Generic
Essential Amino Acid + D-Sorbitol + Electrolytes IV Infusion
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At a glance
Essential Amino Acid + D-Sorbitol + Electrolytes IV Infusion is a parenteral nutritional solution that provides amino acids for protein synthesis. It aids faster recovery in surgery, burns, renal insufficiency, hepatic insufficiency, and cancer management.
Description
This IV solution is a sterile aqueous solution of crystalline Amino Acid and D-Sorbitol with electrolytes, which are necessary as the nitrogen source for parenteral nutrition. Each 100 mL solution contains 8.14% amino acids and 5% D-Sorbitol.
The solution contains all 18 essential and non-essential amino acids needed for protein synthesis. The amino acid composition is such that positive nitrogen balance can be achieved in the postoperative period and during extended periods of intravenous nutrition.
The solution is clear, colorless to pale yellow, with a pH ranging from 5.0 to 7.0. Total nitrogen content: 7.25 g/L and total energy content: 1551 kJ/L (371.14 Kcal/L).
Indications
- Source of amino acids for protein synthesis (parenteral nutrition)
- Faster recovery in surgery
- Burn patients
- Renal insufficiency
- Hepatic insufficiency
- Effective management of cancer
- Patients with basal amino acid requirements
Therapeutic class
Parenteral nutritional preparations
Pharmacological class
Amino Acid Infusion Solution
Pharmacology
This IV solution is a sterile aqueous solution of crystalline Amino Acid and D-Sorbitol with electrolytes. Nitrogen is provided in the form of essential and non-essential amino acids. The solution contains all 18 amino acids needed for protein synthesis. D-Sorbitol provides energy and preserves the nitrogen-sparing effect of proteins. Electrolytes (Na⁺, K⁺, Mg²⁺, Cl⁻, acetate) help maintain electrolyte balance.
Mechanism of action
Amino acids serve as building blocks for protein synthesis in the body. They help in tissue repair, enzyme production, and maintaining immune function. D-Sorbitol provides energy and preserves the nitrogen-sparing effect of proteins. Electrolytes help maintain fluid and electrolyte balance in the body.
Dosage
Adults:
• No or minor metabolic stress (normal nutritional state): 0.10-0.15 g nitrogen/kg/day (15-23 mL/kg/day)
• Moderate metabolic stress (with or without malnutrition): 0.15-0.20 g nitrogen/kg/day (23-30 mL/kg/day)
• Severe catabolism (burns, sepsis, trauma): 0.20-0.25 g nitrogen/kg/day (30-35 mL/kg/day)
• Depending on patient requirements, 1000-2000 mL may be infused intravenously per 24 hours.
• Infusion rate: 1.4-2.8 mL/min (30-60 drops/min)
Obese patients: Dose should be based on estimated ideal weight.
Children and infants: 28-35 mL/kg body weight per day recommended, with step-wise increase during the first week.
Administration
For IV administration only. Infuse slowly at 1.4-2.8 mL/min (30-60 drops/min). Administered by healthcare professional. Patient should not self-administer.
Missed dose
Hospital-only medicine. Administered by doctor or nurse. Missed dose concept does not apply (hospital-administered).
Side effects
- Rare: Nausea
- Vomiting, flushing, and sweating (with infusion rates exceeding recommended maximum)
- Transient liver test increases during parenteral nutrition
- Hypersensitivity reactions
- Thrombophlebitis when peripheral veins are used (incidence reduced by simultaneous infusion of 10% fat emulsion)
- Hyperphenylalaninemia may occur in severely ill, premature infants
Precautions & warnings
- Long-term IV nutrition increases urinary excretion of trace elements (especially zinc and copper); consider this in trace element dosing.
- Monitor phenylalanine levels in severely ill, premature infants and adjust infusion rate as needed.
- Use with caution in patients with diabetes mellitus, severe heart failure, or renal function with fluid restrictions, oliguria/anuria.
- Exogenous insulin may be necessary in hyperglycemic patients.
- In severely malnourished patients, refeeding carbohydrates may trigger thiamine (vitamin B1) deficiency syndrome (high risk in patients with alcohol abuse, anorexia nervosa, prolonged fasting, hyperemesis gravidarum).
- Monitor serum potassium and blood glucose if infused rapidly or in large quantity.
- Additional phosphate supplementation recommended for patients with hypophosphatemia.
Contraindications
- Inborn errors of amino acid metabolism
- Severe liver dysfunction
- Severe uremia (when dialysis facilities are not available)
- Hyperosmolar nonketotic diabetic coma (due to glucose content)
Drug interactions
At recommended dosage, amino acids have no pharmacological effects and are not expected to interact with other medications.
Food interactions
No food-related restrictions (parenteral administration).
Use in pregnancy
Successful and safe administration of amino acid solutions during pregnancy has been reported. Animal reproduction studies have not been conducted.
Use in lactation
Adequate information on use during lactation is not available; consult your doctor.
Pediatric use
Children and infants: 28-35 mL/kg/day with step-wise increase during the first week; monitor phenylalanine in severely ill premature infants.
Geriatric use
No specific dose adjustment required for elderly; dose should be based on patient condition.
Renal / hepatic impairment
Hepatic impairment: Contraindicated in severe liver dysfunction. Use with caution in mild-moderate liver disease.
Overdose effects
Infusion at higher than recommended rate increases risk of nausea, vomiting, and sweating. Thrombophlebitis may occur with peripheral veins. Osmotic diuresis with dehydration may occur if dosage recommendations are exceeded. Hyperglycemia-related symptoms may also occur. Slow down or discontinue infusion if overdose symptoms occur.
Storage conditions
Protect from light and store between 15-25°C. Avoid freezing. Keep out of reach of children.
Chemical structure
L-Isoleucine, L-Leucine, L-Lysine HCl, L-Methionine, L-Phenylalanine, L-Threonine, L-Tryptophan, L-Valine, L-Histidine, L-Tyrosine, L-Arginine, L-Aspartic Acid, L-Glutamic Acid, L-Alanine, L-Cystine, Glycine, L-Proline, L-Serine, D-Sorbitol, Sodium, Potassium, Magnesium, Chloride, Acetate