Фармакодинамика Основное терапевтическое воздействие Аминопл... Инструкция
Показания к применению
Парентеральное питание с целью профилактики и лечения состояний белковой недостаточности вследствие повышенной потери белков и/или повышенной потребности в них:
Травмы средней и тяжелой степени, политравма, ожоги, перитонит, сепсис, полиррганная недостаточность в соответствии с метаболическими потребностями;
Состояния после обширных оперативных вмешательств;
Основное терапевтическое воздействие Аминоплазмаля Б. Браун Е 5 заключается в снабжении организма субстратом синтеза белков при парентеральном питании.
Введение всех аминокислот, необходимых для синтеза белков (включая условно заменимые и заменимые аминокислоты), содержащихся в Аминоплазмале Б. Браун Е5, обеспечивает высокую питательную эффективность и снижает нагрузку на организм при синтезе белка. Для исключения метаболизма вводимых аминокислот в качестве источника энергии, необходимо одновременное введение с Аминоплазмалем Б. Браун Е 5 донаторов энергии, таких как жировые эмульсии и растворы углеводов.
Фармакокинетика
Вводимые внутривенно аминокислоты поступают во внутрисосудистые и внутриклеточные депо эндогенных свободных аминокислот и так же, как и они, функционируют в качестве субстрата для синтеза белков организма. Биодоступность всех компонентов Аминоплазмаля Б. Браун Е 5 при внутривенном введении составляет 100 %.
В Аминоплазмале Б. Браун Е 5 индивидуальные концентрации аминокислот подобраны таким образом, чтобы при внутривенном введении данного раствора относительный рост концентрации каждой аминокислоты в плазме не выходил за пределы нормы, что обеспечивает поддержание гомеостаза аминокислот в плазме.
Аминокислоты, не вовлеченные в синтез белков, метаболизируются следующим образом: в результате трансаминирования аминогруппы отделяются от углеродного скелета, далее углеродные цепи или окисляются до СO2, или используются в качестве субстрата в реакции глюконеогенеза в печени. Аминогруппы метаболизируются в печени до мочевины.
Показания к применению
Парентеральное питание с целью профилактики и лечения состояний белковой недостаточности вследствие повышенной потери белков и/или повышенной потребности в них:
Травмы средней и тяжелой степени, политравма, ожоги, перитонит, сепсис, полиррганная недостаточность в соответствии с метаболическими потребностями;
Состояния после обширных оперативных вмешательств;
Воспалительные заболевания кишечника (в т.ч. болезнь Крона, язвенный колит), кишечные свищи;
Нарушения питания различного генеза (кахексия).
Противопоказания
Гиперчувствительность к компонентам препарата;
Врожденные нарушения аминокислотного метаболизма;
Тяжелые нарушения кровообращения (шок);
Выраженная гипоксия;
Выраженный метаболический ацидоз;
Прогрессирующая печеночная недостаточность;
Острая почечная недостаточность, если невозможно проведение гемофильтрации или гемодиализа;
Превышение предельно допустимой концентрации электролитов, входящих в состав препарата, в плазме крови;
Детский возраст до 2 лет;
Общие противопоказания для проведения инфузионной терапии (декомпенсированная сердечная недостаточность, острый отек легких, гипергидратация).
С осторожностью
Аминоплазмаль Б. Браун Е 5 может применяться только после тщательной оценки соотношения риск/польза в случаях:
Почечной или печеночной недостаточности,
Повышенной осмолярности плазмы,
Гипотонической дегидратации, а также во всех случаях нарушения метаболизма аминокислот, обусловленных причинами, не являющимися противопоказаниями к применению препарата.
Применение при беременности и в период грудного вскармливания
В настоящее время достаточных клинических данных о применении Аминоплазмаля Б. Браун Е 5 в период беременности и лактации нет, поэтому возможно его применение у беременных и кормящих женщин только в случаях, когда ожидаемая польза от лечения препаратом превышает возможный риск развития осложнений.
Способ применения и дозы
Аминоплазмаль Б. Браун Е 5 вводится в периферические и центральные вены.
Для введения Аминоплазмаля Б. Браун Е 5 необходимо использовать только стерильные системы для внутривенной инфузии. Во время применения препарата необходимо контролировать место введения (место пункции, или катетеризации) на предмет наличия признаков воспаления или инфицирования.
Препарат поставляется в бутылках, рассчитанных на однократное применение. Любые неиспользованные объемы препарата не подлежат хранению и должны выбрасываться.
Нельзя использовать препарат, если раствор не прозрачен, на бутылке есть явные следы повреждений или нарушена герметичность.
Доза Аминоплазмаля Б. Браун Е 5 зависит от нутриционного статуса и индивидуальных потребностей пациента в аминокислотах, электролитах и жидкости. Взрослым и детям с 14 лет Средняя суточная доза
20-40 мл/кг массы тела, что соответствует 1-2 г аминокислот/кг массы тела, 1400-2800 мл препарата для пациента с массой тела 70 кг.
Высшая суточная доза
40 мл/кг массы тела, что соответствует 2 г аминокислот/кг массы тела, 140 г аминокислот или 2800 мл препарата для пациента с массой тела 70 кг.
Максимальная скорость введения
2 мл/кг массы тела/час, что соответствует-0,1 г аминокислот/кг массы тела/час, 45 капель/мин или 2,34 мл/мин для пациента с массой тела 70 кг.
Детям
Указанные ниже дозы являются усредненными. Доза должна подбираться в соответствии с возрастом ребенка, стадией и выраженностью заболевания.
Для детей с 2 до 5 лет:
30 мл /кг массы тела, что соответствует 1,5 г аминокислот/кг массы тела.
Для детей с 5 до 14 лет:
20 мл /кг массы тела, что соответствует 1,0 г аминокислот/кг массы тела.
Максимальная скорость введения
2 мл/кг массы тела/час, что. соответствует 0,1 г аминокислот/кг массы тела/час.
Если потребность в аминокислотах превышает 1 г/кг массы тела в сутки, возможно использование более концентрированных растворов аминокислот с целью снижения водной нагрузки.
Продолжительность применения
Ограничений по продолжительности использования препарата не выявлено.
Побочное действие
При соблюдении рекомендаций в отношении указанных мер предосторожности, скорости введения и дозировки, побочных эффектов не наблюдается, однако возможно развитие аллергических реакций. Редко возникающие побочные эффекты (>1:1000, <1:100): тошнота, рвота, головная боль, озноб, лихорадка могут быть связаны с началом проведения парентерального питания и не являются специфичными для Аминоплазмаля Б. Браун Е5.
Передозировка
Передозировка или слишком быстрое введение препарата могут повлечь за собой такие явления, как озноб, тошнота, рвота и повышение экскреции аминокислот почками. В таких случаях введение препарата должно быть прекращенои возобновлено позже с меньшей скоростью инфузии.
Взаимодействие с другими лекарственными средствами
Лекарственные взаимодействия не известны.
Смешивание Аминоплазмаля Б. Браун Е 5 с другими компонентами парентерального питания (углеводами, жировыми эмульсиями, витаминами, микроэлементами) должно проводиться в асептических условиях. Необходимо проверять их совместимость перед применением.
Особые указания
Для обеспечения полного усвоения аминокислот, введение Аминоплазмаля Б. Браун Е 5 следует проводить одновременно с препаратами, обеспечивающими энергетические потребности организма (жировыми эмульсиями и растворами углеводов), а также витаминами и микроэлементами.
Следует учитывать, что возможность введения вышеперечисленных компонентов в периферические вены будет зависеть от результирующей осмолярности этих растворов.
В период лечения необходимо контролировать водно-электролитный и кислотно-основной баланс, уровень сывороточных белков, осмолярность сыворотки крови, концентрацию глюкозы в крови и функции печени.
Для пациентов с печеночной, почечной, сердечной, легочной недостаточностью необходимо подбирать индивидуальный режим дозирования.
При длительном введении (в течение нескольких недель) следует контролировать факторы свертывания и клеточный состав крови. В случае наличия гипотонической дегидратации, сначала, следует восстановить адекватный баланс воды и электролитов, а затем начинать парентеральное питание.
Хранение при температуре ниже 15°С может вызывать образование кристаллов, которые растворяются при нагревании раствора до 25 °С и легком встряхивании.
Форма выпуска
Раствор для инфузий. По 250 мл, 500 мл и 1000 мл в бутылки гидролитического стекла класса 2, укупоренные резиновой пробкой кирпичного цвета, соответствующие требованиям Европейской Фармакопеи для инфузионных растворов, алюминиевым колпачком кирпично-красного цвета и пластмассовой заглушкой серого цвета.
По 10 бутылок по 250 мл или по 500 мл, по 6 бутылок по 1000 мл вместе с инструкциями по применению в соответствующем количестве в картонной коробке(для стационаров).
Условия хранения
Хранить при температуре не выше 25 °С в защищенном от света месте. Не замораживать! Хранить в местах, недоступных для детей.
Срок годности
3 года.
Не использовать после срока годности, указанного на упаковке.
Условия отпуска
Для использования в стационарах
Производитель
Б.Браун Мельзунген АГ, Карл-Браун-Штрассе 1, 34212, Мельзунген, Германия.
Для описания товара использована информация от партнера 36.6
Мобильное приложение «Все аптеки»
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Браун Е 5 заключается в снабжении организма субстратом синтеза белков при парентеральном питании."}},{"type":"paragraph","data":{"text":"Введение всех аминокислот, необходимых для синтеза белков (включая условно заменимые и заменимые аминокислоты), содержащихся в Аминоплазмале Б. Браун Е5, обеспечивает высокую питательную эффективность и снижает нагрузку на организм при синтезе белка. Для исключения метаболизма вводимых аминокислот в качестве источника энергии, необходимо одновременное введение с Аминоплазмалем Б. Браун Е 5 донаторов энергии, таких как жировые эмульсии и растворы углеводов."}},{"type":"paragraph","data":{"text":"Фармакокинетика"}},{"type":"paragraph","data":{"text":"Вводимые внутривенно аминокислоты поступают во внутрисосудистые и внутриклеточные депо эндогенных свободных аминокислот и так же, как и они, функционируют в качестве субстрата для синтеза белков организма. Биодоступность всех компонентов Аминоплазмаля Б. Браун Е 5 при внутривенном введении составляет 100 %."}},{"type":"paragraph","data":{"text":"В Аминоплазмале Б. Браун Е 5 индивидуальные концентрации аминокислот подобраны таким образом, чтобы при внутривенном введении данного раствора относительный рост концентрации каждой аминокислоты в плазме не выходил за пределы нормы, что обеспечивает поддержание гомеостаза аминокислот в плазме."}},{"type":"paragraph","data":{"text":"Аминокислоты, не вовлеченные в синтез белков, метаболизируются следующим образом: в результате трансаминирования аминогруппы отделяются от углеродного скелета, далее углеродные цепи или окисляются до СO\u003csub\u003e2\u003c/sub\u003e, или используются в качестве субстрата в реакции глюконеогенеза в печени. Аминогруппы метаболизируются в печени до мочевины."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Парентеральное питание с целью профилактики и лечения состояний белковой недостаточности вследствие повышенной потери белков и/или повышенной потребности в них:"}},{"type":"list","data":{"style":"ordered","items":["Травмы средней и тяжелой степени, политравма, ожоги, перитонит, сепсис, полиррганная недостаточность в соответствии с метаболическими потребностями;"]}},{"type":"list","data":{"style":"ordered","items":["Состояния после обширных оперативных вмешательств;"]}},{"type":"list","data":{"style":"ordered","items":["Воспалительные заболевания кишечника (в т.ч. болезнь Крона, язвенный колит), кишечные свищи;"]}},{"type":"list","data":{"style":"ordered","items":["Нарушения питания различного генеза (кахексия). "]}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["Гиперчувствительность к компонентам препарата;"]}},{"type":"list","data":{"style":"ordered","items":["Врожденные нарушения аминокислотного метаболизма;"]}},{"type":"list","data":{"style":"ordered","items":["Тяжелые нарушения кровообращения (шок);"]}},{"type":"list","data":{"style":"ordered","items":["Выраженная гипоксия;"]}},{"type":"list","data":{"style":"ordered","items":["Выраженный метаболический ацидоз;"]}},{"type":"list","data":{"style":"ordered","items":["Прогрессирующая печеночная недостаточность;"]}},{"type":"list","data":{"style":"ordered","items":["Острая почечная недостаточность, если невозможно проведение гемофильтрации или гемодиализа;"]}},{"type":"list","data":{"style":"ordered","items":["Превышение предельно допустимой концентрации электролитов, входящих в состав препарата, в плазме крови;"]}},{"type":"list","data":{"style":"ordered","items":["Детский возраст до 2 лет;"]}},{"type":"list","data":{"style":"ordered","items":["Общие противопоказания для проведения инфузионной терапии (декомпенсированная сердечная недостаточность, острый отек легких, гипергидратация). "]}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"list","data":{"style":"ordered","items":["Аминоплазмаль Б. Браун Е 5 может применяться только после тщательной оценки соотношения риск/польза в случаях:"]}},{"type":"list","data":{"style":"ordered","items":["Почечной или печеночной недостаточности,"]}},{"type":"list","data":{"style":"ordered","items":["Повышенной осмолярности плазмы,"]}},{"type":"list","data":{"style":"ordered","items":["Гипотонической дегидратации, а также во всех случаях нарушения метаболизма аминокислот, обусловленных причинами, не являющимися противопоказаниями к применению препарата."]}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"В настоящее время достаточных клинических данных о применении Аминоплазмаля Б. Браун Е 5 в период беременности и лактации нет, поэтому возможно его применение у беременных и кормящих женщин только в случаях, когда ожидаемая польза от лечения препаратом превышает возможный риск развития осложнений."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"\n\nАминоплазмаль Б. Браун Е 5 вводится в периферические и центральные вены."}},{"type":"paragraph","data":{"text":"Для введения Аминоплазмаля Б. Браун Е 5 необходимо использовать только стерильные системы для внутривенной инфузии. Во время применения препарата необходимо контролировать место введения (место пункции, или катетеризации) на предмет наличия признаков воспаления или инфицирования."}},{"type":"paragraph","data":{"text":"Препарат поставляется в бутылках, рассчитанных на однократное применение. Любые неиспользованные объемы препарата не подлежат хранению и должны выбрасываться."}},{"type":"paragraph","data":{"text":"Нельзя использовать препарат, если раствор не прозрачен, на бутылке есть явные следы повреждений или нарушена герметичность."}},{"type":"paragraph","data":{"text":"Доза Аминоплазмаля Б. Браун Е 5 зависит от нутриционного статуса и индивидуальных потребностей пациента в аминокислотах, электролитах и жидкости. Взрослым и детям с 14 лет Средняя суточная доза"}},{"type":"paragraph","data":{"text":"20-40 мл/кг массы тела, что соответствует 1-2 г аминокислот/кг массы тела, 1400-2800 мл препарата для пациента с массой тела 70 кг."}},{"type":"paragraph","data":{"text":"Высшая суточная доза"}},{"type":"paragraph","data":{"text":"40 мл/кг массы тела, что соответствует 2 г аминокислот/кг массы тела, 140 г аминокислот или 2800 мл препарата для пациента с массой тела 70 кг."}},{"type":"paragraph","data":{"text":"Максимальная скорость введения"}},{"type":"paragraph","data":{"text":"2 мл/кг массы тела/час, что соответствует-0,1 г аминокислот/кг массы тела/час, 45 капель/мин или 2,34 мл/мин для пациента с массой тела 70 кг."}},{"type":"paragraph","data":{"text":"Детям"}},{"type":"paragraph","data":{"text":"Указанные ниже дозы являются усредненными. Доза должна подбираться в соответствии с возрастом ребенка, стадией и выраженностью заболевания."}},{"type":"paragraph","data":{"text":"Для детей с 2 до 5 лет:"}},{"type":"paragraph","data":{"text":"30 мл /кг массы тела, что соответствует 1,5 г аминокислот/кг массы тела."}},{"type":"paragraph","data":{"text":"Для детей с 5 до 14 лет:"}},{"type":"paragraph","data":{"text":"20 мл /кг массы тела, что соответствует 1,0 г аминокислот/кг массы тела."}},{"type":"paragraph","data":{"text":"Максимальная скорость введения"}},{"type":"paragraph","data":{"text":"2 мл/кг массы тела/час, что. соответствует 0,1 г аминокислот/кг массы тела/час."}},{"type":"paragraph","data":{"text":"Если потребность в аминокислотах превышает 1 г/кг массы тела в сутки, возможно использование более концентрированных растворов аминокислот с целью снижения водной нагрузки."}},{"type":"paragraph","data":{"text":"Продолжительность применения"}},{"type":"paragraph","data":{"text":"Ограничений по продолжительности использования препарата не выявлено.\n\n"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"При соблюдении рекомендаций в отношении указанных мер предосторожности, скорости введения и дозировки, побочных эффектов не наблюдается, однако возможно развитие аллергических реакций. Редко возникающие побочные эффекты (>1:1000, <1:100): тошнота, рвота, головная боль, озноб, лихорадка могут быть связаны с началом проведения парентерального питания и не являются специфичными для Аминоплазмаля Б. Браун Е5."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Передозировка или слишком быстрое введение препарата могут повлечь за собой такие явления, как озноб, тошнота, рвота и повышение экскреции аминокислот почками. В таких случаях введение препарата должно быть прекращенои возобновлено позже с меньшей скоростью инфузии."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\n\nЛекарственные взаимодействия не известны."}},{"type":"paragraph","data":{"text":"Смешивание Аминоплазмаля Б. Браун Е 5 с другими компонентами парентерального питания (углеводами, жировыми эмульсиями, витаминами, микроэлементами) должно проводиться в асептических условиях. Необходимо проверять их совместимость перед применением. \n\n"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nДля обеспечения полного усвоения аминокислот, введение Аминоплазмаля Б. Браун Е 5 следует проводить одновременно с препаратами, обеспечивающими энергетические потребности организма (жировыми эмульсиями и растворами углеводов), а также витаминами и микроэлементами."}},{"type":"paragraph","data":{"text":"Следует учитывать, что возможность введения вышеперечисленных компонентов в периферические вены будет зависеть от результирующей осмолярности этих растворов."}},{"type":"paragraph","data":{"text":"В период лечения необходимо контролировать водно-электролитный и кислотно-основной баланс, уровень сывороточных белков, осмолярность сыворотки крови, концентрацию глюкозы в крови и функции печени."}},{"type":"paragraph","data":{"text":"Для пациентов с печеночной, почечной, сердечной, легочной недостаточностью необходимо подбирать индивидуальный режим дозирования."}},{"type":"paragraph","data":{"text":"При длительном введении (в течение нескольких недель) следует контролировать факторы свертывания и клеточный состав крови. В случае наличия гипотонической дегидратации, сначала, следует восстановить адекватный баланс воды и электролитов, а затем начинать парентеральное питание."}},{"type":"paragraph","data":{"text":"Хранение при температуре ниже 15°С может вызывать образование кристаллов, которые растворяются при нагревании раствора до 25 °С и легком встряхивании.\n\n"}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nРаствор для инфузий. По 250 мл, 500 мл и 1000 мл в бутылки гидролитического стекла класса 2, укупоренные резиновой пробкой кирпичного цвета, соответствующие требованиям Европейской Фармакопеи для инфузионных растворов, алюминиевым колпачком кирпично-красного цвета и пластмассовой заглушкой серого цвета."}},{"type":"paragraph","data":{"text":"По 10 бутылок по 250 мл или по 500 мл, по 6 бутылок по 1000 мл вместе с инструкциями по применению в соответствующем количестве в картонной коробке(для стационаров).\n\n"}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить при температуре не выше 25 °С в защищенном от света месте. Не замораживать! Хранить в местах, недоступных для детей. "}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"\n\n3 года."}},{"type":"paragraph","data":{"text":"Не использовать после срока годности, указанного на упаковке.\n\n"}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Для использования в стационарах"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Б.Браун Мельзунген АГ, Карл-Браун-Штрассе 1, 34212, Мельзунген, Германия."}}]}],"source":null},"description_toggle":false,"short_description":"Фармакодинамика Основное терапевтическое воздействие Аминоплазмаля Б. Браун Е 5 заключается в снабжении организма субстратом синтеза белков при парентеральном питании. Введение всех аминокислот, необходимых для синтеза белков (включая условно заменимые и заменимые аминокислоты), содержащихся в Аминоплазмале Б. 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