Ornithine
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2019-09-19
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Clinical Pharmacology
Hepa-merz is involved in the ornithine cycle of Krebs urea-forming (biosynthesis of urea from ammonia). Promotes insulin and growth hormone. Improves the detoxification function of the liver, lowers elevated levels of ammonia in the plasma. Improves protein metabolism in diseases requiring parenteral nutrition.
Pharmacokinetics
Dissociates into ornithine and aspartate, which are absorbed in the small intestine by active transport through the intestinal epithelium. Excreted in the urine through the urea cycle.
Indications
- acute and chronic liver disease, accompanied by hyperaemonemia;
- hepatic encephalopathy (latent and severe), including as part of complex therapy for disorders of consciousness (precoma or coma);
- parenteral nutrition of patients with protein deficiency (as a corrective additive).
Ornithine is marketed under different brands and generic names, and comes in different dosage forms:
| Brand name | Manufacturer | Country | Dosage form |
|---|---|---|---|
| granules | |||
| Hepa-Merz | Merz | Germany | ampoules |
| Hepa-Merz | Merz | Germany | tea bags |
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Dosage and Administration
Intravenously, usually - 20 g (4 ampoules), with hepatic encephalopathy, depending on the severity of the condition - up to 40 g (8 ampoules) per day; maximum infusion rate - 5 g / h.
Adverse reactions
Rarely - skin reactions, in some cases - nausea, vomiting.
Contraindications
- Severe renal failure (serum creatinine> 3 mg / 1 dl);
- Lactation period (breastfeeding);
- Hypersensitivity to the drug.
Pregnancy and Lactation
During pregnancy, the use of Hepa-merz is possible only under the strict supervision of a doctor. At the time of treatment should stop breastfeeding.
Special instructions
If nausea or vomiting occurs, reduce the rate of administration.
Influence on ability to drive motor transport and control mechanisms
In hepatic encephalopathy, caution must be exercised when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and psychomotor reactions.
Overdosage
Symptoms: increased severity of side effects.
- Brand name: Ornithine canon
- Active ingredient: Ornithine
- Manufacturer: Vertex
Studies and clinical trials of Ornithine (Click to expand)
- Prenatal monitoring in a family at high risk for ornithine transcarbamylase (OTC) deficiency: A new mutation of an A-to-C transversion in position +4 of intron 1 of the OTC gene that is likely to abolish enzyme activity
- Asymptomatic and late-onset ornithine transcarbamylase deficiency caused by a A208T mutation: Clinical, biochemical and DNA analyses in a four-generation family
- Familial lethal inheritance of a mutated paternal gene in females causing X-linked ornithine transcarbamylase (OTC) deficiency
- Ahrens MJ, Berry SA, Whitley CB, Markowitz DJ, Plante RJ, Tuchman M (1996): Clinical and biochemical heterogeneity in females of a large pedigree with ornithine transcarbamylase deficiency due to the R141Q mutation. Am J Med Genet 66:311-315
- The ornithine transcarbamylase (OTC) gene: Mutations in 50 Japanese families with OTC deficiency
- Maternal gonadal mosaicism causing ornithine transcarbamylase deficiency
- Ornithine decarboxylase activity and its gene expression are increased in benign hyperplastic prostate
- Isolation and sequence of the gene encoding ornithine decarboxylase,SPE1, fromCandida albicans by complementation of aspe1Δ ctrain of Saccharomyces cerevisiae
- Hypoosmotic stimulation of ornithine decarboxylase activity in the brine shrimpArtemia franciscana
- Crystallization of a mammalian ornithine decarboxylase
- Crystallization and preliminary X-ray studies of ornithine decarboxylase fromTrypanosoma brucei
- Crystal structure of human ornithine transcarbamylase complexed with carbamoyl phosphate and L-norvaline at 1.9 Å resolution
- Expression of ornithine decarboxylase mRNA in gastric carcinoma
- Ornithine decarboxylase over-expression stimulates mitogen-activated protein kinase and anchorage-independent growth of human breast epithelial cells
- Ornithine decarboxylase inhibitor lessens the rat gastric carcinogenesis enhancement caused by tyrosine methyl ester
- Two-stage exposure of Syrian-hamster-embryo cells to environmental carcinogens: superinduction of ornithine decarboxylase correlates with increase of morphological-transformation frequency
- Prenatal diagnosis of ornithine transcarbamylase deficiency
- Induced expression of neurotrophins in transgenic mice overexpressing ornithine decarboxylase and overproducing putrescine
- Nerve expansion in nerve regeneration: Effect of time on induction of ornithine decarboxylase and Schwann cell proliferation
- Basic fibroblast growth factor selectively regulates ornithine decarboxylase gene expression in malignant H-ras transformed cells
- A novel missense mutation in the exon containing the putative ornithine-binding domain of the OTC enzyme in a female
- Partial duplication [dup. TCAC (178)] and novel point mutations (T125M, G188R, A209V, and H302L) of the ornithine transcarbamylase gene in congenital hyperammonemia
- Ornithine transcarbamylase deficiency: Characterization of gene mutations and polymorphisms
- A 3-base pair in-frame deletion in exon 8 (delGlu272/273) of the ornithine transcarbamylase gene in late-onset hyperammonemic coma
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