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-electrolyte, aqueous solution primarily used for urological procedures that require bladder or urinary tract irrigation. It is presented in a 1000ml plastic bag and is intended exclusively for irrigation purposes—not for intravenous use.

• Generic name: Glycine 1.5% Irrigation Solution
• Form: Irrigation solution
• Concentration: 1.5% w/v (15 mg/mL)
• Container: 1000 ml plastic bag for single use

This solution is particularly useful in procedures such as transurethral resection of the prostate (TURP), where it provides clear visualization, lubricates the area, and flushes away blood or tissue fragments.

Glycine, being a non-conductive solution, is advantageous in surgeries involving electrocautery. Its hypoosmolar and non-hemolytic nature helps minimize patient risk compared to electrolyte-containing fluids. It is also less likely to cause fluid overload or electrolyte imbalances when used appropriately.

It is important to note that this solution is intended for irrigation only. Accidental intravenous administration can lead to severe complications such as glycine toxicity, electrolyte imbalance, or fluid overload.

How to use 1.5% GLYCINE IRRIGATION SOLUTION USP

1.5% Glycine Irrigation Solution should be used strictly under the guidance of a qualified healthcare professional, typically within surgical or diagnostic procedures requiring bladder or urological irrigation. It is not for parenteral (intravenous) administration.

• Route of Administration: Urologic irrigation only (via urological surgical instruments)
• Typical Use Cases: Procedures such as TURP, bladder irrigation post-operatively, or during diagnostic cystoscopy
• Container Use: Single-use plastic irrigation bag (1000ml); discard any unused portion

Steps for Proper Use:

1. Inspect the solution and container before use; ensure the solution is clear and the bag is intact.
2. Connect the solution bag to appropriate irrigation tubing using aseptic technique.
3. Regulate the flow rate as directed by the physician or surgical team depending on the procedure.
4. Maintain continuous flow during surgery to ensure a clear operative field and flush debris.
5. Monitor the patient closely for fluid absorption and systemic effects during prolonged use.

Healthcare providers must take care to avoid introducing the solution into the bloodstream, and regular monitoring of the patient’s vital signs and fluid balance is essential during extended procedures.

Mode of Action 1.5% GLYCINE IRRIGATION SOLUTION USP

Glycine 1.5% Irrigation Solution acts primarily as a mechanical flushing agent in surgical and diagnostic procedures of the genitourinary tract. It serves several essential roles:

• Provides irrigation: Facilitates visibility by flushing blood, tissue, and debris from the surgical site.
• Non-conductive medium: Supports the use of electrosurgical instruments without causing electrical conduction.
• Osmotic balance: Being a hypoosmolar solution, it reduces the risk of cellular damage and hemolysis.

Glycine's Physiological Action:

• Glycine is a naturally occurring, non-essential amino acid involved in protein synthesis and neurotransmission in the central nervous system.
• In the irrigation solution, it serves no pharmacological function but is included for its inert, non-electrolytic properties.

The mechanism of action in this context is largely physical rather than pharmacological. It offers a clear visual field, helps in maintaining tissue integrity, and ensures smooth instrument manipulation during endoscopic procedures. The solution is designed to be absorbed minimally; however, during prolonged procedures or in cases of mucosal damage, systemic absorption can occur, potentially leading to symptoms related to glycine toxicity or fluid overload.

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

Although 1.5% Glycine Irrigation Solution is used topically and not systemically, some interactions may arise due to inadvertent absorption during surgical procedures.

• With Diuretics: Use with loop diuretics like furosemide may increase the risk of fluid imbalance or electrolyte disturbances if systemic absorption occurs.
• With CNS Depressants: In patients already on sedatives or anesthetics, systemic glycine absorption may enhance central nervous system depression or neurotoxic symptoms (e.g., visual disturbances, confusion).
• Electrosurgery Devices: Glycine is a non-conductive medium, making it compatible with electrocautery. However, the volume and absorption must be monitored to avoid systemic overload.

Clinical Considerations:

• Monitor patients with cardiac or renal conditions for signs of fluid overload if large volumes are used.
• Use caution in patients with pre-existing electrolyte imbalances.

Though systemic interaction is rare, clinicians should remain vigilant, especially in long-duration procedures or when using large volumes of the solution. Inadvertent intravenous exposure or excessive absorption can result in symptoms resembling hyponatremia or glycine-induced encephalopathy.

Dosage of 1.5% GLYCINE IRRIGATION SOLUTION USP

Being an irrigation solution, 1.5% Glycine is not "dosed" in the traditional pharmacologic sense. Instead, the volume used depends on the specific procedure and patient response.

• Usual Volume Range: 1,000 mL to several liters per procedure, depending on duration and type of surgery
• Administration: Continuous irrigation through urologic surgical instruments

Important Considerations:

• Use only the amount necessary to maintain a clear visual field and remove debris during the procedure.
• Minimize dwell time of excess fluid within the bladder to reduce systemic absorption.
• Monitor patient fluid balance, especially in prolonged surgeries or when large volumes are used.

Overuse Concerns:

• Excessive absorption may lead to fluid overload or glycine toxicity.
• Signs include hypotension, bradycardia, nausea, blurred vision, or mental confusion.

Always tailor the volume used to the clinical situation. Strict adherence to surgical protocols and intraoperative monitoring is critical to ensure patient safety.

Possible side effects of 1.5% GLYCINE IRRIGATION SOLUTION USP

Although generally safe when used appropriately, systemic absorption of 1.5% Glycine Irrigation Solution during procedures may result in adverse effects. These are typically associated with fluid overload or glycine toxicity.

• Common Side Effects (from absorption):
• Headache
• Nausea or vomiting
• Dizziness or lightheadedness
• Serious Adverse Effects:
• Hyponatremia (dilutional)
• Seizures or loss of consciousness
• Cardiovascular instability (hypotension, bradycardia)
• Blurred or temporary loss of vision
• Pulmonary edema in case of fluid overload

Risk Factors:

• Prolonged surgeries with large volume use
• Mucosal damage or compromised urologic barriers
• Renal or cardiac impairment affecting fluid clearance

Prompt recognition and management of adverse effects are critical. In most cases, supportive care and discontinuation of the irrigation are sufficient. Always ensure close intraoperative monitoring.

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

There are specific situations where 1.5% Glycine Irrigation Solution should be avoided to prevent harm to the patient.

• Absolute Contraindications:
• Intravenous administration—never intended for systemic infusion
• Known hypersensitivity to glycine or any component of the solution
• Relative Contraindications (use with caution):
• Severe cardiac disease—risk of fluid overload
• Renal impairment—may delay clearance of absorbed fluid
• Electrolyte imbalances—especially hyponatremia

Healthcare providers must evaluate each patient’s medical history prior to use. In high-risk patients, close monitoring and alternative irrigation solutions may be preferred to minimize complications.

Storage of 1.5% GLYCINE IRRIGATION SOLUTION USP

Proper storage of 1.5% Glycine Irrigation Solution is essential to maintain sterility and efficacy.

• Temperature: Store at room temperature (15°C to 25°C)
• Avoid Freezing: Do not freeze the solution as it may compromise sterility and composition
• Protection from Light: Although not light-sensitive, store away from direct sunlight

Storage Guidelines:

• Keep the solution in its original plastic bag until ready to use
• Check for clarity and absence of particulates before use
• Do not use if the container is damaged or leaking
• Single-use only—discard any unused portion after opening

Proper handling and storage help prevent contamination and ensure the safety of patients undergoing irrigation procedures. Always follow institutional protocols and product labeling.