1.5% GLYCINE IRRIGATION SOLUTION USP Irrigation/Solution for

What is 1.5% GLYCINE IRRIGATION SOLUTION USP

1.5% Glycine Irrigation Solution U.S.P. is a sterile, non-pyrogenic, and non-conductive aqueous solution of glycine used primarily for urological irrigation. It contains 1.5 g of glycine per 100 mL of water, making it a hypotonic solution suitable for procedures where electrical current is used, such as transurethral resection of the prostate (TURP) or other endoscopic surgical interventions.

This solution is used to irrigate and flush body cavities, surgical sites, or medical instruments during procedures to maintain visibility, remove blood or tissue, and prevent blockage by coagulated materials.

• Form: Irrigation solution
• Packaging: 500 mL Plastic Bag
• Generic Name: Glycine 1.5%
• Osmolarity: Hypotonic
• Use Environment: Commonly used in endoscopic and urologic surgeries

Glycine is a naturally occurring amino acid, and when used as an irrigating fluid, it is absorbed minimally. Its chemical neutrality and low conductivity make it a safe medium in electrosurgical environments.

How to use 1.5% GLYCINE IRRIGATION SOLUTION USP

1.5% Glycine Irrigation Solution is for use only by trained healthcare professionals during specific medical procedures. It is not intended for intravenous injection or oral consumption. Proper use ensures patient safety and surgical success.

• Preparation: Ensure the solution is clear, free from particles, and at room temperature before use.
• Connection: Attach the irrigation bag to the surgical irrigation system using a sterile administration set.
• Gravity or Pump Method: The solution may be delivered via gravity flow or controlled pressure through an irrigation pump, depending on the procedure requirements.
• Flow Control: Adjust the flow rate as per surgeon’s requirements to maintain clear visual fields during the operation.
• Monitoring: Carefully monitor the patient to avoid over-absorption, especially in prolonged procedures.

Following use, discard any unused portion of the solution. Do not reuse the container or any residual solution to prevent contamination.

Note: Only use in facilities equipped to monitor patient fluid balance and electrolyte levels, especially during prolonged endoscopic procedures.

Mode of Action 1.5% GLYCINE IRRIGATION SOLUTION USP

1.5% Glycine Irrigation Solution acts primarily as a mechanical cleansing agent rather than a pharmacological agent. Its clinical effectiveness lies in its unique chemical and physical properties suitable for use in urological surgeries, particularly during electrosurgical procedures.

• Non-Conductive Medium: Glycine does not conduct electricity, making it an ideal solution during procedures using electric current, such as TURP, minimizing the risk of current dispersion.
• Hypotonic Nature: The low osmolarity helps prevent tissue swelling while maintaining tissue integrity, reducing thermal injury risks during surgical cutting or coagulation.
• Transparency: Being colorless and clear, glycine solution ensures optimal visibility for the surgeon during the procedure.
• Gentle on Tissues: Glycine is a naturally occurring amino acid, metabolized mainly by the liver, minimizing systemic toxicity even when absorbed in small amounts.

Although the solution itself does not provide direct therapeutic effects, its use is integral to procedural safety and efficiency. Its compatibility with delicate tissues, coupled with non-conductive properties, significantly supports successful outcomes in minimally invasive surgeries.

1.5% GLYCINE IRRIGATION SOLUTION USP Interactions 1.5% GLYCINE IRRIGATION SOLUTION USP

Although 1.5% Glycine Irrigation Solution is not absorbed systemically in large amounts, its interactions can still have clinical significance, especially when absorption occurs during prolonged surgical procedures. Therefore, understanding potential interactions is crucial for patient safety.

• Diuretics: Patients on diuretics may be at risk of fluid and electrolyte imbalances if large volumes of glycine are absorbed. Monitor serum sodium and potassium levels.
• Antihypertensives: Overabsorption may result in dilutional hyponatremia, leading to hypotension, which can be exacerbated in patients on blood pressure-lowering drugs.
• General Anesthetics: Combined use during surgery may obscure symptoms of glycine toxicity such as visual disturbances or central nervous system depression.
• Nephrotoxic Agents: In patients with renal compromise, absorption of excess glycine may not be effectively cleared, increasing risk of toxicity.

Clinical Consideration: In rare cases, systemic absorption can lead to glycine encephalopathy or visual impairment. Hence, fluid input and output should be carefully monitored intraoperatively.

Overall, while drug interactions are minimal due to the solution’s local action, clinicians must remain vigilant of systemic changes, particularly during longer procedures or when large volumes are used.

Dosage of 1.5% GLYCINE IRRIGATION SOLUTION USP

1.5% Glycine Irrigation Solution does not have a “dose” in the conventional pharmacological sense, as it is not absorbed for systemic action. Instead, its use is based on clinical need during procedures. However, careful control of volume and exposure time is vital.

• Typical Volume: Varies based on the procedure; urologic procedures may require several liters for adequate irrigation.
• Administration Rate: Controlled via gravity or electronic pump to provide continuous flow for clear visualization during surgery.
• Duration: Used as long as necessary during the surgical procedure, but total exposure should be minimized to reduce the risk of systemic absorption.
• Monitoring: Track fluid input/output meticulously, especially during longer procedures to avoid fluid overload and electrolyte disturbances.

Professional Use Only: This product must be administered under sterile conditions in a hospital or surgical setting by trained healthcare professionals.

Important: Discontinue use immediately upon detection of adverse reactions or systemic signs of absorption.

Possible side effects of 1.5% GLYCINE IRRIGATION SOLUTION USP

While generally safe when used appropriately, 1.5% Glycine Irrigation Solution can cause side effects, particularly if significant volumes are absorbed systemically. Awareness of these risks is critical during extended procedures like TURP.

• Fluid Overload: Excessive absorption may cause volume expansion, leading to pulmonary edema or congestive heart failure in vulnerable patients.
• Electrolyte Imbalance: Dilutional hyponatremia may occur, leading to confusion, seizures, or coma.
• Visual Disturbances: Glycine is involved in retinal neurotransmission, and its accumulation may cause transient blindness or blurred vision.
• Nausea and Vomiting: Gastrointestinal symptoms may arise in response to systemic glycine absorption.
• Encephalopathy: Rare cases of TURP syndrome have been linked to glycine absorption, with symptoms such as agitation, hypotension, and cerebral edema.

Note: Most side effects are related to excessive exposure or improper monitoring. Proper use and surgical technique minimize these risks significantly.

1.5% GLYCINE IRRIGATION SOLUTION USP Contraindications 1.5% GLYCINE IRRIGATION SOLUTION USP

Although 1.5% Glycine Irrigation Solution is safe for most surgical applications, certain conditions may contraindicate its use. Evaluating patients for potential risk factors is crucial before administration.

• Hypersensitivity: Patients with known allergies to glycine or similar compounds should not receive this solution.
• Severe Renal Impairment: Patients with significant renal dysfunction may not effectively clear absorbed glycine, increasing toxicity risk.
• Congestive Heart Failure: Risk of fluid overload makes its use contraindicated unless strict monitoring is ensured.
• Electrolyte Imbalance: Patients with pre-existing hyponatremia or electrolyte disturbances are at increased risk of TURP syndrome.
• Non-Endoscopic Use: Not intended for intravenous or intraperitoneal use; inappropriate routes can lead to severe complications.

Clinical Judgment Required: Always assess the patient’s fluid balance, renal function, and cardiovascular status prior to use. Alternative solutions may be more appropriate in high-risk cases.

Storage of 1.5% GLYCINE IRRIGATION SOLUTION USP

Proper storage of 1.5% Glycine Irrigation Solution ensures its safety, sterility, and effectiveness at the point of use. Follow the manufacturer’s guidelines and institutional protocols for best results.

• Temperature: Store at controlled room temperature between 15°C and 30°C. Avoid exposure to extreme heat or freezing conditions.
• Light Protection: Keep the product in its original packaging to protect from direct light.
• Shelf Life: Refer to the expiry date printed on the label. Do not use if the date has passed.
• Packaging Integrity: Do not use if the plastic bag is damaged, discolored, or contains particulates.
• Single-Use Only: Once opened, the solution must be used immediately and not stored for future use.

Disposal: Discard any unused solution according to local biomedical waste disposal regulations to prevent contamination or misuse.