Amino acids
Indications
Amino acids is used for:
Parenteral nutrition
Adult Dose
Adults: The nitrogen requirement for maintenance of body protein mass depends on the patient's condition (nutritional state and degree of metabolic stress). No or minor metabolic stress and normal nutritional state: 0.10-0.15 g nitrogen/kg/day, Moderate metabolic stress with or without malnutrition: 0.15-0.20 g nitrogen/kg/day, Severe catabolism as in burns, sepsis and trauma: up to 0.20-0.25 g nitrogen/kg/day.
The dosage range 0.10-0.25 g nitrogen/kg/day corresponds to 15-35 ml amino acid IV/kg/day. In obese patients, the dose should be based on the estimated ideal weight.
Child Dose
Infants and Children: In children and infants, the rate of infusion is 28-35 ml/kg body wt/day is recommended, with a stepwise increment in the rate of administration during the first week of treatment.
Renal Dose
Administration
Depending upon patients requirements, 1000-2000 ml amino acid may be infused intravenously per 24 hours. It should be infused slowly, at rates 1.4-2.8 ml (30-60 drops) per minute.
Contra Indications
Contraindicated in patients with inborn errors of amino acids metabolism. Moreover, amino acid should not be used in patients with hepatic coma or metabolic disorders involving impaired nitrogen utilization.
Precautions
Hyperphenylalaninemia has been noted in severely ill, premature infants. In these patients, monitoring of the phenylalanine levels is recommended and the infusion rate adjusted as needed. Do not use if the solution is turbid or contains particles. Discard any unused portion.
Pregnancy-Lactation
Pregnancy Category: C
Lactation: Unknown whether distributed in breast milk
Interactions
Adverse Effects
Side effects of Amino acids :
It is usually well tolerated. Yet nausea, vomiting, flushing and sweating have been observed during infusion of amino acid IV at rates exceeding the recommended maximal rate. Hypersensitivity reactions have been reported. Like all hypertonic infusion solution, thrombophlebitis may occur when peripheral veins are used. The incidence may be reduced by the simultaneous infusion of 10% fat emulsion. If it is infused to severely ill patients, premature infants, hyperphenylalaninemia may occur.
Mechanism of Action
Provides nutritional requirements that support neurotransmitter synthesis and physiological activities involved in neuropathic pain; helps restore nutrient balance of arginine, choline, glutamine, histidine, tryptophan, and serine which support the balance of the neurotransmitters GABA, histamine, nitric oxide, serotonin, and acetylcholine
Under usual physiological conditions, glutamine, arginine, serine, and choline are considered nonessential because endogenous synthesis is sufficient to satisfy metabolic demand; with neuropathic pain, the usual rate of synthesis is no longer sufficient and these nutrients become conditionally essential, requiring that supplemental amounts be consumed.