytsin	5 g
L-leucine	7,4 g
L-valine	6,2 g
L-lysine	6,6 g
(corresponds a L-lysine to monoacetate)	9,31 g
L-methionine	4,3 g
L-threonine	4,4 g
L-phenylalanine	5,1 g
L-alanine	15 g
L-arginine	12 g
glycine	14 g
L-histidine	3 g
L-proline	15 g
L-tryptophane	2 g
L-malic acid	9,28 g
sodium glycerophosphate	9,453 g
Calcii chloridum	0,735 g
chloride magnesium geksagidrat (anhydrous 0,286 g)	1,017 g
potassium hydroxide	1,683 g
excipients: sodium hydroxide; water for injections
Na +	60 mmol
K +	30 mmol
Ca2 +	5 mmol
Mg2 +	5 mmol
Cl-	20 mmol
acetates	45 mmol
malates	69,2 mmol
glycerophosphates	30 mmol
energy value — 1900 kJ/l (440 kcal/l); theoretical osmolarity — 1137 ¼Äß¼/l

Pharmacological properties:

The combined drug for parenteral food containing irreplaceable and replaceable amino acids in an optimum ratio. All amino acids are in a L-form that provides a possibility of their direct participation in biosynthesis of proteins.
Contains all eight irreplaceable amino acids, and also conditionally replaceable L-arginine and a L-histidine. Conditionally replaceable amino acids are synthesized by an organism, but at some pathophysiological states (for example, a renal and liver failure) and at small children concentration them does not reach necessary level. L-arginine promotes optimum transformation of ammonia into urea, connecting toxic ions of ammonium which are formed at a catabolism of proteins in a liver.
L-izoleytsin, L-leucine and L-valine - irreplaceable amino acids with branched side chains - satisfy energy demands of an organism that especially important directly in the postoperative period.
The amino acids containing aromatic rings are necessary for synthesis of full-fledged proteins and are presented by L-phenylalanine and L-tryptophane.
L-malic acid is a power source for urea synthesis.
Cations and anions provide hyper osmolarity of solution, being elements for maintenance of a homeostasis.

Pharmacokinetics. The amino acids entered parenterally are used in an organism at protein synthesis. The amino acids which are not used in this process are deaminized with an ureapoiesis which then is removed with urine. T1/2 of amino acids at healthy people makes 5-15 min.

At bystry in introduction because of sharp increase of concentration of amino acids to blood a part of amino acids can not undergo biotransformation and is removed in not changed look.

Indications to use:

Parenteral food (partial or full with addition of fatty emulsions):
— at impossibility of an enteroalimentation (for prevention and therapy of loss of proteins and liquid);
— at a serious gastrointestinal illness (obstruction of a GIT, a sprue, inflammatory diseases of intestines, pancreatitis, intestinal fistulas);
— at hyper metabolic states (injuries, burns, sepsis);
— at malignant tumors;
— in before - and the postoperative period.

Route of administration and doses:

Establish individually taking into account a condition of the patient.

The adult drug is appointed in the form of slow in/in infusion. The maximum admissible rate of administering of 1 ml/kg/h, and the maximum admissible daily dose makes 20 ml/kg. For patients with the body weight of 70 kg the maximum admissible daily dose of drug makes 1400 ml, and the recommended rate of administering - 20-35 thaws/min. Infusion should be carried out slowly since bystry administration of amino acids leads to bystry removal them in not changed view from an organism and the effect of their use vanishes.

At a liver failure the need for proteins makes 0.8-1.1 g/kg/days.

Features of use:

At purpose of drug it is necessary to consider that the arginine which is a part of drug can cause reduction of concentration of phosphorus and increase in potassium concentration in a blood plasma, especially in patients with a diabetes mellitus. Therefore purpose of this drug to patients with a diabetes mellitus of any type perhaps only against the background of an insulin therapy.
At purpose of Aminosola-Neo E constant control of the acid-base and electrolytic status, balance of liquid in an organism and conditions of function of kidneys is necessary.
At purpose of drug against the background of a hyponatremia it is necessary to control concentration of sodium in plasma.
At addition to therapy of Aminosolom-Neo E standard foods it is necessary to pay attention to compatibility.
Uncontrollable addition of other medicines to Aminosol-Neo solution E is not recommended.
It is necessary to apply only transparent solution from the unimpaired bottle!
Use in pediatrics
Efficiency and safety of use of the drug Aminosol-Neo E for children and teenagers aged up to 18 years are not established.

Side effects:

From the alimentary system: increase in activity of enzymes of a liver, nausea, vomiting, abdominal pain.
From cardiovascular system: increase in the ABP, tachycardia.
Allergic reactions: small tortoiseshell.
From an organism in general: feeling of fatigue, the increased sweating, breath disturbance, fervescence, cyanosis, change of composition of blood, increase in content of ammonia in blood.
Local reactions: irritation of skin in a drug injection site, thrombophlebitis.
From water and electrolytic balance: at high rate of administering - an overhydratation and disturbance of electrolytic composition of plasma (hyperpotassemia).

Interaction with other medicines:

Simultaneous administration of arginine with thiazide diuretics and Aminophyllinum increases the content of insulin in blood.

At simultaneous use of arginine with Spironolactonum development of a heavy hyperpotassemia is possible.

Are oestrogenic also oral contraceptives at simultaneous use with Aminosolom-Neo E can strengthen the increase in level of a growth hormone caused by arginine and lower the glyukagonovy and insulin answer to arginine.

Pharmaceutical interaction

At administration of drug it is necessary to consider that arginine is incompatible with sodium thiopental.

Aminosola-Neo solution E is compatible to antibiotics - amikacin, ampicillin, tsefotaksimy, tseftriaksony, doxycycline, erythromycin, gentamycin, chloramphenicol, clindamycin, netilmitsiny, penicillin, piperatsilliny, tetracycline, Tobramycinum and Vancomycinum, and also to Aminophyllinum, cyclophosphamide, Cimetidinum, Cytarabinum, digoxin, a dopamine, famotidine, phytomenadionum, ftoruratsily, folic acid, furosemide, heparin, Chlorpromazinum, insulin, calcium a gluconate, lidocaine, metildopy, Methylprednisolonum, Metoclopramidum, a methotrexate, morphine, nizatidiny, Norepinephrinum, propranolol, ranitidine and Riboflavinum.

Contraindications:

— metabolic acidosis;
— renal failure of heavy degree;
— heavy liver failure;
— shock;
— chronic heart failure in a decompensation stage;
— overhydratation;
— hyperpotassemia;
— pregnancy;
— lactation period;
— children's and teenage age up to 18 years (efficiency and safety are not established).

With care it is necessary to appoint drug at sepsis, essential arterial hypertension, liver diseases, a diabetes mellitus 2 types.

Use of drug AMINOSOL-NEO E at pregnancy and feeding by a breast
Efficiency and safety of use of the drug Aminosol-Neo E at pregnancy and in the period of a lactation are not established.

Use at abnormal liver functions
At a liver failure need of patients for proteins sostavlt 0.8 - 1.1 g/kg /
It is contraindicated at a heavy liver failure.

Use at renal failures
It is contraindicated at a heavy renal failure.

Use for children
Contraindication: children's and teenage age up to 18 years (efficiency and safety are not established).

Overdose:

Data on overdose of the drug Aminosol-Neo E are not provided.

Storage conditions:

Drug should be stored in protected from light, the place, unavailable to children, at a temperature from 15 °C to 25 °C.

Issue conditions:

According to the recipe

Packaging:

In bottles on 500 ml (complete with the holder for bottles); in a pack of cardboard 1 or 10 sets (for hospitals).