Pharmacological properties
The amino acid structure of the drug Aminoplasmal Hepa-10% is based on the results of studies of amino acids in patients with liver cirrhosis. These patients have typical disturbances in amino acid balance, which are characterized by low concentrations of branched-chain amino acids, increased concentrations of aromatic amino acids and increased concentrations of methionine. These imbalances are considered one of the reasons for the decrease in protein tolerance and the development of hepatic coma in patients with liver cirrhosis. The composition of the drug, which is characterized by an increased content of branched-chain amino acids, is adapted to the amino acid and protein metabolism of patients with liver cirrhosis. The introduction of Aminoplasmal Hepa-10% can achieve correction of the disturbed balance of amino acids. At the same time, cerebral manifestations of a number of diseases, such as hepatic encephalopathy, hepatic precoma or coma, are weakened, and protein tolerance and protein biosynthesis are noticeably improved.
Indication
Providing the body with amino acids during parenteral nutrition of patients with severe liver failure, as well as with the threat of developing hepatic encephalopathy.
Application
Administered by intravenous infusion into the vena cava. Depending on individual needs, the dose for adults and children over 2 years of age is 7-10 ml/kg body weight per day, which corresponds to 0.7-1.0 g of amino acids/kg body weight per day. The maximum dose for adults and children over 2 years of age is 15 ml/kg body weight per day, which corresponds to 1.5 g of amino acids/kg body weight per day.
Infusion rate:
Treatment for hepatic coma
In case of hepatic encephalopathy, it is recommended to start the infusion of Aminoplasmal Hepa-10% at an increased initial rate and administer it until the effect occurs: from the 1st to the 2nd hour - 2 ml/kg/h; from the 3rd to the 4th hour - 1 ml/kg/h; starting from the 5th hour - 0.6 ml/kg/h.
For example, a patient weighing 70 kg is prescribed:
from the 1st to the 2nd hour: 150 ml/h (2 ml/kg/h), which corresponds to approximately 50 drops/min, from the 3rd to the 4th hour: 75 ml/h (1 ml/kg/h) - approximately 25 drops/min, starting from the 5th hour: 45 ml/h (0.6 ml/kg/h) - approximately 15 drops/min.
Supportive therapy/parenteral nutrition
45-75 ml/h, which corresponds to 15-25 drops/min (0.6-1.0 ml/kg/h).
Duration of use: Aminoplasmal Hepa-10% should be used as long as there is a threat of developing hepatic encephalopathy.
Contraindication
Disorders of amino acid metabolism of non-hepatic etiology, shock of various etiologies, acidosis, hyperhydration, hypokalemia, hyponatremia.
There are no data on the use of Aminoplasmal Hepa-10% in children under 2 years of age. Therefore, until reliable information is obtained, administration of the drug to these patients is not recommended.
Side effects
When using the drug according to indications and in recommended doses, no side effects were detected.
Special instructions
Patients with concomitant renal failure Aminoplasmal Hepa-10% is prescribed only after assessing the risk of therapy and the expected beneficial effect. The dose is selected depending on the level of urea and creatinine in the blood serum. It is prescribed with caution in the treatment of patients with increased blood plasma osmolarity. Amino acid therapy does not replace therapeutic measures taken for the treatment of hepatic encephalopathy, such as the use of laxatives, the use of lactulose and / or cleansing the intestines from microorganisms with antibiotics.
Infusion of Aminoplasmal Hepa-10% should be combined with the administration of carbohydrates. Clinical monitoring should include regular monitoring of the water and electrolyte balance of the blood plasma. Electrolytes should be administered as needed.
Interactions
Pharmacological interactions are not known. Due to the risk of microbial contamination and physicochemical incompatibility, it is not recommended to introduce any other drugs into the Aminoplasmal Hepa-10% solution.
Overdose
Overdose or too high an infusion rate may cause nausea, chills, vomiting and renal loss of amino acids. The drug should be discontinued and resumed later at a reduced infusion rate.
Storage conditions
In a place protected from light at a temperature not exceeding 25 °C. After opening the bottle, the drug should be used immediately. Unused contents should not be stored.
