When a patient is given amino acids through IV in the hospital, which amino acids are in the solution?… by Samantha
Is Cysteine or, n-acetyl l-cysteine one of them?
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are there different sets of solutions of amino acids the hospital might administer to various patients on amino acids?
Best Answer:
Interesting question!
Yes, there are different solutions depending on what we are treating and why. The requirements vary overall for children as opposed to adults, and there are also specific amino acid solutions for people who have genetic issues with the ingestion of certain amino acids.
There are ten amino acids that are generally considered to be “essential”: Phenyalanine, histadine, isoleucine, leucine, lysine, methionine, tryptophan, arginine, threonine and valine. Those would be necessary unless contraindicated for medical reasons. Children are also considered to require cysteine, glycine, glutamine, serine and tyrosine.
N-acetyl-cysteine (a derivative of cysteine with an acetyl group attached to the nitrogen) is also used as an antidote for acetominophen poisoning. We wouldn't use that for nutrition. We also give it to kids with cystic fibrosis to help break up the phlegm in the lungs and respiratory tract.
You can Google Aminosyn or Travasol if you want specifics on particular formularies; those are the two I'm familiar with.
ETA: Just to clarify what the next poster said, cystic fibrosis is most commonly caused by a mutation that involves a three-nucleotide deletion on a particular gene (named the CFTR gene, for cystic fibrosis transmembrane regulator). The job of any gene is to make a protein, in this case CFTR, which happens to be a chloride channel found in the lungs and the GI tract.
Nucleotides are the building blocks of DNA and there are four of them (guanine, adenosine, thymine and cytosine–G, A, T and C). In genetic terms, each amino acid that is added to a protein is coded for by a “word” made by three nucleotides on a gene. So if you delete those three nucleotides, you lose that one amino acid being added and in the case of CF, that makes that chloride channel not work properly and that causes the symptoms of CF, because part of its normal job is to make the secretions in the lungs more liquid and easily expelled. CF patients have very thick mucus that is difficult to cough out, which leads to lots of infections in the lungs. (This is HUGELY oversimplified, of course.)
However–and I do have a point here, I promise–that has nothing at all to do with dietary phenylalanine and giving CF patients phenylalanine will not correct the problem. Phenyalanine will never be added to that protein in the correct position unless we come up with a way of doing it genetically (and we're trying). The fact that we give NAC to CF patients is just because it happens to act as an enzyme to help break down secretions in the lungs–it's incidental that it also happens to be an amino acid.
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