Active material: Combined preparation
When ATH: B05BA01
CCF: The preparation for parenteral nutrition (amino acid solution), used in hepatic insufficiency
ICD-10 codes (testimony): E46, K72, R63.3
When CSF: 11.16.05.01
Manufacturer: HEMOFARM A.D. (Serbia)
Solution for infusion 8% clear, colorless to slightly yellow.
| 1 l | |
| L-valine | 10.08 g |
| L-isoleucine | 10.4 g |
| L-leucine | 13.09 g |
| L-lysine monoacetate | 9.71 g, |
| that corresponds to the content of L-lysine | 6.88 g |
| L-methionine | 1.1 g |
| L-threonine | 4.4 g |
| L-phenylalanine | 880 mg |
| L-tryptophan | 700 mg |
| L-alanine | 4.64 g |
| L-arginine | 10.72 g |
| glycine | 5.82 g |
| L-histidine | 2.8 g |
| L-proline | 5.73 g |
| L-serine | 2.24 g |
| N-acetyl-L-cysteine | 700 mg, |
| that corresponds to L-cysteine | 520 mg |
| energy value 320 kcal / l (1344 kJ / l) osmolarity 770 mosm / l pH 5.7-6.3 |
|
Excipients: glacial acetic acid (4.42 g / l), water d / and.
500 мл – флаконы стеклянные (1) в комплекте с пластиковым держателем для флакона – пачки картонные.
Combined preparation for parenteral nutrition. Provides gepatoprotectornoe and desintoksikatine effect, participates in metabolic processes.
The product includes all 8 essential amino acids, 2 conditionally essential amino acids (L-arginine and L-Histidine), which are insufficient in some pathophysiological conditions, and 5 nonessential amino acids, ensure adequate metabolism in patients with liver diseases. Amino acids are L-form, that enables their direct involvement in the biosynthesis of proteins (содержание азота – всего 12.9 g / l).
L-arginine promotes the transformation of ammonia into urea, binds toxic ammonium ions, from catabolism of proteins in the liver.
L-alanine and L-PROLINE reduces the body's need for glicine (This amino acid is poorly absorbed in the body, when its replacement hyperammoniemia development becomes impossible).
L-isoleucine, L-leucine and L-valine (essential amino acids with branched side chains) directly absorbed by perifericescimi tissues (their metabolism does not depend on the extent of liver damage), lower absorption and flow of aromatic amino acids in the CNS, reducing the manifestations of hepatic encephalopathy, normalize energy and nitrogen balance in the body.
Gepasol-neo allows correct amino acid disorders in liver failure, as well as significantly improve portability of proteins in patients with cirrhosis and hepatitis, and reduce the severity of symptoms of hepatic encephalopathy.
The drug contains no carbohydrates and electrolytes.
Entered infuzionno amino acids undergo one of two possible metabolic pathways: anabolic path, in which amino acids linked by peptide bonds and form specific proteins, and kataboliceski path, in the transamination of amino acids.
Imposed total parenteral nutrition, together with glucose and fats (the ratio of carbohydrates and fats 70:30) with speed 10.5 nitrogen mg/kg/h, amino acids reach the balanced concentration in blood 3 no.
The metabolism of amino acids occur in all tissues of the body. The degree of splitting depends on the symptoms of stress, that subjected to body. Stress accelerates the metabolism of amino acids and strengthens the liver, that reduces the metabolism of amino acids. Sepsis also speeds up their metabolism, а снижение функции почек – подавляет.
Amino acids can be displayed in an unmodified form with the rapid increase of its concentration in the blood. T1/2 amino acids (in healthy humans) is 5-15 m (in this short period of amino acids must be used for the synthesis of proteins). Amino acid residues, unused in the synthesis of proteins, subject to dezaminirovaniju, in the process which produces urea, withdrawn from the body. When infusion Gepasola-neo percentage absorption of essential amino acids 99%, а заменимых – 97%. Total and kidney klirensy amino acids make up 0.5 l / min, ie. 1.5 ml / min, а для большинства заменимых аминокислот – 0.6 l / min, ie. 3 ml / min. Arginine is almost completely reabsorbed in the kidney tubules.
-therapy and parenteral nutrition (частичное или полное – при добавлении растворов углеводов и жировых эмульсий) If any of the liver (hepatic insufficiency) with impaired brain function (hepatic encephalopathy) and without it;
— therapy of hepatic coma and prekomatoznyh States.
Set individually, taking into account the concentration of ammonia in the blood and the severity of the disease.
Gepasol-neo give/drip in at the speed of 1.0-1.25 mL/kg body weight/h (30-35 drop / min.), corresponding 0.08-0.1 g amino acids/kg/h. Максимальная скорость введения – 1.25 ml / kg / h (respectively 0.1 g amino acids/kg/h).
The maximum daily dose is 18.75 ml / kg body weight (1.5 amino acid g / kg / day), ie. 1300 ml for patients weighing 70 kg.
Duration of therapy set individually to complete disappearance of neurological symptoms.
In the application shown in the recommended doses, side effects of this drug are unknown.
— metabolism of amino acids;
- Gipergidratatsiya;
- Giponatriemiya;
- Hypokalemia;
- Renal failure (When hepatic coma in patients with renal insufficiency should be taken into account, What two States threatens the life of the patient);
- Heart failure (decompensated);
- Pregnancy;
- Lactation;
- Childhood and adolescence up 18 years (efficacy and safety have not been established);
- Hypersensitivity to the drug.
Effectiveness and safety of drug Gepasol-neo in pregnancy and lactation is not installed. The use of the drug in this category is contraindicated in patients.
Application of solution Gepasol-neo appropriate only for the reasons.
During the use of this drug requires periodic monitoring electrolyte and acid-base status, the degree of hydration of the body, the condition of the kidney.
Use only clear solution from the bottle intact!
Use in Pediatrics
Effectiveness and safety of drug Gepasol-neo at children and adolescents under the age of 18 years not set.
Symptoms: nausea, vomiting, Sweating, fever, tachycardia, increased liver enzymes and concentration of residual nitrogen. Increased speed can lead to gipergidratace and peripheral edema, development of pulmonary edema.
Treatment: It is recommended that you stop the infusion of the drug, start a symptomatic therapy. There is no specific antidote.
There is evidence of in vivo interaction components Gepasola-neo with theophylline, leading to increased clearance.
There are many in vitro interaction data, Therefore, we recommend that you do not add other drugs to a solution of Gepasola-neo.
Pharmaceutical interaction
Раствор Гепасола-Нео совместим с антибиотиками – амикацином, Ampicillin, cefotaksimom, with ceftriaxone, doxycycline, Erythromycin, gentamicin, chloramphenicol, klindamiцinom, netilmicinom, penicillin, piperacillinom, tetracycline, tobramycin and vankomitinom, as well as with aminophylline, tsiklofosfamida, cimetidine, citarabinom, digoksinom, dopamine, famotidinom, fitomenadionom, ftoruracilom, folic acid, furosemidom, geparinom, chlorpromazine, insulinom, calcium glukonatom, lidokainom, methyldopa, methylprednisolone, metoklopramidom, metotreksatom, morphine, nizatidinom, norepinephrine, propranolol, ranitidine and Riboflavin.
The drug is released under the prescription. The drug should be used only in fixed health facilities.
The drug should be stored out of reach of children, dark place at a temperature of 15 ° to 25 ° C . Shelf life - 2 year.
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