Blood-Ammonia Levels in Relation to Hepatic Coma and the Administration of Glutamic Acid

Ammonium Uptake by the Extremities and Brain in Hepatic Coma, 12

“…When steroids, acetazolamide (Diamox®g), analgesics or sedatives were given it is so indicated in the tables because some of these drugs have been used in the treatment of impending hepatic coma or have been implicated in its production. The patients studied received neither glutamic acid nor arginine which may lower blood NH4-N concentrations (20,(22)(23)(24)(25). Neomycin and tetracycline antibiotics also may lower blood NH4-N concentrations in some patients with hepatic disease (26).…”

The Effect of Sodium Glutamate on Hepatic Coma 12

“…Walshe first used glutamic acid in the treatment of hepatic coma with encouraging results (9). Other investigators have since reported variable findings (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). This paper evaluates the effect of intravenous sodium glutamate administered to eleven patients with cirrhosis of the liver.…”

Biochemical Observations on the Use of L-Glutamic Acid in the Treatment of Hepatic Coma

“…Bessman (26) believes that this reasoning is incorrect because the kidney deaminates glutamine so rapidly that it cannot accumulate in the blood. However, a lack of increase in glutamine after glutamic acid administration was also demonstrated by Walshe (7) and Singh, Barclay, and Cooke (12).…”

“…Walshe (6) reported in 1953 the successful treatment of hepatic coma with large amounts of 1-glutamic acid. Although beneficial results have been reported with glutamic acid by some investigators (7)(8)(9)(10)(11), in contrast, no benefit has been observed from this treatment by others (12)(13)(14). However, independent of the clinical result the blood ammonia decreases with glutamic acid therapy (7,12,14).…”