Drug Guide
L-glutamine
Classification
Therapeutic: Supplement / Nutritional Support
Pharmacological: Amino Acid
FDA Approved Indications
- Management of sickle cell disease (Endari)
- Nutritional supplementation in specific conditions
Mechanism of Action
L-glutamine enhances nitrogen transport and acts as a precursor for amino acids and nucleotides, supporting cellular energy production and reducing oxidative stress in red blood cells of sickle cell patients.
Dosage and Administration
Adult: Endari: 5 grams twice daily, orally, with food as directed.
Pediatric: Endari: Dose varies based on body weight, typically 0.3 g/kg twice daily, administered with food.
Geriatric: Similar to adult dosing; consider renal function.
Renal Impairment: Adjust dose based on renal function; use with caution in severe impairment.
Hepatic Impairment: No specific adjustments; monitor closely.
Pharmacokinetics
Absorption: Orally absorbed with variable bioavailability.
Distribution: Widely distributed throughout body tissues.
Metabolism: Metabolized in tissues to urea and other nitrogen compounds.
Excretion: Primarily excreted in urine as urea and other metabolites.
Half Life: Approximately 20-30 minutes in plasma.
Contraindications
- Hypersensitivity to L-glutamine
Precautions
- Use cautiously in patients with renal or hepatic impairment; monitor renal function regularly.
Adverse Reactions - Common
- Nausea (Rare)
- Vomiting (Rare)
- Abdominal pain (Rare)
Adverse Reactions - Serious
- Allergic reactions (rash, itching, swelling) (Rare)
- Respiratory distress (Rare)
Drug-Drug Interactions
- None specifically identified but monitor if used with drugs affecting renal function.
Drug-Food Interactions
- Food may affect absorption; administer with food as recommended.
Drug-Herb Interactions
N/ANursing Implications
Assessment: Monitor nutritional status, renal function, and for adverse reactions.
Diagnoses:
- Impaired nutrition
- Risk for renal impairment
Implementation: Administer as prescribed, with food.
Evaluation: Assess for improvement in nutritional status and reduction in sickle cell crises (for Endari).
Patient/Family Teaching
- Take medication with food to reduce gastrointestinal discomfort.
- Report any signs of allergic reactions.
- Maintain adequate hydration.
Special Considerations
Black Box Warnings:
- None
Genetic Factors: None specific.
Lab Test Interference: May affect renal function tests due to increased nitrogen load.
Overdose Management
Signs/Symptoms: Nausea, vomiting, diarrhea, elevated blood ammonia levels.
Treatment: Supportive care, correction of metabolic disturbances, hemodialysis if severe.
Storage and Handling
Storage: Store at room temperature, away from moisture and light.
Stability: Stable until expiration date.