Glycin: Amino acid nutritional supplement

2021-07-04 06:59 PM

Glycin, aminoacetic acid is a non-essential amino acid, involved in the body's protein synthesis, creatin, glycocholic acid, glutathione, uric acid, heme, in the body, glycin is broken down in many ways.

Glycin: Amino acid nutritional supplement

International generic name: Glycine.

Type of drug: Irrigation solution - Amino acid (non-essential).

Drug form and content

1.5% glycin solution for irrigation and washing.

Tablets have many different active ingredients, including glycin.

Solution for intravenous infusion (in combination with other amino acids, sorbitol, electrolytes).

Pharmacology and activation mechanism

Glycin (amino acetic acid) is a non-essential amino acid, participating in the body's protein synthesis, creatin, glycocholic acid, glutathione, uric acid, hem... In the body, glycin is broken down in many ways.

Glycin is used orally as a free non-essential amino acid to supplement nutrition. Sometimes glycin is used in combination with antacids to treat increased stomach acid. Glycin is also used as an ingredient in some formulations of aspirin to reduce stomach irritation.

Glycin 1.5% solution in water is a hypotonic solution, does not cause hemolysis, does not conduct electricity. It has a refractive index similar to that of water, so this solution is beneficial when used for irrigation and urinary irrigation, genitalia in some surgeries. Especially it uses in transurethral prostatectomy, but the solution may be absorbed into the body from the severed veins. Due to its non-conductive nature, this solution can be used in electrosurgery.

In the absence of a calorie-generating agent, absorbed glycin is metabolized mainly by deamination to ammonia and by amine metabolism to other amino acids, mainly serine.

In subjects with normal liver function, there was no increase in blood ammonia levels.

Indications

Intraoperative irrigation and washing: The solution of choice in transurethral prostatectomy and bladder tumors. Bladder irrigation during endoscopy,  also during and after cystectomy.

Oral use: Nutritional supplement.

In combination with antacids to treat hyperacidity of the stomach.

Parenteral administration (in combination with other amino acids, sorbitol, and electrolytes in infusion solutions): Prevention and treatment of protein deficiency. Malabsorption syndrome. Nutritional adjuvant before and after major surgery in patients who cannot eat.

Contraindications

Hypersensitivity to one or more components of the preparation.

Do not irrigate, wash glycin solution for anuria patients.

Do not give intravenous solutions containing amino acids (including glycine) to people with the following diseases:

  • Severe liver disease.
  • Congestive heart failure.
  • People with fluid retention.
  • Acidosis.
  • Kidney failure with elevated nitrogen in the blood.
  • Metabolic disorders. amino acids.
  • Fructose and sorbitol intolerance.
  • Fructose 1,6-diphosphate deficiency.
  • Methanol poisoning.
  • High blood potassium (for preparations containing sorbitol and electrolytes).

Cautions

Excessive absorption of glycine irrigation solutions into the blood can lead to disturbances in water and electrolyte balance, cardiovascular, and pulmonary disorders.

Take care when irrigating glycine in patients with hepatic impairment, as glycin absorption and metabolism will cause hyperammonemia.

Caution should be exercised when irrigating glycin in patients with cardiac, pulmonary, and renal dysfunction.

If the infusion is too rapid, there will be symptoms of intolerance and increased renal excretion leading to amino acid imbalance.

Adverse drug reactions (ADRs)

Absorption from irrigation solutions into the bloodstream during surgery can cause circulatory and nervous system disturbances.

Absorption of a large amount of glycine-containing fluid (during bladder irrigation, during transurethral prostatectomy) can cause signs and symptoms known as “transurethral resection” syndrome. Signs and symptoms include:

  • Chest pain.
  • Hypertension. 
  • Hypotension.
  • Bradycardia.
  • Anuria. 
  • Dyspnea.
  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Abdominal pain
  • Restlessness.
  • Confusion.
  • Irritability. 
  • Headache. 
  • Convulsions.
  • Chills.
  • Visual disturbances and blindness.
  • Heart attack.
  • Coma, sometimes life-threatening.

There is a high risk of fluid absorption from irrigation solutions used in laparoscopic urinary tract surgery. Excessive blood absorption can lead to hypervolemia, hemolysis, and renal failure, accompanied by a temporary decrease in serum sodium, albumin, and hemoglobin.

Absorption of large amounts of glycine solution may lead to increased blood ammonia due to rapid metabolism. The end product of metabolism may be oxalate and this may affect renal function.

Absorption from irrigants into the bloodstream may lead to pulmonary disorders.

Instructions to handle ADRs

Stop taking the drug.

It is necessary to closely monitor water balance, serum electrolytes, blood glucose, acid-base balance.

Dosage and administration

Irrigation

Glycin 1.5% solution is used in some surgeries, especially transurethral surgery. Because it is non-conductive and transparent, making it easy to observe.

Intravenous use

The dosage depends on each case.

Combined with antacids to treat increased stomach acid. There are many preparations with different active ingredients, the dose depends on each preparation.

Stability and preservation

Store irrigation solution at room temperature, below 40 degrees Celsius, avoid freezing. Do not heat the irrigation solution above 66 degrees Celsius.

Trade name

Glycine.