Intravenous Evaluation of pituitary growth hormone reserve
Adult: As 10% solution: 30 g as a single dose given via infusion over 30 minutes. May repeat test after 24 hours. Child: <60 kg As 10% solution: 0.5 g/kg given via infusion over 30 minutes. Max: 30 g/dose; ≥60 kg As 10% solution: Same as adult dose. May repeat test after 24 hours.
Reconstitution
Dilute with appropriate amount of NaCl 0.9% or glucose 5% inj to provide a final concentration of 10%.
Contraindications
Hypersensitivity. Severe acidosis, hypotension or diseases related to nitric oxide production.
Special Precautions
Patient with electrolyte imbalance, anuria. Moderate renal and severe hepatic impairment. Children. Pregnancy and lactation. Not intended for therapeutic use.
Adverse Reactions
Significant: Local venous irritation, haematuria, decreased platelet count, extravasation (e.g. burn-like reaction). Gastrointestinal disorders: Nausea, vomiting. Metabolism and nutrition disorders: Rarely, severe hyperkalaemia. Nervous system disorders: Headache, numbness. Vascular disorders: Flushing. Rarely, hypotension. Potentially Fatal: Extravasation (e.g. skin necrosis). Rarely, severe allergic reactions (e.g. anaphylaxis, rash).
Monitor blood pressure during use and for 24 hours after completion of infusion.
Overdosage
Symptoms: Metabolic acidosis with hyperventilation, cerebral oedema, hypotension, anaphylaxis, death. Management: Supportive therapy. Correct acidosis by a calculated dose of an alkalising agent.
Drug Interactions
Potentially Fatal: May cause severe hyperkalaemia with spironolactone in patient with severe hepatic impairment.
Action
Description: Mechanism of Action: Arginine is an essential amino acid that stimulates the pituitary release of human growth hormone (hGH) and prolactin that may be used, instead of, or in addition to other diagnostic tests. It is also an important constituent for the storage and excretion of ammonia in the urea cycle and an acidifying agent in cases of severe metabolic alkalosis. Pharmacokinetics: Absorption: Time to peak plasma concentration: Approx 20-30 minutes. Distribution: Enters breast milk. Volume of distribution: Approx 33 L/kg. Metabolism: Extensively metabolised in the liver and intestines via hydrolytic cleavage by the guanidine group to ornithine and urea. Excretion: Via urine (16% during the 1st 90 minutes). Elimination half-life: 42 ± 2 minutes.
Chemical Structure
Arginine Source: National Center for Biotechnology Information. PubChem Database. Arginine, CID=6322, https://pubchem.ncbi.nlm.nih.gov/compound/Arginine (accessed on Jan. 21, 2020)
B05XB01 - arginine hydrochloride ; Belongs to the class of amino acids solutions used in I.V. solutions.
References
Anon. Arginine. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 13/04/2018.Anon. Arginine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 13/04/2018.Buckingham R (ed). Arginine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/04/2018.R-Gene 10 (Pharmacia and Upjohn Company LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 13/04/2018.
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