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Product Name: Glutabest
Generic Name : L-Alanyl-L-GlutamineInfusion
Manufacturer : Alniche
L-alanyl-L-glutamine also known as alanylglutamine, is adipeptide molecule, consisting of L-glutamine and L-alanine, two amino acids.L-alanyl-L-glutamine is sometimes supplemented for prolonged physical exerciseas it can enhance electrolyte absorption and improve endurance and performance.Tests on rodents suggest L-alanyl-L-glutamine is more successful at increasingmuscular glutamine levels after supplementation than glutamine itself. This isbecause glutamine is absorbed better via the liver and intestines aftersupplementation. Since L-alanyl-L-glutamine is a dipeptide molecule it meansthat it contains more than one amino acid for the intestines to absorb,allowing glutamine to reach the muscles.
Adding L-alanyl-L-glutamine to any rehydration solutionwill be significantly more effective at increasing water and electrolyteabsorption than consuming either a glutamine or glucose-containing solution.Current studies on L-alanyl-L-glutamine use a dose of 1-3g a day. Overdosage ofL-alanyl-L-glutamine may result in chills, nausea and vomiting.Precautions need to be taken with patients who suffer from severe hepaticimpairment, severe metabolic acidosis as it maycontradict the medication. There are no reported side effects of the drug.Following the prescribed dosage of approximately 231 and 266 mg ofL-alanyl-L-glutamine per pound of bodyweight per day for men and women.
Under these conditions,L-glutamine becomes an essential amino acid and must be supplied to the body inorder to prevent breakdown of muscle tissue, immune dysfunction and compromiseof the gut mucosal barrier function with consequent bacterial translocationinto the body. L-glutamine is arguably the most needed amino acid and, indeed,one of the most needed nutrients under these circumstances.
Until recently, L-glutaminewas lacking from TPN. The reason for this is because L-glutamine is not verysoluble in water 1 g dissolves in 20.8 mL of water at 30Â°C and L-glutamine isunstable in solution. The problem has been solved by the synthesis of glutaminecontaining dipeptides, which are very soluble in water and stable in solution.
Two (2) syntheticglutamine-containing dipeptides that may be used in TPN areL-alanyl-L-glutamine (Ala-Gln) and glycyl-L-glutamine (Gly-Gln). The molecularweight of Ala-Gln is 217.24 daltons and L-glutamine comprises 67% of thedipeptide. L-glutamine comprises 72% of Gly-Gln and its molecular weight is203.22 daltons.
USESOF L-ALANYL-L-GLUTAMINE IN DETAILS
As part of an IV parenteralnutrition regimen
Adult: As solutioncontaining L-alanyl-Lglutamine 200 mg in each ml. Usual dose: 0.3-0.4 g/kg/day.Dose depends on severity of the catabolic state and amino acid requirement; notto exceed 2 g amino acids/kg/day in parenteral nutrition; amount of amino acidssupplied through L-alanyl-L-glutamine should not exceed 20% of the totalsupply. To be mixed with a compatible amino acid carrier solution or an aminoacid containing infusion regimen before admin. Max treatment duration: 3 wk.
There are rare reports ofconstipation and bloating with high-dose glutamine peptides in TPN.
Glutamine peptides arecontraindicated in those hypersensitive to any component of L-alanyl-l-glutamine.L-alanyl-l-glutamine should not be administered to patient with severe renal[creatinine clearance (CrCl <25 mL/min)] and hepatic insufficiency, andsevere metabolic acidosis.