Libra solution for infusions 42 mg/ml. 100 ml. vial

Description

Libra Composition
active substance: arginine hydrochloride;

100 ml of solution contains arginine hydrochloride 4.2 g

excipients: water for injection.

Ionic composition per 1000 ml of the preparation: С6Н14N4O2 – 200 mmol; Cl¯- 200 mmol.

Libra Dosage form
Solution for infusion.

Basic physical and chemical properties: transparent colorless or slightly yellowish-brown liquid theoretical osmolarity – 398 mosmol / l pH 5.0-6.5.

Libra Pharmacotherapeutic group
Blood substitutes and perfusion solutions. Additional solutions for intravenous administration. Amino acids. Arginine hydrochloride.

ATX code B05X B01.

Pharmacodynamics
Arginine (a-amino-d-guanidinovaleric acid) is an amino acid that belongs to the class of conditionally essential amino acids and is an active and versatile cellular regulator of numerous vital functions of the body, exhibiting protective effects that are important in the case of a critical state of the body.

Arginine has antihypoxic, membrane stabilizing, cytoprotective, antioxidant, antiradical, detoxification activity, manifests itself as an active regulator of intermediate metabolism and energy supply processes, plays a role in maintaining hormonal balance in the body. It is known that arginine increases the level of insulin, glucagon, growth hormone and prolactin in the blood, takes part in the synthesis of proline, polyamine, agmatine, is involved in the processes of fibrinogenolysis, spermatogenesis, and has a membrane-depolarizing effect.

Arginine is one of the main substrates in the urea cycle in the liver. The hypoammonaemic effect of the drug is realized by activating the conversion of ammonia into urea. It has a hepatoprotective effect due to its antioxidant, antihypoxic and membrane stabilizing activity, and has a positive effect on the processes of energy supply in hepatocytes.

Arginine is a substrate for NO synthase, an enzyme that catalyzes the synthesis of nitric oxide in endothelial cells. The drug activates guanylate cyclase and increases the level of cyclic guanidine monophosphate (cGMP) in the vascular endothelium, reduces the activation and adhesion of leukocytes and platelets to the vascular endothelium, suppresses the synthesis of adhesion proteins VCAM-1 and MCP-1, thereby preventing the formation and development of atherosclerosis 1, which is a potent vasoconstrictor and stimulator of proliferation and migration of vascular smooth myocytes. Arginine also inhibits the synthesis of asymmetric dimethylarginine, a potent endogenous stimulant of oxidative stress. The drug stimulates the activity of the thymus gland, which produces T cells, regulates blood glucose during exercise. It has an acid-producing effect and helps to correct the acid-base balance.

Pharmacokinetics
With continuous infusion, the maximum plasma concentration of arginine hydrochloride is reached 20-30 minutes after the start of administration. Arginine crosses the placental barrier, is filtered in the renal glomeruli, but is almost completely reabsorbed in the renal tubules.

Indications
Metabolic alkalosis, hyperammonemia, atherosclerosis of the vessels of the heart and brain, atherosclerosis of peripheral vessels, including with manifestations of intermittent claudication, diabetic angiopathy, arterial hypertension, chronic heart failure, hypercholesterolemia, chronic obstructive pulmonary disease, pulmonary hypertension and pre-exclamation as part of complex therapy.

Contraindications
Hypersensitivity to the components of the drug. Severe renal dysfunction, hyperchloremic acidosis, history of allergic reactions, use of potassium-sparing diuretics, as well as spironolactone. Myocardial infarction (including a history).

Interaction with other medicinal products and other types of interactions
When using the drug Libra, it is necessary to take into account that it can cause severe and persistent hyperkalemia against the background of renal failure in patients taking or taking spironolactone. Prior use of potassium-sparing diuretics can also increase blood potassium levels. With simultaneous use with aminophiline, an increase in the level of insulin in the blood is possible. Arginine is incompatible with thiopental.

Application features
In patients with renal insufficiency, diuresis and plasma potassium levels should be checked before starting the infusion, since the drug can contribute to the development of hyperkalemia.

Use with caution in case of dysfunction of the endocrine glands. Arginine can stimulate the secretion of insulin and growth hormone.

If you experience dry mouth, check your blood sugar.

It should be used with caution in case of electrolyte metabolism disorders, kidney diseases. If, while taking the drug, the symptoms of asthenia increase, the treatment must be canceled.

Use with caution in patients