Cairan OTSU

NEO-MUNE® The First Complete Immune-enhancing Formula for Surgical, Trauma, Burn and ICU patients Description : NEO-MUNE is a nutritionally complete formula with immune nutrients (Arginine, Glutamine and Omega 3) for oral and tube feeding. Composition : Each 48 g/ sachet, contains : Energy 200 kkal Protein 12.5 g Casein 8.76 g Arginine 2.50 g Glutamine 1.25 g Carbohydrate 25.01 g Fat 5.79 g Vitamins, Minerals Dosage : 8-10 sachets daily Supplement: 4-8 sachets daily Pre operation nutrition : 3-4 sachets daily administered at least 5-7 days pre operation. Flavor : Vanilla Package : Powder 48 g/sachet Registration Number :  NEO-MUNE, flavor Vanila POM SD. 034 204 231

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PAN-AMIN G®

Composition : Each 1000 ml Contains : L-Leucine * : 4.1 g L-Isoleucine * : 1.8 g L-Valine * : 2 g L-Lysine Monohydrochloride : 6.2 g L-Threonine : 1.8 g L-Tryptophan : 0.6 g L-Methionine : 2.4 g L-Phenylalanine : 2.9 g L-Histidine Monohydrochloride : 1.3 g L-Arginine Monohydrochloride : 2.7 g Glycine : 3.4 g D-Sorbitol : 50 g Cl- : 52 mEq OSMOLARITY : 507 mOsm/L Indications : PAN-AMIN G is indicated for the provision of amino acid in the following clinical situations : Hypoproteinemia, malnutrition, or before or after surgery. Dosage and administration : Intravenous infusion of 500 ml in usual cases per day at moderate speed Storage : Store in cool place, away from direct sunlight. Package : 500 ml in Softbag Reg. No. DKL 7818704649A1 •

PAN-ENTERAL® Complete and Balanced Enteral Nutrition, High MCT and Low Osmolarity Description : Pan Enteral is nutritionally complete formula for oral and tube feeding Composition : Each 40 g/sachet, contains : Energy 200 kcal Protein 6.12 g Carbohydrate 21.81 g Fat 10.28 g Vitamins, Minerals Dosage : Adult : 1 sachet in 200 mL water administered 8 - 10 times daily. •

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Children ages of 2 years and above : 1 sachet in 200 mL water administered 6 - 8 times daily. Infant (4-24 months) : 1 sachet in 200 mL water administered 3 - 5 times daily.

Flavor : Vanilla Package : Powder 40 g/sachet Registration Number : PAN-ENTERAL, Vanila Flavor POM SI. 084 226 831

PROTEN® Daily Intake Protein to Prevent Protein Energy Malnutrition and accelerate patient’s recovery Composition : Each 52 g/ Sachet, contains : Soy powder 25.5 gr  Energy 212 kcal Protein 10 g Carbohydrate 27.7 g

Fat 5.8 g Fiber 1.4 g Vitamin, Mineral Dosage : Adult : 1 sachet in 200 ml water administered 2-6 times daily Children : day 1 : 1/2 sachet in 200 mL water administered twice daily. day 2 onwards : 1 sachet in 200 mL water administered 1-4 times daily. •

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Flavor : Chocolate and Vanilla Package : Powder 52 g/sachet Registration Number : PROTEN, Chocolate Flavor POM SD. 021 203 061 •

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PROTEN, Vanila Flavor POM SD. 021 201 871

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AMINOFLUID® AMINOFLUID®(electrolytes, glucose, amino acids)

Composition

500 mL

1000 mL

 Na+

17.5 mEq

35 mEq

K +

10 mEq

20 mEq

Mg

2.5 mEq

5 mEq

Ca2+

2.5 mEq

5 mEq

Cl SO4=

17.5 mEq 2.5 mEq

35 mEq 5 mEq

Acetate-

6.5 mEq

13 mEq

Gluconate-

2.5 mEq

5 mEq

Lactate-

10 mEq

20 mEq

Citrate3-

3 mEq

6 mEq

5 mmol 2.5 µmol

10 mmol 5 µmol

Glucose Glucose concentration

37.50 g 7.5%

75.00 g 7.5%

Total free amino acids

15.00 g

30.00 g

Total nitrogen

2.35 g

4.70 g

1.44

1.44

30% (w/w)

30% (w/w)

Total calories

210 kcal

420 kcal

 Non protein calories  Nonprotein calories/nitrogen

150 kcal 64

300 kcal 64

2+

-

P Zn2+

Essential/nonessential amino acids Branched-chain amino acids

AMINOVEL® AMINOVEL® AMINOVEL 600 injection is a well-balanced mixture of L-Amino acids optimally  proportional for maximum protein synthesis. Sorbitol, vitamins and electrolytes supplement nutritional needs for the body. AMINOVEL 600 injection is a sterile aqueous solution supplying approx 600 calories per  litre. Composition : Each 1000 ml AMINOVEL-600 contains : Amino acids (L form) : 50 g

D-Sorbitol : 100 g Ascorbic acid : 400 mg Inositol : 500 mg  Nicotinamide : 60 mg Pyridoxine HCl : 40 mg Riboflavin Sodium Phosphate : 2.5 mg Electrolytes  Na+ : 35 mEq K + : 25 mEq Mg++ : 5 mEq Acetate- : 35 mEq Malate- : 22 mEq Cl- : 38 mEq Indications : AMINOVEL 600 injection is recommended for parenteral nutrition supply In the following conditions. 1. As supplement nutrition in the case of the impairement of the gastrointestinal tract as in clinical situation of short bowel syndrome, anorexia and severe gastro-intestinal disorder. 2. Prolonged gastro-intestinal rest is necessary as in case of enterocutaneous fistulae and involving the gastro-intestinal tract. 3. In increased metabolic need as in the cases of severe burns, trauma and after surgery. 4. In other critical cases, which require exogenous nutrition such as tumor, severe infections, severe stress and protein deficiency. Dosage and administration : For internal disorder or presurgical protein deficiency : the usual dosage is 500 ml. •

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AMINOVEL 600 injection by intravenous drip infusion over 4-6 hr (20-30 drops/min) simultaneously or followed by a 10% sugar solution 500 ml over 2 hr (6080 drop/min). These infusions are repeated at 12 hr intervals for 5-7 days. The intervals may be prolonged to 24 hr according to patient condition and response. For postsurgical impairement of protein synthesis : The usual adult dosage is 500 ml of AMINOVEL 600 injection by intravenous drip infusion over 4-6 hr (20-30 drops/min) following drip infusion of Darrow’s solution 1000 ml over 4 hr (60-100 drops/min) and followed by drip infusion of a 10% sugar solution 500 ml over 2 hr  (60-100 drops/min). These infusions are started on the 3 rd postsurgical day, and repeated at 24 hr intervals for 5-7 days.

Action and characteristics : AMINOVEL 600 Injection supplies the following essential components for parenteral nutrition :

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The eight essential amino acids : Isoleucine, Leucine, Lysine, Methionine, Phenylalanine, Threonine, Tryptophan and Valine are indispensable for protein synthesis. Sorbitol to supply calories to meet metabolic energy requirements Vitamins to prevent deficiencies and to promote the biosynthesis of protein. Minerals to maintain electrolyte balance and to promote synthesis of protein

Storage : Store below 30oC, protect from light. Package : In Soft Bag 500 ml Reg. No. DKL 9218702749A1 •

AMIPAREN ® AMIPAREN is a sterile injection solution of total amino acids intended For use in hyperalimentation and general parenteral nutrition. AMIPAREN contains relatively larger  amounts of branched chain amino Acids (leucine, isoleucine and valine), which suppress  protein breakdown and promote protein synthesis in the muscle. A series of preclinical and clinical Studies established that AMIPAREN was effective in sparing protein in various types of insults and malnutrition state. Composition per 1000 ml : Total free amino acids : 100 g Essential amino acids (E) : 59.10 g  Non-essential amino acids (N) : 40.90 g E / N ratio : 7.2 Branched chain amino acids : 30% w/w % Total nitrogen : 15.7 g  Na+ : 2 mEq Acetate- : 120 mEq

Indications : AMIPAREN is indicated for amino acids supply in the following instances : Hypoproteinemia, malnutrition and pre and or postoperative condition. Dosage and administration : Central vein infusion : The usual adult dosage is 400-800 ml per day by drip infusion via the central vein. The dosage may be increased or decreased depending on the patient's age,symptoms and body weight. Peripheral vein infusion : The usual adult dosage is 200-400 ml per dose by drip infusion via the peripheral vein. The usual peripheral infusion rate is such a rate as to provide about 10 g of amino acids over 60 minutes of infusion in order to achieve optimal physiological utilization of amino acids. A typical infusion rate in adults is 100 ml over 60 minutes (about 25 drops per  minute), and the rate should be adjusted downward in the case of children, elderly  patients and severely ill patient's. The dosage may be increased or decreased depending on the patient's age, symptoms and body weight. Combination of AMIPAREN with a carbohydrate solution is highly recommended for  efficients utilization of amino acids in the body. Pharmacology : The value of AMIPAREN as a source of amino acids in the nutritional support was assessed in hyperalimentation therapy using normal rats and insulted rats : 1. AMIPAREN promptly improved and maintained nitrogen balance. 2. The solution promoted synthesis of plasma total protein and albumin. 3. The Urinary 3-methylhistidine / creatinine ratio, an indicator of protein catabolism in the muscle under insult, was low after infusion treatment, indicating a very potent inhibitory efect of the solution on muscle protein breakdown. 4. The plasma concentrations of free amino acids including branched chain amino acids showed minor fluctuation during infusion treatment. Amino acid metabolism was  judged to be steady during AMIPAREN therapy. Storage : Store below 30oC, protect from light. Package : 500 ml in Soft Bag. Reg. No. DKL 9218703649A2 •

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AMINOLEBAN® INJECTION The Main Therapy for Fast and Persistently Improving All Degrees of Hepatic Encephalopathy Composition : Each 1000 mL Aminoleban Infusion, contains : Amino Acids : 7.99 % Branched-Chain Amino Acid (BCAA) : 35.5 % Arginine : 7.3 g Fischer’s Ratio : 37.05 E/N Ratio : 1.09 Total Nitrogen : 12.2 g/L  Na+ Approx : 14 mEq/L Cl- Approx : 94 mEq/L Osmolarity : 768 mOsm/L Indications : Treatment of hepatic encephalopathy in patients with chronic liver disease. Dosage and Administration : Adult : 500 – 1000 mL by intravenous drip infusion. The usual peripheral infusion rate is 500 mL over 180-300 minutes in adult ( approx. 25-40 drops per minute ). For Total Parenteral Nutrition : 500 – 1000 mL of the injection should be suitably combined with dextrose or other solution and administered over 24 hours via the central vein. The dosage may be adjusted depending on the patient’s age symptoms and body weight. Contra Indications : 1. Patients with severe renal disorder (the amount of water tends to be excessive and the  patients clinical condition may be worsened. Urea and other amino acid metabolites may be retained, which may worsen the patients clinical condition ) •

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2. Patients with abnormal amino acid metabolism (since the infused amino acids are not adequately metabolized, the patient’s clinical condition may be worsened) Precaution : Careful administration in patients with severe acidosis and congestive heart failure. Used in children : the safety of Aminoleban Infusion in children has not been established. Adverse Reactions : Hypersensitive skin rashes or other hypersensitive reactions have been rarely reported and administration should be discontinued if such signs develop. Digestive : Nausea and Vomiting may infrequently occur. Large dose and rapid administration : Acidosis may occur after a rapid and large dose of Aminoleban Infusion. Others : Chills, Fever, headache and vascular pains may infrequently occur. Storage : Store below 30oC, protect from light. Package : Soft Bag 500 mL Registered Number : DKL 87187016949A1 • •

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Aminoleban® Oral Nutritional treatment for improving Quality and Survival of patients with Liver Disease Benefit : Improvement of Nutritional state of the chronic hepatic insufficiency patients including those with hepatic encephalopathy. Dosage and Administration : Usually for Adult, reconstitute 1 package ( 50 g ) of Aminoleban Oral in about 180 mL (approximately 200 kcal/ 200 mL) and ingest with meals 3 times a day. The dosage may be adjusted according to the age of the patient and severity of symptoms. Preparation : Pour about 180 mL of water at ambient temperature or approximately 50ºC into shaker bottle or blender, add the entire contents of 1 Aminoleban Oral package and thoroughly reconstitute. The volume of reconstitution is approximately 200 mL and this provides about 210 kcal of energy. Composition : Each 50 g / sachet, contains : Energy : 210 kkal Protein : 13.5 g Carbohydrate : 32.35 g Fat (Rice Oil) : 3.5 g Vitamin, Mineral Flavor : Orange and Neutral Package : Powder 50 g/ sachet Registration Number : Aminoleban Oral, Orange Flavor POM SD. 051 219 451 •

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Aminoleban Oral, Neutral Flavor POM SD. 051 219 441

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ASERING® Composition : Electrolyte mEq/L  Na+ = 130 Cl- = 108.7 K + = 4 Ca++ = 2.7 Acetate- = 28 Indication , Side Effect Precaution and Contraindication, please see brochure in package. Package : 500 mL,Softbag and Plabottle Reg. No. DKL 9918705449A1 •

Basic Solution Otsu RL®

Composition: Electrolyte mEq/L  Na+ = 130 Cl- = 108.7

K + = 4 Ca++ = 2.7 Lactate = 28 Indication , Side Effect Precaution and Contraindication, please see brochure in package. Package : 500 mL Reg. No. DKL 9818705249A1 • •

Otsu NS®

Composition: Electrolyte mEq/L  Na+ = 154 Cl- = 154 Indication , Side Effect Precaution and Contraindication, please see brochure in package. Package : 100 mL, 250 mL, 500 mL, 1000 mL Reg. No. DKL 9818705149A1 • •

Otsu D5®

Composition Dextrose 50 g/L Indication , Side Effect Precaution and Contraindication, please see brochure in package. Package : 100 mL, 250 mL, 500 mL, Reg. No. DKL 9818705049A1 • •

KA-EN

KA-EN 1B® Composition ; Electrolyte mEq/L  Na+ = 38.5 Cl- = 38.5 Dextrose = 37.5 gr/L Indication , Side Effect Precaution and Contraindication, please see brochure in package. Package : • 500 mL • Reg. No. DKL 9118702149A2 KA-EN 3A® Composition : Electrolyte mEq/L  Na+ = 60 Cl- = 50 K + = 10 Lactate- = 20 Dextrose = 27 gr/L Indication , Side Effect Precaution and Contraindication, please see brochure in package. Package : • 500 mL, • Reg. No. DKL 9218703049A1 KA-EN 3B® Composition : Electrolyte mEq/L  Na+ = 50 Cl- = 50 K + = 20 Lactate- = 20 Dextrose = 27 gr/L. Indication , Side Effect Precaution and Contraindication, please see brochure in package. Package : • 500 mL • Reg. No. DKL9218703149A1 KA-EN 4A® Composition : Electrolyte mEq/L  Na+ = 30 Cl- = 20 Lactate- = 10 Dextrose = 40 gr/L Indication , Side Effect Precaution and Contraindication, please see brochure in package. Package : • 500 mL, • Reg. No. DKL 9318703249A1

KA-EN 4B® Composition : Electrolyte mEq/L  Na+ = 30 Cl- = 28 K + = 8 Lactate- = 10 Dextrose = 37.5 gr/L

Indication , Side Effect Precaution and Contraindication, please see brochure in package. Package : 500 mL, Reg. No. DKL 9218703349A1 • •

KA EN MG3® KA-EN MG3 is generally recommended for the supply or replenishment of water and electrolytes which are needed for daily maintenance. The composition is based on the average required amounts of water and electrolytes in normal humans.

These solution is used as a maintenance solution for patients with difficulties in the oral intake of water and electrolytes after surgery, or for hypertonic dehydration with hypokalemia. Composition per 1000 ml :  Na+ : 50 mEq K + : 20 mEq Cl- : 50 mEq Lactate- :20 mEq Glucose : 100 g Calories : 400 Kcal/l Osmolarity : 695 mOsm/l Indications : KA-EN MG3 is indicated in patients with carbohydrate and electrolyte imbalance In following cases : Insufficient oral intake, for example : Unconsciousness at cerebral stroke, anorexia due to malignant tumors, general marasmus, meningitis, encephalitis, malnutrition,  pneumonia Surgical procedure, Neonatology, Diabetic acidosis Dosage and administration : The usual dose is 500-1000 ml at one time by gradual intravenous drip infusion. The dosage should be adjusted according to the patient’s condition (loss amounts of   body water and electrolytes, etc). 500 ml solution in bottle of 1000 ml : allowing for admixture with e.g Amino acid infusion. Storage : At room temperature, and away from direct sunlight. Package : In plastic bottle of 500 ml, and 500 ml in bottle of 1000 ml Reg. No. : •

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500 ml DKL 9118702049A1

KIDMIN® KIDMIN is a 7.2% amino acid injection containing large amounts of branched-chain Amino acids, such as leucine, isoleucine and valine which inhibit the breakdown of Muscle protein and promote muscle protein synthesis. KIDMIN also contains some nonessential amino acids, except for glycine, the demand for  Which is increased in renal insufficiency. The ratio of essential to nonessential amino acids Of this solution is 2.6 and each 100 ml contains 1 g of nitrogen, it is thus easy to calculate the nitrogen content of a given dose. Composition : Each 1000 ml KIDMIN contains : Total free amino acids : 72.05 g Essential amino acids (E) : 52.05 g  Non-essential amino acids (N) : 20 g E / N ratio : 2.6 Branched chain amino acids : 45.8 % (w/w) Total nitrogen : 10 g  Na+ : 2 mEq Acetate : 46 mEq Indications : KIDMIN is indicated for the provision of amino acids in the following instances in  patients with acute of chronic renal failure : hypoproteinemia, malnutrition, and  before and after surgery. Dosage and administration : Chronic Renal Failure Peripheral vein infusion : The usual adult dosage is 200 ml per day, infused via a  peripheral vein. The usual infusion rate in adults is 100 ml over 60 min (approximately 25 drops per min) and it should be slowly infused in children, the elderly and seriously ill patients. The dosage may be adjusted according to the  patient’s condition, body weight and age. When administered during hemodialysis, it should be infused via the vein side injection port of dialysis circuit starting 90-60 min.  before the end of hemodialysis therapy. Regarding calories, more than 1500 kcal per  day is recommended to be provided for the efficiency of amino acid utilization. Central vein infusion : The usual adult dosage is 400 ml per day, infused via a central vein by total parenteral nutrition. The dosage may be adjusted according to the  patients condition, body weight and age. More than 300 kcal of nonprotein calories should be administered per 1 g of nitrogen (100 ml of this product) for the efficiency of amino acid utilization. Acute Renal Failure The usual adult dosage is 600 ml per day, infused via a central vein by total parenteral nutrition. •

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The dosage may be adjusted according to the patients condition, body weight and age. More than 300 kcal of nonprotein calories should be administered per 1 g of nitrogen (100 ml of this product) for the efficiency of amino acid utilization. Storage : Store below 30oC, protect from light. Package : 200 ml in Soft Bag. Reg. No. DKL 9918705649A1 •

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