Glycine

(rINN)
Glycine Chemical formula
Synonyms: Acidum Aminoaceticum; Aminoacetic Acid; Aminoättiksyra; Aminoetikkahappo; E640 (glycine or glycine sodium); G; Glicin; Glicina; Glicinas; Glicyna; Gly; Glycin; Glycinum; Glycocoll; Glysiini; Sucre de Gélatine.
Cyrillic synonym: Глицин.

💊 Chemical information

Chemical formula: C2H5NO2 = 75.07.
CAS — 56-40-6.
ATC — B05CX03.
ATC Vet — QB05CX03.

Pharmacopoeias.

In Chin., Eur., Jpn, and US.

Ph. Eur. 6.2

(Glycine). A white or almost white crystalline powder. It exhibits polymorphism. Freely soluble in water; very slightly soluble in alcohol. A 5% solution in water has a pH of 5.9 to 6.4.

USP 31

(Glycine). A white, odourless crystalline powder. Soluble 1 in 4 of water at 25°, 1 in 2.6 at 50°, 1 in 1.9 at 75°, and 1 in 1.5 at 100°; soluble 1 in 1254 of alcohol; very slightly soluble in ether. Its solutions are acid to litmus.

💊 Adverse Effects and Precautions

Systemic absorption of glycine irrigation solutions can lead to disturbances of fluid and electrolyte balance and cardiovascular and pulmonary disorders (see below). Glycine irrigation should be used cautiously in patients with hepatic impairment since any absorption and consequent metabolism may cause hyperammonaemia. The possible effects on fluid and electrolyte balance warrant cautious use in patients with cardiopulmonary or renal dysfunction; glycine irrigation is contraindicated in anuric patients.

Systemic absorption.

Absorption of glycine irrigation solution during surgical procedures can cause disturbances of the circulatory and nervous systems.1-3 Often seen after transurethral resection of the prostate, these symptoms and signs have been referred to as the transurethral resection syndrome,1 although they have also been described after other urological or gynaecological surgical procedures.4,5 Hyponatraemia and glycine toxicity are thought to be responsible for the clinical manifestations.1,2,5 Symptoms and signs include chest pains, hypertension, hypotension, bradycardia, anuria, dyspnoea, nausea, vomiting, restlessness, confusion, apprehension, irritability, headache, and seizures.1,3-5 Chills, diarrhoea, and abdominal pain have also been reported,1 as have visual disturbances and blindness.3,6 Myocardial infarction,7,8 coma, and death may occur.5,7 Absorption may occur rapidly, through the intravascular route, or, more rarely, slowly via extravascular absorption.1,2,4 Extravasation should be suspected when abdominal pain and swelling are apparent.4,9 Ethanol has been added to the irrigation fluid, and ethanol breath tests performed regularly during procedures in order to detect and monitor absorption.1,2,4,9 However, the syndrome has still occurred despite monitoring;9 awareness of the pattern of ethanol changes and clinical symptoms associated with extravascular as well as intravascular absorption are considered essential.4,9
1. Olsson J, et al. Symptoms of the transurethral resection syndrome using glycine as the irrigant. J Urol (Baltimore) 1995; 154: 123–8
2. Tauzin-Fin P. Complication des liquides d’irrigation à base de glycocolle: le syndrome de résorption. Therapie 2002; 57: 48–54
3. Radziwill AJ, et al. Visual disturbances and transurethral resection of the prostate: the TURP syndrome. Eur Neurol 1997; 38: 7–9
4. Hahn RG. Transurethral resection syndrome after transurethral resection of bladder tumours. Can J Anaesth 1995; 42: 69–72
5. Siddiqui MA, et al. Glycine irrigant absorption syndrome following cystoscopy. Clin Nephrol 1996; 45: 365–6
6. Karci A, Erkin Y. Transient blindness following hysteroscopy. J Int Med Res 2003; 31: 152–5
7. Byard RW, et al. Glycine toxicity and unexpected intra-operative death. J Forensic Sci 2001; 46: 1244–6
8. Hahn RG, Persson P-G. Acute myocardial infarction after prostatectomy. Lancet 1996; 347: 335
9. Hahn RG. Life-threatening transurethral resection syndrome despite monitoring of fluid absorption with ethanol. Eur J Anaesthesiol 1995; 12: 431–3.

💊 Uses and Administration

Glycine is a non-essential aliphatic amino acid. It is used as a dietary supplement. Glycine is sometimes used with antacids in the treatment of gastric hyperacidity. It is also used as an ingredient of some aspirin preparations with the object of reducing gastric irritation. Sterile solutions of glycine 1.5% in water, which are hypotonic and non-conductive, are used as urogenital irrigation solutions during certain surgical procedures, particularly transurethral resection of the prostate. Glycine hydrochloride has also been used.

💊 Preparations

BP 2008: Glycine Irrigation Solution; USP 31: Glycine Irrigation.

Proprietary Preparations

Fr.: Derm Hydralin; Gyn-Hydralin; Hong Kong: Gyn-Hydralin; Mex.: Glisuret†. Multi-ingredient: Arg.: Normoprost Compuesto; Austral.: Cal Alkyline; Austria: Centramin; Braz.: B-Vesil; Chile: Dolotol 12; Fr.: Cristopal†; Derm’Intim; Item Alphazole; Phakan†; Pruriced; India: Cotaryl; Ital.: Detoxicon; Digestivo Antonetto; Mex.: Segel†; Port.: Phakan†; Rus.: Eltacin (Элтацин); Spain: Sanieb†; Tebetane Compuesto; Switz.: DAM Antacidum; Phakolen†. Used as an adjunct in: Austral.: Cardiprin; Disprin Direct; Cz.: Godasal; Ger.: Godamed; Praecineural; Hong Kong: Cardiprin; Glyprin; Indon.: Contrexyn; Inzana; Minigrip; Israel: Lysoprin†; Ital.: Aspiglicina; Geyfritz†; Malaysia: Cardiprin; Glyprin; NZ: Cardiprin†; Pol.: Alka-Prim; Asprocol; Singapore: Cardiprin; Glyprin; Thai.: Caparin; Cardiprin.
Published January 01, 2019.