Indications
This is an intravenous (IV) nutrition solution containing amino acids, D-sorbitol (a sugar alcohol used as an energy source), vitamins and electrolytes. It is used to provide protein and some energy to patients who cannot eat enough or cannot absorb food through the gut, such as after surgery, in severe illness or in malnutrition. Some versions are specially balanced for patients with liver disease (higher in branched-chain amino acids).
How It Works
Amino acids are the building blocks of protein, needed for healing, muscle, enzymes and immunity. D-sorbitol is converted in the liver into fructose and then used for energy, helping the amino acids to be used for building tissue. The added vitamins and electrolytes support normal body chemistry, fluid balance and the use of nutrients. Liver-adapted formulas help reduce the build-up of substances linked to hepatic encephalopathy (brain effects of liver failure).
Dosage and Administration
Given only in hospital by a doctor or nurse as a slow infusion into a vein. The amount and rate depend on the patient’s weight, condition, fluid needs and blood tests, as prescribed. It is often combined with other sources of energy and nutrients.
Interactions
Only compatible medicines should be added to the infusion. Diuretics, steroids and insulin can change electrolyte and sugar levels, so monitoring guides the plan. Vitamins in the solution, such as vitamin K, may affect Warfarin treatment.
Contraindications
- Hereditary fructose intolerance, because D-sorbitol is converted to fructose: this can cause severe, life-threatening reactions.
- Inborn errors of amino acid metabolism.
- Severe kidney failure without dialysis, and severe liver failure unless a liver-adapted formula is specifically prescribed.
- Fluid overload, uncorrected shock, severe acidosis or serious electrolyte imbalance.
Side Effects
Nausea, vomiting, flushing, chills and vein irritation at the drip site may occur, especially with fast infusion. Electrolyte and acid-base changes, high blood ammonia or raised liver enzymes can occur. Allergic reactions to added vitamins are rare.
Patients are monitored closely. Tell staff immediately about fever, chills, pain or swelling at the drip site, breathlessness, confusion, unusual sleepiness, or sweating with shakiness.
Pregnancy and Lactation
Used in pregnancy and breastfeeding only when parenteral nutrition is clearly needed, under close medical supervision. Hereditary fructose intolerance must be excluded.
Precautions and Warnings
Ask about hereditary fructose intolerance before use. Monitor blood sugar, electrolytes, acid-base balance, liver and kidney tests. Use with care in heart, kidney or liver disease and in children. Strict sterile technique is needed.
Overdose
Infusing too much or too fast can cause fluid overload, nausea, vomiting, electrolyte and acid-base problems. The infusion is slowed or stopped and symptoms are treated.
Therapeutic Class
Parenteral nutrition solution (amino acids with sorbitol, vitamins and electrolytes).
Storage
Hospital product: store as directed on the pack, below 25 to 30°C as stated, protected from light; do not freeze. Use promptly once opened.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.