MG TNA-Peri Special Precautions

Carefully administer to the following patients: Patients with disorders of lipid metabolism induced by renal failure, pancreatitis, impaired liver function, hypothyroidism (accompanied by hypertriglyceridemia), sepsis, etc.
Lactic acidosis, insufficient cellular oxygen supply, increased serum osmolarity, patients who need a fluid resuscitation.
Patients with a tendency toward electrolyte retention.
General cautions: Special clinical monitoring is required at the beginning of intravenous infusion. Should any abnormal sign occur, the infusion must be stopped.
Prior to initial administration, the state of electrolyte imbalance (e.g. extraordinarily high or low concentration of serum electrolytes) of the patients must be corrected in advance.
As central venous injection increases the risk of infection, strict aseptic procedures should be taken during the insertion and manipulation of catheters to avoid any contamination.
The serum triglyceride level should not exceed 2 mmol/l in 5~6 hours after the administration.
As intravenous administration of amino acids accompanies the increased urinary excretion of trace elements such as copper or zinc, additional administration of these trace elements should be taken into consideration in case of long-term administration.
As there is a chance of false coagulation reaction, should not be injected with same syringes containing blood at the same time.
During the administration, serum glucose level, electrolytes, osmolarity, fluid balance, acid-base status, liver enzyme level (alkaline phosphatase, ALT, AST) etc. should be carefully monitored.
Blood cell count and coagulation should be monitored during long term administration.
In case of the administration to patients with renal failure, the intake of phosphate and potassium should be carefully controlled in order to prevent hyperphosphatemia or hyperkalemia.
The amount of additional electrolytes should be determined by frequent monitoring of the condition of patients and the serum electrolyte concentration.
In case of initial intravenous administration to the patients under malnutrition state, careful monitoring of the patients and fine-tuning of the amount of additional solutions, electrolytes, vitamins, minerals are required.
Influence on laboratory measurements: As the lipid ingredients may interfere with certain laboratory measurements (such as bilirubin, lactate dehydrogenase, oxygen saturation, hemoglobin, etc.) when the blood is collected prior to the entire elimination of lipid from the blood, it's better to collect the blood in 5-6 hours after administration.
Use in Elderly: As aged people generally shows reduced physiological activities, should be administered more slowly or reduced dose.