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active ingredients: 1 liter of solution for infusion contains L-alanine 4,00 g, glycine 7,00 g of L-arginine 4,55 g, L-aspartic acid 2.00 g, L-glutamic acid 5,00 g, L-histidine 1.35 g, L-isoleucine 2.10 g, L-lysine hydro chloride a solution of 2.50 g (equivalent to 2.00 g of L-lysine, L-methionine of 1.75 g L-2.75 g leucine, L-phenylalanine 3,15 g, L-treanna 1,60 g, L-tryptophan 0.50 g, L-valine 2.25 g of sodium acetate three hydrate (3.4 g, potassium chloride solution of 1.86 g of magnesium chloride hexahydrate 0,51 g of sodium hydroxide of 0.60 g of xylitol 50,00 g;
excipients: sodium disulfi, water for injections.
A dosage form. Solution for infusion.
Pharmacotherapeutic group. Means for parenteral nutrition.
Code PBX IN V AND 10.
The clinical features.
Testimony. Parenteral nutrition in the prevention and treatment of loss of body protein and to provide a liquid, such as after surgery, bleeding, burns. Fulfillment, or deal with the shortage of protein that occur in it due to increased requirements, increased it costs, or violation of protein in the process of digestion, absorption and excretion.
Contraindications. Severe liver, disorders of amine kislotno metabolism, lactate acidosis, traumatic brain injury, hyperhydration, methanol intoxication, hypersensitivity to sodium disulfide. Children up to 2 years. Hyperkalemia, shock, acidosis, severe renal insufficiency (in the absence of sufficient diuresis). Relative contraindications – heart failure.
Method of application and doses. The dosage depending on the clinical condition of the patient and his needs and the amine kislota, electrolytes and fluid (body mass and degree of catabolism caused by disease). In case of predominance of catabolism it is recommended to use the upper range given dosing. To start the infusion slowly and within one hour to bring the speed to the desired value.
Adults: from 0.6 to 1.0 g of amine ocelot (25 ml Pesol® 40 per kilogram of body weight per day), and in the predominance of catabolism – from 1.3 to 2.0 g amine ocelot (50 ml Pesol® 40 per kilogram of body weight per day).
Children aged 3 years to 18 years: 1.0 to 2.0 g amine ocelot (50 ml Pesol® 40 per kilogram of body weight per day).
Maximum infusion rate.
2.5 ml/kg of body weight per hour equals approximately:
0.1 g of amine ocelot/kg of body weight per hour;
0.125 g of xylitol/kg of body weight per hour;
0,8 drops/kg of body weight per minute.
175 ml/70 kg of body weight per hour is equal to:
7 g of amine ocelot/70 kg of body weight per hour;
8.75 g of xylitol/70 kg of body weight per hour;
60 drops/70 kg of body weight per minute.
The greater the body's need for fluid and calories calculated amount of the drug Pesol® 40 can be supplemented by simultaneous or successive administration of solutions of electrolytes, glucose, etc. possible partial oral feeding amount of the drug Pesola® 40 is injected parenterally, decreases the amount of fluid and calories, administered orally. The drug is administered until the patient is on enteral or oral feeding.
Adverse reactions. In a few cases – nausea, vomiting, fever, headache, fever, irritation of the walls of the vein, especially during rapid infusion. Through the content of a preparation of sodium disulfo, in some cases (especially in patients with asthma) may occur hyperergic reactions, which can manifest as vomiting, diarrhea, erratic breathing, acute asthma attack, disturbances of consciousness, shock. These reactions in each case may be manifested in different ways and lead also States that threaten the patient's life. Furthermore, the reaction products of sodium disulfo with another component of the drug – tryptophan can raise the level of bilirubin and liver enzymes in the blood.
Overdose. Too rapid injection or the introduction of a large number Kalvi solutions, particularly when acidosis or renal failure, can lead to hyperkalemia. Threatening concentration of potassium in serum is > 6.5 mmol/L. Symptoms of hyperkalemia may be due to muscle weakness, impaired sensation, disorders of the heart (sinus bradycardia, arrhythmia, conduction disturbances, widening of the QRS complex until the development of the blockade feet beam Guisa, the sharpening of the T wave on the ECG; patients who use digitalis preparations, the changes of the T wave can be difficult to recognize). Treatment. Immediate cessation of infusion. The holding of osmotic diuresis. In cases of life-threatening – hemodialysis.
Use during pregnancy or breastfeeding. There are no reservations.
Children. Through the specific need for the amine kislota of using the drug in children under 2 years of age is contraindicated.
Specific security measures. The product contains sodium disulfi, so it can not be used in patients with bronchial asthma have an increased sensitivity to sulfites.
The application features. Pesol® 40 can be used with limited kidney function. In renal failure, hyperkalemia, acidosis and shock Pesol® 40 is used after achieve adequate diuresis. The drug is administered internally by long-venous infusion. During slow infusion components of the drug are absorbed better than during rapid infusion. With the rapid infusion of the possible reactions of intolerance, as well as real losses amine ocelot violation of their balance. In applying the drug should be control of electrolytes in the blood serum, the concentration of glucose in the blood, acid-base balance and water balance. For long, it is recommended to access the subclavian vein.
Influence on velocity reactions while driving by motor transport or operating other mechanisms. The drug is used only in a hospital environment.
Interaction with other medicinal products and other forms of interaction. Has not been studied.
Pharmacodynamics. Amin ocelote, carbohydrates and electrolytes is a physiological substance, or metabolic equivalents. Amin ocelote imposed internally tively, serve as the locus for the synthesis of proteins. Xylitol is a carrier of energy, which is in the process of carbohydrate metabolism in the liver is split, with its metabolites enter into the processes of glycolysis and gluconeogenesis.
The pharmacokinetics. Amin ocelote fully utilized for protein synthesis. Excess amine ocelote that is not needed for synthesis of proteins and other biomolecules, can be accumulated in the body like fatty acids and glucose. Only 5% amine ocelot can be inferred from the body in an unmodified state. Cleavage of amine ocelot occurs by design a-amino group, which is converted into urea, which is excreted by the kidneys. Carbohydrate skeleton that is left is included in the citric acid cycle, where it goes into acetyl-Co-A, acetone acetyl Co-A, pyruvate or an intermediate product.
Basic physical and chemical properties. A clear, almost colorless or yellowish liquid. Theoretical osmolarity: 801,8 mOsm/l; pH: 5,7-7,0; titrated the acid content: max. + 13 mmol/l and pH 7.4; total energy value 1551,0 kJ/l; total nitrogen – 6.3 g/L.
The incompatibility. Due to the risk of microbial contamination and incompatibility, solutions containing amine ocelote, should not be mixed with other drugs. The product contains sodium disulfide is a compound that has a very high reactivity, so we need to keep in mind that introduced along with the drug Pesol® 40 vitamin B1 will rossellinis.