Stability of Famotidine in Minibags Refrigerated and/or Frozen in Total Parenteral Nutrition Solutions

DICP ◽  
1989 ◽  
Vol 23 (10_suppl) ◽  
pp. S44-S46
Author(s):  
Linda S. Bullock

The use of histamine2-receptor antagonists could be beneficial in critically ill patients for protection against stress-induced gastrointestinal bleeding. Famotidine, similar to cimetidine and ranitidine, is stable when mixed in dextrose 5% injection and NaCl 0.9% injection at a concentration of 200 μg/mL and stored in polyvinyl chloride bags at 4 °C for 14 days or when frozen for 28 days and subsequently refrigerated for 14 days. Furthermore, famotidine, also like cimetidine and ranitidine, is stable when added to most common total parenteral nutrition (TPN) solutions. Famotidine in concentrations of 20 mg/L and 40 mg/L is stable in crystalline amino acid solutions (20 g/L and 42.5 g/L) when refrigerated for 24 hours, then held at room temperature for 24 hours, at room temperature for 48 hours, or refrigerated for seven days. The concentration of amino acids in the TPN solutions containing 42.5 g/L also is not affected by the addition of famotidine 40 mg/L when stored under conditions similar to those stated above for 48 hours. TPN solutions remain clear and free of turbidity.

1981 ◽  
Vol 19 (15) ◽  
pp. 57-59

Perifusin (BDH) is a solution of L-amino-acids and electrolytes which contains 5g nitrogen per litre, but no other source of energy. It is intended for the intravenous nutrition of well nourished patients through a peripheral vein, for the first few days after abdominal surgery or trauma while they cannot eat. The manufacturer claims that this form of nutrition speeds postoperative recovery and reduces complications. Perifusin thus differs in purpose, composition and route of administration from the more concentrated amino-acid solutions intended for use in total parenteral nutrition.1


1993 ◽  
Vol 27 (2) ◽  
pp. 146-150
Author(s):  
Michael L. Christensen ◽  
Julienne Burgess ◽  
Richard A. Helms ◽  
Joseph Mirro ◽  
David K. Kalwinsky ◽  
...  

Objective To assess the effect of parenteral amino acid solutions on plasma amino acid concentrations in patients with acute nonlymphocytic leukemia (ANLL) receiving parenteral nutrition (PN). Design Ten patients were studied at diagnosis, on the morning PN was started, and three times during PN therapy coinciding with the sequential administration of three different amino acid solutions (Aminosyn, FreAmine HBC, and TrophAmine). The order of amino acid solution administration in each patient was by a randomized, block design. Results The patients were undergoing identical intensive induction therapy. There was no significant difference in the number of days they received PN or the amount of protein or calories received during the three PN study periods. At diagnosis, phenylalanine and glutamic acid concentrations were elevated compared with previously published normal values and remained elevated at all observation times. During PN, asparagine, aspartic acid, and tyrosine concentrations were significantly lower with all three amino acid solutions compared with their concentrations at diagnosis. Glycine and threonine concentrations were also significantly lower with FreAmine HBC and TrophAmine administration and cysteine concentrations were significantly lower with FreAmine HBC administration than at the time of diagnosis. Aminosyn was associated with plasma amino acid concentrations most similar to those measured at diagnosis. Conclusions These results indicate that most amino acid concentrations fall within the normal range at diagnosis in the ANLL patients studied. Plasma concentrations for certain amino acids can be influenced by the amino acid solution used in PN. Further understanding of the derangements in amino acid metabolism and the influence of parenterally administered amino acid solutions on plasma amino acid concentrations may lead to improvements in the nutritional support of cancer patients.


1997 ◽  
Vol 20 (6) ◽  
pp. 309-315 ◽  
Author(s):  
H-J. Guth ◽  
M. Wiersbitzky ◽  
M. Ziesche ◽  
H-J. Rose ◽  
G. Kraatz

The removal of amino acids during continuous renal replacement therapies induces clinical problems. Previous studies on animals have shown nephroprotective (glycine, alanine) or negative effects (lysine) on renal function in occurrence of acute renal failure. Disturbed metabolism in acute renal failure needs adequate parenteral nutrition. On the other hand, experience with continuous renal replacement therapies of metabolic crises in inborn errors of metabolism indicate a good control of disturbed amino acid metabolism. The aim of our study was to find amino acids, that might play an important role in the pathogenesis, prognosis and detection of acute renal failure and severe illness, so far only estimated by lactic acid. Thirty-three probes (serum and hemofiltrate) were taken from patients, suffering with acute renal failure caused by septic shock, severe pancreatitis and hepatorenal syndrome, one hour after the beginning of extracorporal circulation, the conditions of treatment were standardized. The material was deproteinized and studied by the amino acid analyzer LBK 4251 Apha Plus (Pharmacia, Stockholm, Sweden), while the lactic acid concentration was determined in a standard laboratory. Proline, glycine, alanine, methionine and histidine showed a close relationship to the lactic acid levels, but these amino acids were an essential part of parenteral nutrition. A statistical relationship was also established in (amino acids with amide groups) asparagine, glutamine, citrulline, cystathionine and phosphoethanolamine. The mean values of most of the amino acids were higher than normal, but standard deviations were increased. The presence of these amino acids in hemofiltrate and the good sieving coefficients could mean that the better prognosis of critically ill patients in continuous renal replacement therapies may also be due to continuous control of amino acid levels (especially with amide groups).


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