Alamin Se

Uses

Amino Acids is used for a source of amino acids for protein synthesis in patients needing intravenous nutrition. It is particularly suitable for a patient with basal amino acid requirements. Amino Acids is also used for faster recovery in surgery, burns, renal insufficiency, hepatic insufficiency and effective management of Cancer.

This is used for irrigating fluid of choice in:

• Transurethral resection of prostate.
• Endoscopic procedures within the urinary tract.
• Urinary bladder surgery etc.

Sorbitol is a product that can be used as a laxative to relieve constipation, and also as a urologic irrigating fluid. May also be used as a pharmaceutical sweetener.

Used as a non-stimulant laxative via an oral suspension or enema.

Alamin Se is also used to associated treatment for these conditions: Creatinine Clearance 5-15 mL/min, Uremia, Nutritional Support, Parenteral Nutrition, Total parenteral nutrition therapyCoronary vascular graft occlusion, Deep Vein Thrombosis, Myocardial Infarction, Stroke, Transient Ischemic Attack, Vascular Occlusion, Bladder distension, Bladder irrigation therapy, Irrigation therapy, Recovery, Amino acid supplementationConstipation, Constipation caused by Pregnancy, Occasional Constipation, Bladder irrigation therapy, Bowel preparation therapy, Preparation for rectoscopic or sigmoidoscopic examination

How Alamin Se works

In the CNS, there exist strychnine-sensitive glycine binding sites as well as strychnine-insensitive glycine binding sites. The strychnine-insensitive glycine-binding site is located on the NMDA receptor complex. The strychnine-sensitive glycine receptor complex is comprised of a chloride channel and is a member of the ligand-gated ion channel superfamily. The putative antispastic activity of supplemental glycine could be mediated by glycine's binding to strychnine-sensitive binding sites in the spinal cord. This would result in increased chloride conductance and consequent enhancement of inhibitory neurotransmission. The ability of glycine to potentiate NMDA receptor-mediated neurotransmission raised the possibility of its use in the management of neuroleptic-resistant negative symptoms in schizophrenia.
Animal studies indicate that supplemental glycine protects against endotoxin-induced lethality, hypoxia-reperfusion injury after liver transplantation, and D-galactosamine-mediated liver injury. Neutrophils are thought to participate in these pathologic processes via invasion of tissue and releasing such reactive oxygen species as superoxide. In vitro studies have shown that neutrophils contain a glycine-gated chloride channel that can attenuate increases in intracellular calcium and diminsh neutrophil oxidant production. This research is ealy-stage, but suggests that supplementary glycine may turn out to be useful in processes where neutrophil infiltration contributes to toxicity, such as ARDS.

Sorbitol exerts its laxative effect by drawing water into the large intestine, thereby stimulating bowel movements.

Dosage

Alamin Se dosage

Adults:

The nitrogen requirement for maintenance of body protein mass depends on the patient's condition (nutritional state and degree of metabolic stress).

No or minor metabolic stress and normal nutritional state: 0.10-0.15 g nitrogen/kg/day,

Moderate metabolic stress with or without malnutrition: 0.15-0.20 g nitrogen/kg/day,

Severe catabolism as in burns, sepsis and trauma: up to 0.20-0.25 g nitrogen/kg/day.

The dosage range 0.10-0.25 g nitrogen/kg/day corresponds to 15-35 ml Amino Acids/kg/day.

In obese patients, the dose should be based on the estimated ideal weight. Depending upon patients requirements, 1000-2000 ml Amino Acids may be infused intravenously per 24 hours. Amino Acids should be infused slowly, at rates 1.4-2.8 ml (30-60 drops) per minute.

Infants and Children:

In children and infants, the rate of infusion is 28-35 ml/kg body wt/day is recommended, with a stepwise increment in the rate of administration during the first week of treatment.

The total volume of solution used for irrigation depends on the judgment of the attending surgeon. Height from the operating table of 60 cm (approx. 2ft) is likely to cause increased intravascular absorption of glycine.

• Check infusion set and infusion solution prior to use
• Pull moderately to tear off the protective cover of the Eurohead
• Hold lightly the Eurohead but not the bag
• Open the flow regulator fully and hold the giving set on the top white area, but not the membrane venting region
• Insert the spike of the administration set to the Eurohead and fit the connector of the administration set firmly to the needle
• Gradually allow the fluid to flow down to the needle tip and close
• Remove the protective cover of the needle
• Locate the veinpuncture site and clean the site with an antiseptic solution, and then insert the needle
• Securely tape the puncture site
• Securely tape the wings and tubing
• Start infusion while adjusting drip speed

Side Effects

Amino Acids is usually well tolerated. Yet nausea, vomiting, flushing and sweating have been observed during infusion of Amino Acids at rates exceeding the recommended maximal rate. Hypersensitivity reactions have been reported. Like all hypertonic infusion solution, thrombophlebitis may occur when peripheral veins are used. The incidence may be reduced by the simultaneous infusion of 10% fat emulsion. If it is infused to severely ill patients, premature infants, hyperphenylalaninemia may occur.

Large intravenous doses of glycine are known to cause nausea and salivation. Other consequences of systemic absorption of glycine include electrolyte loss, diuresis, edaema, thirst, dehydration, cardiovascular and pulmonary disorders.

Toxicity

ORL-RAT LD₅₀ 7930 mg/kg, SCU-RAT LD₅₀ 5200 mg/kg, IVN-RAT LD₅₀ 2600 mg/kg, ORL-MUS LD₅₀ 4920 mg/kg; Doses of 1 gram daily are very well tolerated. Mild gastrointestinal symptoms are infrequently noted. In one study doses of 90 grams daily were also well tole.

Acute oral toxicity (LD50): 15900 mg/kg [Rat].

Precaution

Hyperphenylalaninemia has been noted in severely ill, premature infants. In these patients, monitoring of the phenylalanine levels is recommended and the infusion rate adjusted as needed.

Do not use if the solution is turbid or contains particles. Discard any unused portion.

Precautions: Patients with cardiovascular disease should be evaluated after transurethral resection of prostate using glycine. Care should be exercised if the liver or kidney is impaired.

Warning: Aseptic technique is essential while using glycine. Unused portion should be discarded. Do not use if the bottle is leaking, solution is cloudy, contains particles or after expiry date.

Interaction

Additives may be incompatible. When introducing additives, use aseptic technique, mix thoroughly and do not store.

Elimination Route

Absorbed from the small intestine via an active transport mechanism.

Elimination Route

Sorbitol will either be excreted in the urine by the kidneys, or metabolized to carbon dioxide and dextrose.

Pregnancy & Breastfeeding use

Successful and safe administration of amino acid solutions during pregnancy in the human has been reported. Animal reproduction studies have not been carried out with Amino Acids.

Contraindication

Amino acid is contraindicated in patients with inborn errors of amino acids metabolism, irreversible liver damage and severe uremia when dialysis facilities are not available.

Glycine Irrigation Solution is not for injection in any route. It is contraindicated in patients with anuria.

Special Warning

In children and infants, the rate of infusion is 28-35 ml/kg body weight per day is recommended, with a step wise increase in the rate of administration during the first week.

Storage Condition

Protect from light and store between 15-25 °C temperature. Avoid freezing. Keep medicament's out of reach of children.

Store at controlled room temperature, protect from light and heat

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