glutamine + metoclopramide + selenium + zinc

This is a combination therapy consisting of four active ingredients: - **Glutamine** (specifically L-glutamine): a non-essential amino acid important for intestinal health, immune function, and as a precursor for protein synthesis. It helps maintain the integrity of the gut barrier and supports immune cell function. - **Metoclopramide**: a dopamine D2 receptor antagonist used primarily as an antiemetic and prokinetic agent. It increases gastrointestinal motility and is also known to reverse hypoprolactinemia by antagonizing dopamine receptors. - **Selenium**: an essential trace element with antioxidant properties, incorporated into selenoproteins that protect cells from oxidative damage and support immune function. - **Zinc**: another essential trace element involved in numerous enzymatic reactions, supporting growth, wound healing, immunity, and maintaining skin hydration. This specific combination has been studied in critically ill pediatric populations to prevent stress-induced immune suppression (CRISIS) associated with nosocomial infections or sepsis. The rationale is that supplementation with zinc, selenium, glutamine (enterally), plus parenteral metoclopramide may help restore or maintain immune competence during critical illness[1][2][3]. However, clinical trials have not demonstrated significant reductions in mortality or late-onset sepsis with this regimen[3].