Infezol

Infezol is an infusion fluid that contains amino acids with electrolytes, which are physiological elements or metabolic analogues.

Amino acids are extremely important in the process of protein formation within the body. Xylitol has a very high energy potential because it is broken down during intrahepatic carbohydrate metabolism processes, forming metabolic components that are required to perform glycolysis with gluconeogenesis.

Indications Infezola

It is used as a parenteral nutrition agent during the following disorders:

• hypoproteinemia;
• loss of fluid of various etiologies (poisoning, intestinal obstruction, burn disease, damage to the digestive organs with protein absorption disorder, etc.);
• temporary inability to take food through the mouth (during operations in the stomach or esophagus, etc.);
• replenishment of protein deficiency that occurs due to an increased need for proteins, severe loss of proteins, or a disorder of protein metabolism during digestion, absorption, or excretion processes;
• improvement of metabolic and reparative processes after major operations.

Release form

The drug is released in the form of an infusion liquid:

• like Infezol 40, in bottles with a capacity of 0.1, 0.25 or 0.5 l; there are 10 such bottles in a box;
• like Infezol 100, in 0.1 or 0.25 l bottles; 10 bottles inside a pack.

Pharmacodynamics

Infusion agents containing amino acids are used as substances for parenteral nutritional procedures. In combination with fluid, electrolytes and energy carriers, these drugs help improve the general condition, support metabolism and reduce the risk of weight loss in various critical conditions.

If there is a deficiency in exogenous amino acid intake (due to illness), a significant deterioration in the plasma amino acid set occurs, which is manifested both in percentage indicators and in the absolute level of individual amino acids.

Pharmacokinetics

The amino acids contained in the drug are completely broken down into proteins after entering the body. Excess substances do not accumulate, which distinguishes the substance from fatty acids with glucose.

A small amount of amino acids (less than 5%) is eliminated from the body unchanged.

Amino acid molecules are broken down by deamination of the α-amino group; it is subsequently converted into urea and excreted in this state through the kidneys.

The carbon backbone that remains after deamination takes part in the citric acid cycle where it is metabolized and subsequently transformed into pyruvate, an intermediate, or acetyl-CoA.

Dosing and administration

The medication is administered intravenously through a drip. The dosage regimen is determined by the clinical picture, the body's need for fluid and amino acids with electrolytes, and in addition, the patient's weight and the level of catabolism.

Due to the prevalence of catabolism processes, the drug should be used according to the upper range scheme. The infusion procedure is performed at a low rate, while during the first 60 minutes of use, the rate of fluid administration is brought to the required values.

Infezol 40

Adults are administered intravenously via a dropper in portions of 25 ml/kg per day (contains 0.6-1 g of amino acids). In case of catabolic conditions, it is necessary to use up to 50 ml/kg of the substance per day (contains 1.3-2 g of amino acids).

No more than 0.1 g/kg of amino acids can be administered in 60 minutes – this corresponds to a rate of 0.8 drops/kg per minute (amino acids in the amount of 2.5 ml/kg and xylitol in a portion of 0.125 g/kg). Thus, with a weight of 70 kg and the administration of 7 g of amino acids in 60 minutes, the dosage is 175 ml; the xylitol indicator is 8.75 g; in this case, 60 drops of medicinal liquid must be administered.

If the patient requires slightly more fluid and calories, the volume of infusion fluid is supplemented by the simultaneous or alternating use of parenteral electrolyte and glucose fluids. If it is possible to partially feed orally, the portion of the drug used is reduced in accordance with the volume of fluid and calories administered orally. The drug should be used as long as it is needed - until the patient can be transferred to enteral nutrition or oral administration.

Infezol 100

Adults use a daily dose of 1-2 g/kg of amino acids (equivalent to 10-20 ml/kg); for a weight of 70 kg, this is equal to 0.7-1.4 l of liquid or 70-140 g of amino acids.

No more than 20 ml/kg (2 g/kg amino acids) can be administered per day. For a person weighing 70 kg, the dose will be 1.4 l of the drug (140 g amino acids).

The drug can be administered at a rate of no more than 1 ml/kg per hour – this corresponds to 0.1 g/kg of amino acids. People weighing 70 kg – 70 ml of the substance per 60 minutes (7 g of amino acids).

If the above maximum dose is used, it is prohibited to exceed the daily dosage limit of 2 g/kg and the drug administration rate of 0.1 g/kg. During parenteral nutrition administration in adults, the total volume of fluid used per day should not exceed 40 ml/kg.

Use of medication in pediatrics.

The instructions below are indicative; the treatment regimen and dosage are selected individually, taking into account the intensity of the pathology and the age of the child.

Age subgroup 2-5 years: 15 ml/kg of the drug is administered per day.

Age category 5-14 years: 10 ml/kg of medication is used per day.

Infezol should be administered at a rate of no more than 1 ml/kg per hour (equivalent to 0.1 g/kg per hour).

Infezol 100 can be used only intravenously through a dropper. In case of a low infusion rate, the drug elements are utilized much more actively than in case of a high session rate. The drug is used until the moment when it is possible to make a full transition to enteral nutrition or oral use.

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Use Infezola during pregnancy

Clinical trials of Infezol in pregnant or breastfeeding women have not been performed.

The available information regarding the use of amino acid parenteral drugs in the above groups is sufficient to confirm the absence of risks to the fetus, infant, and the woman herself. However, the probable risks and benefits should still be assessed before prescribing the medication.

Contraindications

Among the relative contraindications of the drug:

• hyperkalemia;
• hyperhydria;
• SN;
• TBI;
• severe stage of renal or hepatic insufficiency (only in the absence of the necessary diuresis);
• amino acid metabolism disorder;
• hyponatremia;
• methanol poisoning;
• severe intolerance associated with sodium disulfide;
• acidosis.

Among the absolute contraindications:

• tissue hypoxia – poor oxygen supply to tissues with cells;
• shock and other situations in which unstable blood flow and danger to life are observed.

Side effects Infezola

When using the drug, nausea with chills and vomiting may occur occasionally. In case of excessively high infusion rate, phlebitis may appear or hyperkalemia or -ammonemia may develop.

Infezol contains sodium disulfide, which has occasionally caused vomiting, hyperergic symptoms, diarrhea, shortness of breath, shock, and impaired consciousness (especially in people with bronchial asthma). In addition, people with bronchial asthma may experience attacks of this disease.

Elements produced during the interaction of sodium disulfide and tryptophan often lead to an increase in the levels of intrahepatic enzymes and bilirubin, determined during a biochemical study of blood serum.

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Overdose

Poisoning with a drug often occurs when the required volume of the substance is incorrectly selected or the rate of parenteral administration is too high. In such situations, nausea with chills occurs, as well as vomiting, intolerance symptoms and significant loss of amino acids by the kidneys. A significant excess of the optimal portion can lead to amino acid poisoning, hyperhydria and electrolyte imbalance. In people with acidosis and renal failure, there is an extremely high probability of hyperkalemia in case of poisoning with a drug. A serum potassium level of 6.5 mmol/l is life-threatening.

Signs of hyperkalemia include sensory impairment, muscle weakness, and cardiac problems (conduction abnormalities, sinus bradycardia, bundle branch block, and arrhythmia). Changes in ECG readings occur: a large QRS complex, reaching a sharpening of the T-wave, and a block affecting the bundle branch of His. It should be noted that in people who regularly use SG, changes affecting the T-wave are erased.

To prevent amino acid poisoning, it is necessary to quickly reduce the rate of administration of the medicinal fluid or even completely stop the infusion and use substances that correct the electrolyte balance. In case of very severe overdose, it is necessary to carry out osmotic diuresis, and in case of life-threatening conditions, hemodialysis sessions.

Interactions with other drugs

The sodium disulfide contained in the drug is capable of inactivating the effects of thiamine.

Since the drug is extremely sensitive to bacterial contamination, it cannot be mixed with other drugs administered parenterally.

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Storage conditions

Infezol must be stored in a dark place, at a temperature of no more than 25°C. The substance must be administered immediately after opening the bottle. The remaining liquid cannot be reused - this part is disposed of.

Shelf life

Infezol can be used for a period of 24 months from the date of manufacture of the medicinal substance.

Application for children

It is prohibited to use in children under 2 years of age, because there is not enough information regarding the use of Infezol in this age group.

Analogues

The analogs of the drug are Aminoven, Intralipid, Aminosteril with Aminol, Dextrose with Aminoplasmal, and in addition Nephrotect, Aminosol, Tivortin, Hepasol with Nutriflex, Lipofundin with Kabiven and Oliklinomel.