Indications
This product is a concentrated, sterile amino acid solution for intravenous (IV) nutrition. It supplies the protein building blocks the body needs when a patient cannot eat or absorb enough protein through the gut, for example after major surgery, in severe illness, burns, injury or bowel failure. It is usually given together with glucose, fat emulsion, electrolytes, vitamins and trace elements as part of a full parenteral nutrition plan, and is also one component of some ready-mixed multi-chamber nutrition bags.
How It Works
The solution contains essential and non-essential amino acids in balanced amounts. Once in the bloodstream, they are taken up by cells and used to make new proteins for muscle, organs, enzymes, blood cells and the immune system, and to repair tissue and heal wounds. Supplying amino acids helps prevent the body from breaking down its own muscle when food intake is not possible.
Dosage and Administration
Given only in hospital by doctors and nurses. The amount and infusion rate are calculated for each patient according to body weight, illness, kidney and liver function, fluid needs and blood tests, and are given as prescribed. Because it is concentrated, it is usually given into a large central vein, or mixed with other nutrition solutions before infusion. It is infused slowly, often over 24 hours.
Interactions
Only compatible additives should be mixed into the solution, under pharmacy guidance, because some medicines may be unstable or cause precipitation. When given with glucose, insulin may be needed to control blood sugar. Tell the medical team about all other medicines and infusions.
Contraindications
Not used in people with inborn errors of amino acid metabolism, severe liver failure or liver coma, severe kidney failure when dialysis is not available, raised blood ammonia, uncontrolled acidosis, shock, fluid overload or acute pulmonary oedema, or allergy to any component.
Side Effects
Possible effects include nausea, vomiting, flushing, fever, chills, headache, and pain or inflammation of the vein at the infusion site, particularly if infused too fast. Raised blood urea or ammonia, acid-base and electrolyte disturbances, and liver changes may occur during prolonged use. Infection of the IV line is a serious risk.
Tell the nurse or doctor straight away about fever or shivering, pain or swelling at the drip site, rash, swelling of the face, breathing difficulty, confusion or unusual drowsiness, as these need urgent medical attention.
Pregnancy and Lactation
It may be used in pregnancy and breastfeeding when the doctor decides that IV nutrition is necessary, with careful monitoring.
Precautions and Warnings
- Fluid balance, electrolytes, blood sugar, urea, ammonia, kidney and liver function are monitored regularly.
- Start slowly in severely malnourished patients to avoid refeeding syndrome.
- Use strict sterile technique for the IV line.
- Use with care in kidney or liver disease, heart failure and in children.
- Use only if the solution is clear and the container undamaged; discard any unused portion.
Overdose
Too much or too fast an infusion can cause nausea, vomiting, flushing, sweating, acidosis, raised ammonia and fluid overload. The infusion is stopped or slowed and the patient treated according to symptoms.
Therapeutic Class
Parenteral nutrition solution (amino acid infusion)
Storage
Store below 25°C, do not freeze, and protect from light in the outer carton or overpouch, or as directed on the pack. 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.