MG TNA-Peri

Supply of water, electrolytes, amino acids & cal to patients by TPN when oral or enteral nutrition is unfeasible, insufficient or contraindicated.

IV drip infusion Generally 27-40 mL/kg [equiv to amino acid 0.7-1 g/kg daily (nitrogen 0.1-0.15 g/kg)] into peripheral or central veins. Adult Individualized dosage. Normal nutritional state or mild catabolic stresses Amino acid 0.7-1 g/kg (nitrogen 0.1-0.15 g/kg) daily. Moderate to high catabolic stresses Amino acid 1-2 g/kg (nitrogen 0.15-0.3 g/kg). Administration rate: Should not exceed 3.7 mL/kg/hr (equiv to glucose 0.25 g/kg, amino acid 0.09 g/kg, lipid 0.13 g/kg). Infusion period: 12-24 hr. Childn 2-10 yr 14-28 mL/kg, may increase by 10-15 mL/kg/day. Max: 40 mL/kg/day.

Hypersensitivity to eggs & soy protein. Hyperlipemia, severe liver insufficiency & blood coagulation disorders, congenital disorder of amino acid metabolism, severe renal insufficiency w/o hemofiltration or dialysis, acute shock, hyperglycemia requiring insulin over 6 u hrly, elevated serum levels including electrolytes. Acute pulmonary edema, hyperhydration, decompensated heart failure, hypotonic dehydration; hemophagocytotic syndrome; unstable conditions (eg, severe post-traumatic conditions, decompensated diabetes, acute MI, metabolic acidosis, severe sepsis, hyperosmolar coma). Hypokalemia, patients w/ existing or history of MI. Neonates or infants <2 yr.

Interrupt use immediately if any signs/symptoms of anaphylactic reaction or abnormal signs occurs. Lipid metabolism disorders induced by renal failure, pancreatitis, impaired liver function, hypothyroidism (accompanied by hypertriglyceridemia), sepsis. Lactic acidosis, insufficient cellular O₂ supply, increased serum osmolarity, patients who need fluid resuscitation. Patients w/ tendency toward electrolyte retention. Correct electrolyte imbalance prior to initial administration. Increased risk of infection for central venous inj. Serum triglyceride should not exceed 2 mmol/L 5-6 hr after administration. Consider additional administration of trace elements eg, Cu, Zn in case of long-term administration. False coagulation reaction. Monitor serum glucose level, electrolytes, osmolarity, fluid balance, acid-base status, liver enzyme level (alkaline phosphatase, ALT, AST), CBC & coagulation during administration. Renal failure. May interfere lab measurements eg, bilirubin, LDH, O₂ saturation, Hb. Malnourished patients. Pregnancy & lactation. Elderly.

Elevated body temp or induced shivering, chillness, nausea/vomiting; increased liver enzyme activities; thrombophlebitis; hypersensitivity reactions (eg, anaphylactic reaction, rash, urticaria), resp symptoms (hyperventilation), hyper/hypotension; hemolysis, increased reticulocytes, abdominal pain, headache, fatigue, penile stiffness. Excessive administration: hyperlipidemia, fever, fatty infiltration, hepatomegaly, megalosplenia, anemia, leukocytopenia, thrombocytopenia, blood agglutination disorder, coma.

May interfere lipase system w/ insulin. Increased plasma lipolysis accompanied by decreased triglyceride clearance rate w/ heparin. May interfere therapeutic effect of coumarin derivatives. May precipitate when mixed w/ acidic soln.

Parenteral Nutritional Products

B05BA - Solutions for parenteral nutrition ; Used in I.V. solutions.

Rx