Аминоплазмаль Гепа Раствор, 10 шт, 500 мл, 10 %, для инфузий

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Состав этого раствора характеризуется относительно высоким содержанием разветвленных аминокислот по отношению к ароматическим аминокислотам и адаптирован к метаболизму аминокислот и белков у пациентов с печеночной недостаточностью."}},{"type":"paragraph","data":{"text":"При острой и хронической печеночной недостаточности наблюдается дисбаланс аминокислот в плазме характеризующийся пониженным уровнем разветвлённых аминокислот - валина лейцина изолейцина и повышенным уровнем ароматических аминокислот - фенилаланина и тирозина. Пониженный уровень разветвлённых аминокислот в плазме связан с повышенным катаболизмом этих аминокислот в мышцах."}},{"type":"paragraph","data":{"text":"Повышение концентрации ароматических аминокислот окислительные ферменты которых локализованы только в печени связано с пониженным печёночным метаболизмом обусловленным печеночной недостаточностью. Кроме того при острой и хронической печеночной недостаточности повышен распад белков в мышцах что приводит к дополнительному высвобождению ароматических аминокислот в плазму."}},{"type":"paragraph","data":{"text":"Назначение препарата Аминоплазмаль Гепа направлено на уменьшение катаболической утилизации аминокислот и поддержание аминокислотного гомеостаза в плазме."}},{"type":"paragraph","data":{"text":"Введение всех аминокислот необходимых для синтеза белков (включая условно заменимые и заменимые аминокислоты) входящих в состав препарата Аминоплазмаль Гепа обеспечивает высокую питательную эффективность и снижает нагрузку на организм при синтезе белка."}},{"type":"paragraph","data":{"text":"Таким образом основное терапевтическое воздействие препарата Аминоплазмаль Гепа заключается в снабжении организма субстратом синтеза белков при парентеральном питании больных с печеночной недостаточностью. При этом церебральные проявления заболевания т.е. печеночная энцефалопатия печеночная прекома или кома ослабевают а переносимость белков и их биосинтез значительно улучшаются."}},{"type":"paragraph","data":{"text":"При инфузии препарата Аминоплазмаль Гепа достигаются следующие результаты: нормализуется уровень аминокислот с разветвленной цепью; нормализуется уровень ароматических аминокислот; нормализуется коэффициент Фишера; уменьшается выраженность симптомов печеночной энцефалопатии; снижается концентрация аммиака в крови."}},{"type":"header","data":{"text":"Фармакокинетика:","level":3}},{"type":"paragraph","data":{"text":"Аминокислоты образующиеся из поступающих извне белков и аминокислоты в составе растворов вводимых парентерально подвергаются одним и тем же биохимическим процессам."}},{"type":"paragraph","data":{"text":"Вводимые внутривенно аминокислоты поступают во внутрисосудистые и внутриклеточные депо эндогенных свободных аминокислот. Аминогруппы образующиеся в результате дезаминирования разветвлённых аминокислот связываются с глутаматом с образованием глутамина который переносится кровотоком в кишечник и мышцы для дальнейшей утилизации. Биодоступность внутривенно вводимых аминокислот - 100%."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Для парентерального питания при нарушении аминокислотного баланса возникающего при острых и хронических заболеваниях печени а также для предупреждения и лечения печеночной энцефалопатии."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- Нарушения аминокислотного обмена внепеченочной этиологий;"}},{"type":"paragraph","data":{"text":"- Тяжелые нарушения кровообращения (шок);"}},{"type":"paragraph","data":{"text":"- Отек легких;"}},{"type":"paragraph","data":{"text":"- Выраженный ацидоз;"}},{"type":"paragraph","data":{"text":"- Гипергидратация;"}},{"type":"paragraph","data":{"text":"- Выраженная гипокалиемия;"}},{"type":"paragraph","data":{"text":"- Выраженная гипонатриемия;"}},{"type":"paragraph","data":{"text":"- Гиперчувствительность к компонентам препарата;"}},{"type":"paragraph","data":{"text":"- Детский возраст до 2 лет;"}},{"type":"paragraph","data":{"text":"- Беременность;"}},{"type":"paragraph","data":{"text":"- Период лактации."}},{"type":"paragraph","data":{"text":"В связи с особенностью аминокислотного состава Аминоплазмаль Гепа необходимо применять только в соответствии с вышеперечисленными показаниями. При использовании препарата Аминоплазмаль Гепа в других случаях могут возникнуть нарушения аминокислотного обмена."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Следует применять с осторожностью у пациентов с повышенной осмолярностью плазмы."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Противопоказан во время беременности и в период лактации."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Аминоплазмаль Гепа вводится внутривенно через центральный венозный катетер."}},{"type":"paragraph","data":{"text":"Методика применения препарата:"}},{"type":"paragraph","data":{"text":"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."}},{"type":"paragraph","data":{"text":"Рекомендованные дозы"}},{"type":"paragraph","data":{"text":"Если врачом не предписано иначе то с учетом индивидуальных потребностей пациента рекомендуются следующие дозы:"}},{"type":"paragraph","data":{"text":"Взрослым:"}},{"type":"paragraph","data":{"text":"Стандартная доза:"}},{"type":"paragraph","data":{"text":"7-10 мл/кг массы тела/сутки что соответствует 07 - 1 г аминокислот/кг массы тела/сутки."}},{"type":"paragraph","data":{"text":"Максимальная доза:"}},{"type":"paragraph","data":{"text":"15 мл/кг массы тела/сутки что соответствует 15 г аминокислот/кг массы тела/сутки."}},{"type":"paragraph","data":{"text":"Детям с 2-х лет:"}},{"type":"paragraph","data":{"text":"Стандартная доза:"}},{"type":"paragraph","data":{"text":"7-10 мл/кг массы тела/сутки что соответствует 07 - 1 г аминокислот/кг массы тела/сутки."}},{"type":"paragraph","data":{"text":"При применении препарата Аминоплазмаль Гепа у детей необходимо особенно тщательно учитывать возраст нутриционный статус и основное заболевание пациента."}},{"type":"paragraph","data":{"text":"В случае полного парентерального питания также необходимо вводить углеводы незаменимые жирные кислоты витамины и микроэлементы."}},{"type":"paragraph","data":{"text":"Скорость инфузии:"}},{"type":"paragraph","data":{"text":"Лечение печеночной комы"}},{"type":"paragraph","data":{"text":"Для пациентов с печеночной энцефалопатией рекомендуется в начале лечения вводить Аминоплазмаль Гепа с высокой скоростью до тех пор пока не наступит эффект. Например для пациента массой 70 кг: в течение первых двух часов инфузии:"}},{"type":"paragraph","data":{"text":"50 капель/мин что примерно соответствует 150 мл/час (2 мл/кг массы тела/час)"}},{"type":"paragraph","data":{"text":"с 3-го по 4-й час инфузии:"}},{"type":"paragraph","data":{"text":"25 капель/мин что примерно соответствует 75 мл/час (1 мл/кг массы тела/час)"}},{"type":"paragraph","data":{"text":"начиная с 5-го часа инфузии:"}},{"type":"paragraph","data":{"text":"15 капель/мин что примерно соответствует 45 мл/час (06 мл/кг массы тела/час)."}},{"type":"paragraph","data":{"text":"Поддерживающая терапия/парентеральное питание:"}},{"type":"paragraph","data":{"text":"15-25 капель/мин что примерно соответствует 45-75 мл/час (06 - 10 мл/кг массы тела/час)."}},{"type":"paragraph","data":{"text":"Продолжительность применения:"}},{"type":"paragraph","data":{"text":"Аминоплазмаль Гепа следует применять до тех пор пока не исчезнет угроза развития печеночной энцефалопатии."}}]},{"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."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Передозировка или превышение рекомендуемой скорости инфузии препарата могут повлечь за собой такие явления как озноб тошнота рвота и повышение экскреции аминокислот почками. В таких случаях введение препарата должно быть прекращено и возобновлено позже с меньшей скоростью инфузии."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Лекарственные взаимодействия с другими препаратами не известны."}},{"type":"paragraph","data":{"text":"В связи с опасностью бактериальной контаминации и физико-химической несовместимости не рекомендуется вводить какие-либо другие препараты в Аминоплазмаль Гепа предпочтительно включать их в стандартные растворы углеводов или электролитов. Однако возможно смешивание препарата"}},{"type":"paragraph","data":{"text":"Аминоплазмаль Гепа с другими растворами для парентерального питания после проверки их совместимости."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Не вводить в периферические вены."}},{"type":"paragraph","data":{"text":"При одновременном наличии у пациента почечной недостаточности дозу аминокислот следует корригировать в зависимости от уровня мочевины и креатинина в сыворотке."}},{"type":"paragraph","data":{"text":"Терапия растворами аминокислот не заменяет установленных для лечения печеночной энцефалопатии других терапевтических мер."}},{"type":"paragraph","data":{"text":"Одновременно с введением аминокислотного состава показано использование других нутриентов. Введению препарата Аминоплазмаль Гепа должно сопутствовать введение адекватного количества углеводов. Электролиты должны использоваться в соответствии с потребностями."}},{"type":"paragraph","data":{"text":"В период лечения необходимо контролировать вводно-электролитный баланс осмолярность плазмы кислотно-основной баланс концентрацию глюкозы в крови и функции печени. Частота и способ контроля зависят от остроты протекания заболевания и тяжести состояния пациента. Продолжительность введения из одной бутылки не должна превышать 24 часов."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для инфузий 10 %."}}]},{"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":"3 года."}},{"type":"paragraph","data":{"text":"Не использовать после срока годности указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Б.Браун Мельзунген АГ, Carl-Braun-Strasse 1, 34212, Melsungen, Germany, Германия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Б.Браун Мельзунген АГ"}}]}],"source":null},"description_toggle":false,"short_description":"Аминоплазмаль Гепа содержит 20 аминокислот в виде левовращающих изомеров. Состав этого раствора характеризуется относительно высоким содержанием разветвленных аминокислот по отношению к ароматическим аминокислотам и адаптирован к метаболизму аминокислот и белков у пациентов с печеночной недостаточностью. При острой и хронической печеночной недостаточности наблюдается дисбаланс аминокислот в плазме характеризующийся пониженным уровнем разветвлённых аминокислот - валина лейцина изолейцина и повышенным уровнем ароматических аминокислот - фенилаланина и тирозина. Пониженный уровень разветвлённых аминокислот в плазме связан с повышенным катаболизмом этих аминокислот в мышцах. Повышение концентрации ароматических аминокислот окислительные ферменты которых локализованы только в печени связано с пониженным печёночным метаболизмом обусловленным печеночной недостаточностью. Кроме того при острой и хронической печеночной недостаточности повышен распад белков в мышцах что приводит к дополнительному высвобождению ароматических аминокислот в плазму. Назначение препарата Аминоплазмаль Гепа направлено на уменьшение катаболической утилизации аминокислот и поддержание аминокислотного гомеостаза в плазме. Введение всех аминокислот необходимых для синтеза белков (включая условно заменимые и заменимые аминокислоты) входящих в состав препарата Аминоплазмаль Гепа обеспечивает высокую питательную эффективность и снижает нагрузку на организм при синтезе белка. Таким образом основное терапевтическое воздействие препарата Аминоплазмаль Гепа заключается в снабжении организма субстратом синтеза белков при парентеральном питании больных с печеночной недостаточностью. При этом церебральные проявления заболевания т.е. печеночная энцефалопатия печеночная прекома или кома ослабевают а переносимость белков и их биосинтез значительно улучшаются. При инфузии препарата Аминоплазмаль Гепа достигаются следующие результаты: нормализуется уровень аминокислот с разветвленной цепью; нормализуется уровень ароматических аминокислот; нормализуется коэффициент Фишера; уменьшается выраженность симптомов печеночной энцефалопатии; снижается концентрация аммиака в крови. Аминокислоты образующиеся из поступающих извне белков и аминокислоты в составе растворов вводимых парентерально подвергаются одним и тем же биохимическим процессам. Вводимые внутривенно аминокислоты поступают во внутрисосудистые и внутриклеточные депо эндогенных свободных аминокислот. Аминогруппы образующиеся в результате дезаминирования разветвлённых аминокислот связываются с глутаматом с образованием глутамина который переносится кровотоком в кишечник и мышцы для дальнейшей утилизации. 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