CN103385889B - Carbohydrate and electrolyte mixed injection and preparation method thereof - Google Patents

Carbohydrate and electrolyte mixed injection and preparation method thereof Download PDF

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CN103385889B
CN103385889B CN201310306791.6A CN201310306791A CN103385889B CN 103385889 B CN103385889 B CN 103385889B CN 201310306791 A CN201310306791 A CN 201310306791A CN 103385889 B CN103385889 B CN 103385889B
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solution
injection
carbohydrate
chloride
sodium
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CN103385889A (en
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黄毅
熊骏宇
陈敏
张晓敏
张晓鹏
章长生
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Zhuhai homologous Pharmaceutical Co., Ltd.
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BIOCHEMICAL PHARMACEUTICAL FACTORY OF ZHUHAI SEZ
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Abstract

The invention relates to a carbohydrate and electrolyte mixed injection. The injection comprises following components in per bottle: 30 g of glucose (regarded as an anhydrous substance), 15 g of fructose, 7.5 g of xylitol, 0.730 g of sodium chloride, 0.410 g of sodium acetate, 0.185 g of calcium chloride, 0.255 g of magnesium chloride, 0.870 g of dipotassium phosphate, 0.700 mg of zinc sulfate, 0.18 g of L-valine, an appropriate amount of citric acid and 500 mL of water for injection. The invention also provides a preparation method of the carbohydrate and electrolyte mixed injection. The preparation method comprises a step of adding the calcium chloride and the dipotassium phosphate into 400 mL of the water for injection, wherein the temperature of the water for injection is 70 DEG C, and adjusting pH to 5.0 by using the citric acid after the mixture is stirred into an opacifying form; a step of adding the magnesium chloride, the sodium chloride, the sodium acetate and the zinc sulfate, and stirring until the solution is colorless and clear; a step of adding the glucose, the fructose and the xylitol, and stirring until the solution is colorless and clear; a step of adding the L-valine, and stirring until the solution is colorless and clear; a step of adding active carbon used for injections, stirring uniformly, allowing the mixture to stand, filtering by using microfiltration membranes to remove the carbon and to degerm; and a step of adding the remaining water for injection to obtain the carbohydrate and electrolyte mixed injection.

Description

Carbohydrate-electrolyte solution and preparation method thereof
Technical field
The present invention relates to carbohydrate-electrolyte solution and preparation method thereof.
Background technology
Wound, patient with operation and critical patient, because its body is in high decomposing state, cause malnutrition, and immunologic hypofunction usually needs fluid-supplement therapy to sustain life.An importance of fluid-supplement therapy is to supplement heat energy, and the supply of heat energy is the most conventional with glucose.Stress state because critical patient exists, changes body carbohydrate metabolism, has insulin resistant, and operation wound also can cause insulin resistant and cause hyperglycemia; But mainly, still because of the too much glucose of infusion (comprising parenteral nutrient solution), cause the generation of glucose far away more than utilization, produce hyperglycemia, hyperglycemia causes a large amount of glucoses to lose from urine, causes osmotic diuresis, can cause water, electrolyte disturbance.Simultaneously hyperglycemia can expand body inflammatory reaction and oxidative stress status after wound, then increases SIRS and infects the probability of complication, and severe patient can cause multiple organ dysfunction syndrome.Solve the measure of hyperglycemia: the hyperglycemia causing except disease itself needs symptomatic treatment, the more important thing is to change traditional with glucose or Dextrose and Sodium Chloride Inj. the mode to body energy supply, application fructose or xylitol Substitute For Partial glucose are body energy supply.Fructose mainly generates fructose 1-phosphate through fructokinase catalysis in liver, kidney and small intestinal, because it can walk around the rate-limiting enzyme (phosphofructokinase) in glycolysis, therefore the decomposition rate in liver is faster than glucose, metabolic process does not rely on insulin, do not raise and reduce blood glucose, can, in the situation that participating in without insulin, be converted into glycogen, impact on blood glucose is less, the absorbing of easier body; But use separately fructose energy supply can cause the acidosis of metabolic.Xylitol additional heat and glucose are suitable, can improve carbohydrate metabolism, metabolism does not rely on the participation of insulin in vivo, directly permeate through cell membranes involved in sugar metabolism and do not increase blood sugar concentration, and there are the insulin secretion of promotion and hepatic glycogen synthetic, still have the ketoplastic effect of inhibition, can make blood plasma fatty acid generate and reduce, contribute to the metabolism of protein, fat and steroid, but use separately xylitol energy supply easily to cause renal dysfunction.The expert of Japan and European countries draws glucose through a large amount of zoopery and clinical verifications: the standard proportioning of fructose: xylitol=4:2:1, mixed sugar by this standard proportional is the most abundant at body metabolism, can make the side effect of these three kinds of monosaccharide be down to minimum, can supplement body fluid and energy for patient, can reduce the fluctuation of blood sugar for human body and insulin again, reduce the damage to organs such as human kidneys.
Another main purpose of fluid-supplement therapy is to correct water, electrolyte and acid-base balance simultaneously, supplements main trace element.Normal human, by regulating actions such as nerve, endocrine, maintains body fluid capacity, osmotic pressure, various electrolyte concentration and acid-base value in normal range.Except this above-mentioned balance of normal appearance in generation, evolution of a lot of diseases is not normal, body fluid is lost in a large number or simple a large amount of infusion saccharide is infused also can cause that above-mentioned balance is not normal.There is corresponding clinical symptoms in water, electrolyte and acid base imbalance, some is threat to life even.
For a long time, the domestic glucose injection using clinically, Dextrose and Sodium Chloride Inj., chloride injection liquid measure remain on more than 90% in transfusion kind always, and annual consumption reaches billions of bottles (bag).Above-mentioned transfusion is except part is as pharmaceutical carrier, most of for fluid-supplement therapy.Along with going deep into of scientific and technological progress and clinical application research, the hyperglycemia hazardness of the heat energy that glucose injection or Dextrose and Sodium Chloride Inj. are made to fluid-supplement therapy due to supplying with manifests day by day.The clinical medicine that needs in a large number place of glucose injection or Dextrose and Sodium Chloride Inj..
Summary of the invention
Problem to be solved by this invention is to provide a kind of carbohydrate-electrolyte solution and preparation method thereof, gained carbohydrate-electrolyte solution energy place of glucose injection or Dextrose and Sodium Chloride Inj. and good stability.
Technical scheme provided by the invention is: carbohydrate-electrolyte solution, every bottle contains: glucose (by anhydride): 30g, and fructose: 15g, (sugar part adds up to xylitol: 7.5g: 52.5g), sodium chloride: 0.730g, sodium acetate: 0.410g, calcium chloride: 0.185g, magnesium chloride: 0.255g, citric acid: appropriate (adjusting pH to 5.0), dipotassium hydrogen phosphate: 0.870g, zinc sulfate: 0.700mg, Valine 0.18g and water for injection: 500ml.
Every bottle of injection is also containing 0.210g sodium sulfite.
The present invention also provides the preparation method of above-mentioned carbohydrate-electrolyte solution, comprises the following steps:
(1) calcium chloride, dipotassium hydrogen phosphate are joined in the water for injection of 70 ℃ of 400 ml, stir into after milkiness shape, with citric acid, adjust pH5.0, obtain clear solution ;
(2) magnesium chloride, sodium chloride, sodium acetate, sodium sulfite (when needed) and zinc sulfate are joined to solution , be stirred to solution achromaticity and clarification and obtain solution ;
(3) at solution in add glucose, fructose and xylitol, be stirred to solution achromaticity and clarification and obtain solution III;
(4) in solution III, add Valine, be stirred to solution achromaticity and clarification and obtain solution IV;
(5) get after needle-use activated carbon adds a small amount of water for injection tune charcoal paste and join in solution IV, stir evenly, standing 20 minutes, adopt the de-charcoal of 0.45 μ m filtering with microporous membrane, adopt 0.22 μ m microporous filter membrane fine straining degerming, add water for injection and obtain carbohydrate-electrolyte solution to full dose.
Main applicable disease is: can not oral administration or oral administration can not fully absorb time, and supplement and maintain moisture and electrolyte, and supply energy.
Usage and dosage: slowly intravenous drip.Conventionally, each 500ml~1000ml that is grown up.Injection speed (pressing glucose meter), being conventionally grown up per hourly must not surpass 0.5g/kg body weight.According to different situations such as age, symptom and body weight, can consider increase and decrease.
Preparation of the present invention is compound recipe bulk capacity injection; Glucose wherein, fructose, xylitol, sodium chloride, calcium chloride, sodium acetate, potassium dihydrogen phosphate, zinc sulfate raw material all record by two of Chinese Pharmacopoeia versions in 2010, magnesium chloride records in the 5th of national drug standards chemical drugs provincial standard rising national standard.
Glucose in carbohydrate-electrolyte solution of the present invention, fructose, xylitol form in 4:2:1 ratio, study and experimental results show that, mixed sugar by this standard proportioning is the most abundant at body metabolism, can make the side effect of glucose, fructose, xylitol be down to minimum, can supplement body fluid and heat for patient, can reduce the fluctuation of blood sugar for human body and insulin again, reduce the damage to organs such as human kidneys.
The present invention contains sodium chloride, magnesium chloride, calcium chloride, dipotassium hydrogen phosphate, sodium acetate, can supplement the main electrolyte that needed by human body is wanted, not only can supplement intracellular fluid but also can supplement the required cation of extracellular fluid, take into full account the required electrolytical supply of Human Physiology.If sodium is the main cation of extracellular fluid, be the body fluid osmotic pressure concentration that remains constant and the main matter of extracellular fluid volume; Potassium is main cation in cell, to keeping normal neural muscle excitability to play an important role; Calcium phosphorus is except participating in bone metabolism, calcium ion is closely related as second message,second messenger and the many functions of body in cell, as assisted, regulate neurotransmitter and endocrine release and storage, maintain nervimuscular NE, promote nerve ending secretion acetylcholine, blood calcium reduction can cause neural muscle excitability to raise, and twitches.Phosphorus is that energy i (in vivo) metabolism institute is essential; Magnesium is the important cation that is only second to potassium in cell, as the cofactor of a lot of enzymes, can maintain myocardium ionic equilibrium, regulates potassium channel, and low magnesium can cause multiple arrhythmia.Sodium acetate generates new salt and acetic acid August with strong acid in vivo, simultaneously muscle and peripheral organization's metabolism are bicarbonate radical (being finally decomposed into carbon dioxide and water) to acetic acid in vivo, therefore sodium acetate has sour cushioning effect, can correct metabolic acidosis, contained buffer salt dipotassium hydrogen phosphate can maintain the acid-base balance of human body.
Preparation of the present invention also contains trace zinc, zinc participates in the synthetic of plurality of enzymes (as carbonic anhydrase, DNA and RNA polymerase, lactic acid dehydrogenase, thymidine kinase, alkali phosphatase, pancreas peptidase etc.) and activates, protein, nucleic acid absorption and digestion synthetic, intestinal albumen are brought into play to important physiological function, enhancing development; By to the synthetic of gustin in taste bud and prevent buccal mucosa epithelial cell parakeratosis, maintain normal appetite and the sense of taste, strengthen phagocyte phagocytic activity, chemotactic vigor and sterilizing function; And by sudismase, keep Free Radical Level in phagocyte, the cell membrane of free radical energy destroy microorganisms, performance bactericidal action, the healing of acceleration of wound, burn, ulcer; The metabolism of vitamin A and vision are played an important role; Promote and maintenance function; Stabilizing cell membrane, improves tissue energy metabolism and Tissue respiration.
Glucose can dewater under certain condition and generate harmful 5 hydroxymethyl furfural (as human body band thigh and internal organs are had to detrimental effect).Applicant surprisingly finds, adds a certain amount of Valine can suppress the increase of its content in the generation of 5 hydroxymethyl furfural and storing process in carbohydrate-electrolyte solution, improves the stability of carbohydrate-electrolyte solution.
Preparation of the present invention is high-capacity injection, and clinical use does not need allotment, can directly carry out intravenous drip, and clinical practice is convenient.
Carbohydrate-electrolyte solution of the present invention has insulin-dependent little, and blood glucose fluctuation is little, is applicable to the patient's of metabolism obstacles of blood glucose state energy supply; Can provide energy fast, completely, the heat that uses more separately three kinds of components to provide is high, and every 100ml can provide the heat of 42 kilocalories of human bodies; Promotion to protein, lipogenesis significantly strengthens; Multiple electrolyte (potassium, sodium, calcium, magnesium, zinc, chlorine, phosphorus) can be provided, supplement in time physiology required, regulate the feature of acid-base balance.The fluid-supplement therapy that is applicable to critical patient, wound and hands postoperative patient, can reduce glucose or Dextrose and Sodium Chloride Inj., the untoward reaction causing for the hyperglycemia due to fluid-supplement therapy; Can place of glucose injection or Dextrose and Sodium Chloride Inj. and good stability.Progressively will replace glucose or Dextrose and Sodium Chloride Inj. carries out fluid-supplement therapy with mixed sugar or Nulomoline electrolytes injection clinically, so the present invention have wide potential applicability in clinical practice and huge market capacity.
The specific embodiment
Embodiment 1:
Carbohydrate-electrolyte solution, every bottle contains: glucose (by anhydride): 30g, fructose: 15g, (sugar part adds up to xylitol: 7.5g: 52.5g), sodium chloride: 0.730g, sodium acetate: 0.410g, calcium chloride: 0.185g, magnesium chloride: 0.255g, sodium sulfite: 0.210g, citric acid: appropriate, dipotassium hydrogen phosphate: 0.870g, zinc sulfate: 0.700mg, Valine 0.18g and water for injection: 500ml.
The present invention also provides the preparation method of above-mentioned carbohydrate-electrolyte solution to comprise the following steps:
(1) calcium chloride, dipotassium hydrogen phosphate are joined in the water for injection of 70 ℃ of 400 ml, stir into after milkiness shape, with citric acid, adjust pH5.0, obtain clear solution ;
(2) magnesium chloride, sodium chloride, sodium acetate, sodium sulfite and zinc sulfate are joined to solution , be stirred to solution achromaticity and clarification and obtain solution ;
(3) at solution in add glucose, fructose and xylitol, be stirred to solution achromaticity and clarification and obtain solution III;
(4) in solution III, add Valine, be stirred to solution achromaticity and clarification and obtain solution IV;
(5) get after needle-use activated carbon adds a small amount of water for injection tune charcoal paste and join in solution IV, stir evenly, standing 20 minutes, adopt the de-charcoal of 0.45 μ m filtering with microporous membrane, adopt 0.22 μ m microporous filter membrane fine straining degerming, add water for injection and arrive full dose.
(6) embedding: medicine liquid irrigation is encapsulated in infusion bottle.
(7) sterilizing: after leak detection, 115 ℃ of sterilizings 30 minutes.
Comparative example 1:
Carbohydrate-electrolyte solution, every bottle contains: glucose (by anhydride): 30g, fructose: 15g, (sugar part adds up to xylitol: 7.5g: 52.5g), sodium chloride: 0.730g, sodium acetate: 0.410g, calcium chloride: 0.185g, magnesium chloride: 0.255g, 0.21 part of sodium sulfite, citric acid: appropriate, dipotassium hydrogen phosphate: 0.870g, zinc sulfate: 0.700mg, water for injection: 500ml.
Preparation method is with embodiment 1.
Comparative example 2:
Carbohydrate-electrolyte solution, every bottle contains: glucose (by anhydride): 30g, and fructose: 15g, (sugar part adds up to xylitol: 7.5g: 52.5g), sodium chloride: 0.730g, sodium acetate: 0.410g, calcium chloride: 0.185g, magnesium chloride: 0.255g, 0.21 part of sodium sulfite, dipotassium hydrogen phosphate: 0.870g, zinc sulfate: 0.700mg, water for injection: 500ml.
Preparation method:
By recipe quantity, add glucose, fructose, xylitol, sodium chloride, sodium acetate, calcium chloride, magnesium chloride, sodium sulfite, dipotassium hydrogen phosphate, zinc sulfate, adds 80 ℃ of waters for injection by 90% of amount of preparation, is stirred to completely and dissolves.Add needle-use activated carbon, under 55-65 ℃ of heating condition, stir 20 minutes, the decarburization of solution filtered while hot, adds surplus water for injection, adjust pH 5.0, and with 0.45 μ m microporous filter membrane fine straining, fill, plug bottle, rolls lid, 115 ℃ of sterilizings 30 minutes.
The carbohydrate-electrolyte solution of embodiment 1 and comparative example 1 and comparative example 2 preparations is carried out to accelerated stability investigation (40 ℃ ± 2 ℃, RH 75% ± 5%) and long-time stability investigation, the results are shown in Table 1.Particulate determination wherein: according to two appendix IX C of Chinese Pharmacopoeia version in 2010, first method inspection.
Table 1 carbohydrate-electrolyte solution accelerated test result
Table 2 carbohydrate-electrolyte solution long-term test results
Experimental data shows: the content of the carbohydrate-electrolyte solution 5 hydroxymethyl furfural that the embodiment of the present invention 1 makes is low and substantially unchanged, and particulate matter is low and change little; Content and the particulate matter of the carbohydrate-electrolyte solution 5 hydroxymethyl furfural that comparative example 1, comparative example 2 make are higher, and along with the variation of time large (in Table 1,2).The embodiment of the present invention 1 is because added Valine than comparative example 1, compare its preparation method from comparative example 2 and adopt the technology controlling and process such as different charging sequence, pH value, control the content of particulate matter and 5 hydroxymethyl furfural, improved stability and the safety of product.
Compare carbohydrate-electrolyte solution of the present invention and the clinical effectiveness of traditional glucose injection to complication patient.
Method: adopt randomized controlled method, select 100 customary surgery patients, be divided into each 50 examples for the treatment of group and matched group.Aftertreatment group patient venoclysis mixed sugar electrolyte, matched group patient infusion 10% glucose injection, continuously 4d.Record blood glucose and insulin dosage, measure the variation of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), detect urine ketoboidies, glucose in urine and urinary nitrogen discharge capacity, record the untoward reaction in therapeutic process.Result: compare with matched group, after treatment group operation in patients, 2~4d treatment group blood sugar increasing amplitude obviously reduces (P0.05); Postoperative 1~4d insulin dosage obviously reduces (P0.01); The IL-6 of postoperative 3d and 4d and TNF-α all obviously reduce (P0.05 or 0.01); Urine ketoboidies is close with glucose in urine positive rate; Urinary nitrogen discharge capacity obviously reduces (P0.05); In therapeutic process, without obvious adverse reaction, occur.Conclusion: mixed sugar electrolyte is less to blood sugar influence, and insulin dosage is few, body inflammatory response light, is applicable to the postoperative use of surgery patients.

Claims (4)

1. carbohydrate-electrolyte solution, every bottle of injection contains: glucose: 30g, fructose: 15g, xylitol: 7.5g, sodium chloride: 0.730g, sodium acetate: 0.410g, calcium chloride: 0.185g, magnesium chloride: 0.255g, citric acid: appropriate, dipotassium hydrogen phosphate: 0.870g, zinc sulfate: 0.700mg, Valine 0.18g and water for injection: 500ml.
2. carbohydrate-electrolyte solution according to claim 1, is characterized in that: every bottle of injection is also containing 0.210g sodium sulfite.
3. the preparation method of carbohydrate-electrolyte solution claimed in claim 1, comprises the following steps:
(1) calcium chloride, dipotassium hydrogen phosphate are joined in the water for injection of 70 ℃ of 400 ml, stir into after milkiness shape, with citric acid, adjust pH5.0, obtain clear solution ;
(2) magnesium chloride, sodium chloride, sodium acetate, sodium sulfite and zinc sulfate are joined to solution , be stirred to solution achromaticity and clarification and obtain solution ;
(3) at solution in add glucose, fructose and xylitol, be stirred to solution achromaticity and clarification and obtain solution III;
(4) in solution III, add Valine, be stirred to solution achromaticity and clarification and obtain solution IV;
(5) get after needle-use activated carbon adds a small amount of water for injection tune charcoal paste and join in solution IV, stir evenly, standing 20 minutes, adopt the de-charcoal of 0.45 μ m filtering with microporous membrane, adopt 0.22 μ m microporous filter membrane fine straining degerming, add water for injection and obtain carbohydrate-electrolyte solution to full dose.
4. preparation method according to claim 3, is characterized in that: when adding magnesium chloride, sodium chloride, sodium acetate and zinc sulfate in step (2), add sodium sulfite, the addition of sodium sulfite is counted 0.210g by every bottle of injection.
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Cited By (1)

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CN105560281A (en) * 2014-10-08 2016-05-11 华仁药业股份有限公司 Mixed saccharide electrolyte injection and preparation method thereof
CN105497061B (en) * 2015-12-24 2019-01-08 长沙利星医药科技开发有限公司 A kind of electrolyte injection and preparation method thereof without glucose
CN109091500A (en) * 2018-10-09 2018-12-28 济南康和医药科技有限公司 A kind of children's compound electrolyte glucose injection and preparation method thereof

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Address after: 519041 Guangdong province Zhuhai Sanzao Jinhai Road No. 6

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