Pharmacological properties : תכונות פרמקולוגיות

Pharmacodynamic Properties

5.1 Pharmacodynamic properties
Pharmacotherapeutic group: Amino acids – concentrate for solution for parenteral nutrition, ATC code: B05X B02 The dipeptide N(2)-L-alanyl-L-glutamine is endogenously split into the amino acids glutamine and alanine hereby supplying glutamine with infusion solutions for parenteral nutrition. The released amino acids flow as nutrients into their respective body pools and are metabolised according to the needs of the organism. Many disease conditions, in which parenteral nutrition is indicated, are accompanied by a glutamine depletion.

A large multicenter study in critically ill patients with at least two organ failures at admission has shown a trend towards higher mortality in patients who received a very high total dose of glutamine-dipeptides (see section 4.9). This may exceed the patient’s ability to metabolize glutamine (see also section 4.4).

Pharmacokinetic Properties

5.2 Pharmacokinetic properties
N(2)-L-alanyl-L-glutamine is rapidly split into alanine and glutamine after infusion. In man, half- lives of between 2.4 and 3.8 min (in terminal renal insufficiency 4.2 min) and a plasma clearance of between 1.6 and 2.7 l/min were determined. The disappearance of the dipeptide was accompanied by an equimolar increase of the corresponding free amino acids.
Hydrolysis probably takes place exclusively in the extracellular space. Renal elimination of N(2)-L-alanyl-L- glutamine under constant infusion is below 5% and thus the same as that of infused amino acids.