Pharmacodynamics main therapeutic effect Aminoplazmalya B. Braun E 5 consists in supplying the organism with a substrate protein synthesis parenteral nutrition. Introduction of amino acids necessary for protein synthesis (including conditionally-essential and nonessential amino acids) contained in Aminoplazmale E5 B. Brown, provides high the nutrient efficiency and reduces the load on the body by protein synthesis. To eliminate the input of amino acids as an energy source, it is necessary, simultaneous administration with Aminoplazmalem B. Braun E 5 donators energy such as fat emulsions and carbohydrate steroid masterons. In addition to amino acids Aminoplazmal B. Braun E5 contains minerals necessary to maintain water and electrolyte and acid-base balance.
Pharmacokinetics of intravenous amino acids enter into intravascular and endogenous intracellular depot and free amino acids as well as they function as a substrate for the synthesis of proteins of the organism. Bioavailability of all components Aminoplazmalya B. Braun E 5 with intravenous injection is 100%. In Aminoplazmale B. Braun E 5 individual concentration of amino acids selected in such a way as to not go beyond the norm with the intravenous administration of the steroid masteron biomex labs relative growth of each amino acid plasma concentrations that maintains the homeostasis of plasma amino acids. The amino acids not involved in protein synthesis, are metabolized as follows: as a result separated from the transamination of an amino group of a carbon skeleton or carbon chains further oxidized to CO 2 , or used as a substrate in the gluconeogenesis alpha pharma usa in the liver reactions. Amino groups are metabolized in the liver to urea.
Therapeutic indications Parenteral nutrition for the prevention and treatment of conditions of protein deficiency due to excessive loss of protein and / or an increased need for them:
- Injuries moderate and severe, polytrauma, burns, peritonitis, sepsis, polirrgannaya failure according to the metabolic needs;
- Conditions after major surgery;
- Inflammatory bowel disease (including Crohn’s disease, ulcerative colitis), intestinal fistula;
- Eating disorders of various origins (cachexia).Contraindications
- Hypersensitivity to the drug;
- Inborn errors of amino acid metabolism;
- Severe circulatory disorders (shock);
- Severe hypoxia;
- Severe metabolic acidosis;
- Progressive liver failure;
- Acute renal failure, if it is impossible to conduct hemodialysis or hemofiltration;
- Exceeding the maximum allowable concentration of electrolytes that are part of the drug in the blood plasma;
- Children under 2 years old;
- General contraindications for infusion therapy (decompensated heart failure, acute pulmonary edema, hyperhydration).Precautions Aminoplazmal B. Braun E 5 can only be used after careful assessment of risk / benefit ratio in the following cases:
- Renal or hepatic insufficiency,
- Increased plasma osmolality,
- Hypotonic dehydration, as well as in all cases of violation of metabolism of amino acids, due to the reasons, is not a contraindication to the use of the drug.Use during pregnancy and lactation At present, insufficient clinical data on the use Aminoplazmalya B. Braun 5 E during pregnancy and lactation is not therefore possible its use in pregnant and lactating women only when the expected benefit from drug treatment than the potential risk of complications.Dosing and Administration Aminoplazmal B. Braun E 5 is introduced into the peripheral and central veins. To introduce Aminoplazmalya B. Braun E 5 is necessary to use only sterile system for intravenous infusion. During the use of the drug is necessary to control the injection site (the puncture site, or catheter) for signs of inflammation or infection. The drug is supplied in bottles designed for a single application. Any unused amounts of the drug can not be stored and should be discarded. Do not use the medication if the steroid masteron is not transparent, on the bottle there are clear signs of damage or broken seal. Dose Aminoplazmalya B. Braun E 5 is dependent on nutritional status and the individual patient’s needs in amino acids, electrolytes and liquid.Adults and children from 14 years of average daily dose of 20-40 ml / kg body weight, which corresponds to 1-2 g amino acids / kg body weight, 1400-2800 ml of the drug to patients with a body weight of 70 kg. The highest daily dose of 40 ml / kg body weight, which corresponds to amino acids 2 g / kg body weight, 140 g of amino acids, or 2800 ml of the drug for a patient weighing 70 kg. The maximum injection rate of 2 ml / kg body weight / hour, which corresponds to amino acids-0.1 g / kg body weight / hour, 45 drops / min or 2.34 ml / min for a patient weighing 70 kg. Babies Given below are the average dose. The dose should be selected according to the child’s age, stage and severity of the disease. For children from 2 to 5 years: 30 ml / kg body weight, which corresponds to amino acids 1.5 g / kg body weight. For children from 5 to 14 years: 20 ml / kg body weight, which corresponds to amino acids 1.0 g / kg body weight. The maximum injection rate of 2 ml / kg body / weight per hour, which. corresponds to amino acids 0.1 g / kg body weight / hour. If the need for amino acids is greater than 1 g / kg of body weight per day may use more concentrated steroid masterons of amino acids to reduce the water load. Duration of limitation on the duration of use of the drug is not revealed.Side effects
In compliance with the recommendations in respect of these precautions, the speed of administration and dosage, side effects were observed, however, may develop allergic reactions. Rarely occurring adverse events (> 1: 1000, <1: 100): nausea, vomiting, headache, chills, fever may be associated with the beginning of parenteral nutrition and are not specific for B. Braun Aminoplazmalya E5.
Overdose Overdose or a too rapid injection of the drug masteron can lead to phenomena such as fever, nausea, vomiting and increasing renal excretion of amino acids. In such cases, the drug administration should be resumed later prekraschenoi a lower infusion rate.
Interactions with other drugs and other forms of interaction Drug interactions are not known. Mixing Aminoplazmalya B. Braun E 5 with the other components of parenteral nutrition (carbohydrates, fats, emulsions, vitamins, trace elements) should be carried out under aseptic conditions. It is necessary to check compatibility before use.
Cautions To ensure complete digestion of amino acids, the introduction Aminoplazmalya B. Braun E 5 should be carried out simultaneously with drugs that provide the energy needs of the body (fat emulsions and carbohydrate steroid masterons), as well as vitamins and trace elements. It should be borne in mind that the possibility of introducing the above components in a peripheral vein will depend on the resultant osmolality of the steroid masterons. The period of treatment is necessary to control the water and electrolyte and acid-base balance, the level of serum proteins masteron steroid, osmolarity of blood serum concentration of glucose in the blood and liver. For patients with hepatic, renal, cardiac, pulmonary insufficiency necessary select an individual dosage regimen. When long-term administration (several weeks) should monitor coagulation and cellular composition of blood factors. In the case of hypotonic dehydration, first, it is necessary to restore an adequate balance of water and electrolytes, and then start parenteral nutrition. Storage at temperatures below 15 ° C can cause the formation of crystals which were dissolved by heating the steroid masteron to 25 ° C and gentle shaking.
Product form steroid masteron for infusion. 250 ml, 500 ml and 1000 ml bottles hydrolytic glass class 2, sealed with a rubber stopper brick color matching requirements of the European Pharmacopoeia for infusion steroid masterons aluminum cap brick-red color and a plastic cap gray. By 10 bottles of 250 ml or 500 ml, 6 ml bottles 1000 together with instructions for use in an appropriate amount in a cardboard box (for hospitals).