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May 1958

Effect of Arginine and Glutamate on Tolerance to Intravenously Administered Ammonium Chloride

AMA Arch Surg. 1958;76(5):766-768. doi:10.1001/archsurg.1958.01280230106016

The intravenous administration of ammonium chloride is sometimes used in the treatment of patients with severe alkalosis. It has been suggested that the toxic reactions occasionally encountered when ammonium chloride is administered may be due to ammonia intoxication.1-3 It is possible, therefore, that the toxicity of ammonium chloride solutions may be prevented if the increase in the blood ammonia that follows their administration can be controlled.

In various clinical states in which ammonia intoxication is a pathogenic factor, glutamic acid has been used to lower the blood ammonia.4,5 This amino acid may lower the blood ammonia by forming glutamine, a reaction in which one mol of ammonia is utilized per mol of glutamine formed. Urea formation is quantitatively a more important metabolic route for disposal of ammonia than is glutamine formation. Urea production and a consequent lowering of the blood ammonia can be enhanced by the intravenous administration