Nutriflex Peri/Nutriflex Plus Mechanism of Action

Pharmacotherapeutic group: Solutions for parenteral nutrition, combinations. ATC code: B05B A10.
Pharmacology: Pharmacodynamics: Mechanism of action: The purpose of parenteral nutrition is to supply all necessary nutrients and energy for growth and regeneration of tissue as well as to maintain all body functions.
Amino acids are the primary building blocks for protein synthesis and the nitrogen source for the body. Some amino acids are of particular importance since they are essential and cannot be synthesized by humans.
Intravenously administered amino acids are incorporated in the respective intravascular and intracellular amino acid pools where they serve as substrate for the synthesis of functional and structural proteins and as precursors for various functional molecules. However, to prevent the metabolisation of amino acids for energy production, and also to fuel the other energy consuming processes in the organism, simultaneous energy supply in the form of carbohydrate and/or fat is necessary.
Glucose is ubiquitously metabolised within the organism. Some tissues and organs, such as CNS, bone marrow, erythrocytes, tubular epithelium, cover their energy requirement mainly from glucose. In addition, glucose acts as a structural building block for various cell substances. Additional energy is ideally supplemented in the form of fat. Electrolytes are administered for the maintenance of metabolic and physiological functions.
Pharmacokinetics: Absorption: Nutriflex Peri/Nutriflex Plus is infused intravenously. Hence, all substrates are available for metabolism immediately. It's bioavailability is 100%.
Distribution: Amino acids are incorporated in a variety of proteins in different organs of the body. In addition each amino acid is maintained as free amino acid in the blood and inside cells.
As glucose is water-soluble, it is distributed with the blood over the whole body. At first, the glucose solution is distributed in the intravascular space and then it is taken up into the intracellular space.
Electrolytes are available in sufficient amounts to sustain the numerous biological processes that they are required for.
Biotransformation: Amino acids that do not enter protein synthesis are utilized by the body as precursors in various metabolic pathways for the biosynthesis of N-containing molecules like nucleotides, haemoglobin, signaling molecules (e.g. thyroxin, dopamine, adrenalin) or co-enzymes (nicotinamide adenine dinucleotide) and energy substrates. The latter metabolism starts with the separation of the amino group from the carbon skeleton by transamination. The remaining carbon chain is then either oxidised directly to CO₂ or utilized as substrate for gluconeogenesis in the liver. The amino group is metabolised in the liver to urea.
Glucose is metabolised to CO₂ and H₂O via the known metabolic routes. Some glucose is utilised for lipid synthesis.
Elimination: Only minor amounts of amino acids are excreted unchanged in urine. Excess glucose is excreted in urine only if the renal threshold of glucose is reached.
Toxicology: Preclinical safety data: Non-clinical studies have not been performed with Nutriflex Peri/Nutriflex Plus. Toxic effects of mixtures of nutrients given as substitution therapy at the recommended dosage are not to be expected.