Indications
This is a sterile intravenous (IV) solution that supplies amino acids (the building blocks of protein) together with D-sorbitol as an energy source, vitamins and electrolytes (body salts). It is used to provide protein and nutrition through a vein for patients who cannot eat enough or whose protein needs are raised, for example before and after surgery, after injury or burns, in severe illness or when there is low protein in the blood. It is usually part of a wider nutrition plan.
How It Works
The amino acids are taken up by the body’s cells and used to build and repair proteins, supporting wound healing, muscle and the immune system. D-sorbitol is converted in the liver into a form of sugar the body can use for energy, which helps spare protein from being burned as fuel. The added vitamins support the use of nutrients, and the electrolytes help keep the body’s salt and fluid balance.
Dosage and Administration
Given only in hospital or a clinic by a doctor or nurse as a slow infusion into a vein. The volume, speed and duration are decided by the doctor according to the patient’s weight, condition, fluid needs and blood test results, and are given as prescribed. Infusing too quickly can cause nausea, flushing and vein irritation.
Interactions
Other medicines should be added to the solution only if known to be compatible, under pharmacy guidance. Care is needed with medicines that affect potassium or sodium, such as diuretics, ACE inhibitors and corticosteroids. Vitamin content may affect some tests or treatments; for example, vitamin K can reduce the effect of Warfarin if present in the formulation.
Contraindications
Not used in people with hereditary fructose intolerance (because sorbitol is turned into fructose and can cause a dangerous reaction), inborn errors of amino acid metabolism, severe liver failure or hepatic coma, severe kidney failure without dialysis, severe acidosis, fluid overload, heart failure with fluid retention, high electrolyte levels that the solution contains, or allergy to any ingredient.
Side Effects
Possible effects include nausea, vomiting, flushing, chills, fever, headache, chest discomfort and pain or inflammation of the vein at the infusion site, especially if infused too fast. Electrolyte or acid-base disturbance, raised blood urea and allergic reactions can occur.
Tell the nurse or doctor straight away about rash, itching, swelling of the face, difficulty breathing, severe vomiting, confusion, or pain and swelling at the drip site, as these need urgent medical attention.
Pregnancy and Lactation
It may be used in pregnancy and breastfeeding if the doctor considers IV nutrition necessary, with monitoring.
Precautions and Warnings
- Ask about fructose intolerance before use, especially in children.
- Fluid balance, electrolytes, blood sugar, kidney and liver function are monitored.
- Use with care in kidney or liver disease, heart failure and in older patients.
- Infuse slowly and use strict sterile technique.
- Use only if the solution is clear and the container undamaged; discard any unused portion.
Overdose
Excess or rapid infusion may cause fluid overload, nausea, vomiting, flushing, chills, acidosis and electrolyte imbalance. The infusion is stopped and the patient treated according to symptoms.
Therapeutic Class
Parenteral nutrition solution (amino acids with sorbitol, vitamins and electrolytes)
Storage
Store as directed on the pack, usually below 25°C, protected from light, do not freeze. Hospital use only; keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.