Aminosyn II 15 % – a 15 % amino‑acid solution for intravenous use
| Item | Details |
|------|---------|
| Manufacturer | Various (e.g., Baxter, Fresenius Kabi, B. Braun) |
| Packaging | Usually a 100 mL or 200 mL plastic vial (polypropylene) with a screw‑cap, or a 50 mL plastic syringe for pre‑filled use. The vial is sterile, single‑use, and contains a clear, colourless solution. |
| Composition (per 100 mL) | • 15 % total amino acids (w/v) – 150 g amino acids per 1 L |
• 7.5 % L‑arginine |
• 4.0 % L‑lysine |
• 4.0 % L‑methionine |
• 3.8 % L‑isoleucine |
• 3.8 % L‑leucine |
• 3.3 % L‑phenylalanine |
• 2.5 % L‑serine |
• 2.5 % L‑threonine |
• 2.5 % L‑tryptophan |
• 2.5 % L‑valine |
• 1.5 % L‑histidine |
• 1.0 % L‑cysteine (if present) |
• 1.0 % L‑glycine |
• 0.6 % L‑alanine |
• Electrolytes (Na⁺, K⁺, Mg²⁺, Ca²⁺) and glucose to adjust osmolarity (~270 mOsm/kg). |
| Indications | • Parenteral nutrition (PN) for patients with inadequate enteral intake or impaired gastrointestinal function.
• Nutritional support in patients with high metabolic demands (e.g., burns, severe trauma). |
| Dose & Administration | • Typical adult dose: 0.25 – 1.5 mL / 100 kcal / day (≈0.1 – 0.5 mL / kcal / day).
• Start with a slow infusion: 5 – 10 mL / hr, titrate to 20–40 mL / hr (≈0.1–0.2 mL / kg / hr).
• Dilute with 0.9 % NaCl or 5 % dextrose if required for volume/flow‑rate.
• Check compatibility with other drugs; avoid mixing with high‑potency drugs that precipitate or cause vesicant damage. |
| Contraindications | • Severe hepatic or renal failure (unless PN is specifically indicated and monitored).
• Known allergy to any amino‑acid or excipient. |
| Precautions & Monitoring | • Electrolyte balance – monitor serum Na⁺, K⁺, Ca²⁺, Mg²⁺, phosphate, and blood glucose.
• Blood ammonia – in patients with urea cycle disorders.
• Metabolic alkalosis/acidosis – monitor pH, bicarbonate.
• Volume status – watch for fluid overload.
• Allergic reactions – rash, itching, anaphylaxis. |
| Storage | • Store at 2–8 °C (refrigerated).
• Keep protected from light.
• Do not freeze.
• Once reconstituted, use within 48 h (or per label). |
| Safety & Handling | • Use aseptic technique when drawing or mixing.
• The plastic vial is single‑use; do not reuse.
• Dispose of any residual solution according to local biohazard regulations. |
| Common Side‑Effects | • Hyperglycaemia (due to dextrose).
• Hypo‑ or hyper‑natremia.
• Hypokalaemia (often due to renal loss).
• Injection site pain (rare with IV).
• Allergic reactions. |
| Drug Interactions | • Non‑steroidal anti‑inflammatory drugs (NSAIDs) – may alter amino‑acid metabolism.
• Diuretics – can influence electrolyte balance.
• Antibiotics (e.g., aminoglycosides) – monitor for nephro‑toxicity. |
| Clinical Notes | • Parenteral nutrition: Aminosyn II 15 % is part of a “complete” PN solution that also contains a lipid emulsion and a dextrose solution.
• The 15 % concentration is higher than typical 10 % or 8 % solutions, providing a more concentrated amino‑acid load and allowing a smaller infusion volume – useful in patients with limited vascular access or fluid‑restricted states.
• The solution’s osmolarity (~270 mOsm/kg) is compatible with peripheral IV lines but is usually given via central line for prolonged therapy. |
| Regulatory Status | • Approved for use in hospital settings under the relevant national drug authority (FDA, EMA, etc.).
• Always check local formulary for specific brand variations. |
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Quick Checklist for Nursing/Medical Staff
| Step | Action | Notes |
|------|--------|-------|
| 1 | Verify prescription & label | Confirm dosage, concentration, and patient allergies. |
| 2 | Inspect vial | No cloudiness, colour change, or particulate matter. |
| 3 | Use aseptic technique | Disinfect cap, use sterile syringe and needle. |
| 4 | Dilute if needed | Add sterile water or 5 % dextrose to reach desired volume. |
| 5 | Check compatibility | Verify no precipitating agents are co‑administered. |
| 6 | Infuse at recommended rate | Use infusion pump; start at slow rate, titrate. |
| 7 | Monitor vitals & labs | Hourly BP, HR, urine output, daily electrolytes, glucose. |
| 8 | Document | Note infusion rate, volume, any adverse reactions. |
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When to Contact a Specialist
- Persistent hyperglycaemia despite insulin therapy.
- Signs of electrolyte imbalance that are difficult to correct.
- Any allergic reaction or anaphylaxis.
- Renal dysfunction or rising creatinine.
- Unusual fluid shifts or signs of pulmonary edema.
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Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice. Always consult your prescribing physician or pharmacist before using any medication.