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Calcium + Alfacalcidol + Zinc Pharmacology
Calcium + Alfacalcidol + ZincAbout Calcium + Alfacalcidol + ZincN/AMechanism of Action of Calcium + Alfacalcidol + ZincN/APharmacokinets of Calcium + Alfacalcidol + ZincN/AOnset of Action for Calcium + Alfacalcidol + ZincN/ADuration of Action for Calcium + Alfacalcidol + ZincN/AHalf Life of Calcium + Alfacalcidol + ZincN/ASide Effects of Calcium + Alfacalcidol + ZincN/AContra-indications of Calcium + Alfacalcidol + ZincN/ASpecial Precautions while taking Calcium + Alfacalcidol + ZincN/APregnancy Related InformationUse with cautionOld Age Related InformationN/ABreast Feeding Related InformationUse with cautionChildren Related InformationN/AIndications for Calcium + Alfacalcidol + Zinc1.Osteoporosis
Interactions for Calcium + Alfacalcidol + ZincN/ATypical Dosage for Calcium + Alfacalcidol + Zinc2 capsule / daySchedule of Calcium + Alfacalcidol + ZincN/AStorage Requirements for Calcium + Alfacalcidol + ZincN/AEffects of Missed Dosage of Calcium + Alfacalcidol + ZincN/AEffects of Overdose of Calcium + Alfacalcidol + ZincN/A
CalciumAbout CalciumCalcium is necessary for cardiac function, muscle contraction, nervous activity, coagulation of blood and for maintaining structural integrity of cell membranes.
Plasma concentration of calcium is kept in normal range by three endocrine factors which control metabolism of calcium. These are (a) Parathyroid hormone, (b) Calcitonin, (c) Vitamin D. Calcium in plasma is bound to albumin, is complexed with anions (e.g. phosphate) and as diffusible ionic calcium. The physiological effects are exerted by ionic calcium. The predominant source of calcium is dairy products and the daily intake varies from 200 - 2500 mg. Adequate calcium intake is particularly important during periods of bone growth in childhood and adolescence and during pregnancy and lactation.
Patients with advanced renal insufficiency exhibit phosphate retention and some degree of hyperphosphataemia. The retention of phosphate plays a pivotal role in causing secondary hyperparathyroidism associated with osteodystrophy and soft tissue calcification. Calcium acetate, when taken with meals, combines with dietary phosphate to form insoluble calcium phosphate which is excreted in the faeces.
Deficiency signs and symptoms: Osteoporosis, pathological fractures, brittle nails and hair.Mechanism of Action of CalciumCalcium is essential for maintaining the functional integrity of nervous, muscular, and skeletal system. It controls excitability of nerves and muscles and regulates permeability of cell membrane. It also regulates cell adhesion and maintains integrity of cell membrane. Calcium acts as intracellular messenger for hormones, autacoids, and transmitters. It is required for excitation-contraction coupling in all types of muscle and excitation-secretion coupling in exocrine and endocrine glands. It is essential for release of transmitters from nerve endings and other release reactions. It is also essential for impulse generation in heart and determines level of automaticity and
A-V conduction. Calcium is also required for blood-coagulation.
Pharmacokinets of CalciumAbsorption: Actively absorbed from gastrointestinal tract in an ionized form; and vitamin D in it`s active form is required for calcium absorption, Distribution: Distributed mainly in to skeletal tissue (99%) and 1% is distributed equally between the intracellular and extra cellular fluid. CSF levels are about half of the serum calcium levels, Metabolism: Not significantly metabolized in the body, Excretion: Excreted mainly through faeces and a small amount is excreted through urine.Onset of Action for CalciumN/ADuration of Action for CalciumN/AHalf Life of CalciumN/ASide Effects of Calcium1.Constipation
Contra-indications of Calcium1.Renal calculi
Special Precautions while taking Calcium1.Renal impairment
7.End stage renal failure
10.Prolonged use of therapeutic amounts.
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationMay be usedChildren Related InformationUse with cautionIndications for Calcium1.Hypocalcaemia
2.Calcium and vitamin D deficiency
3.Calcium deficiency during pregnancy and lactation
5.Prevention of osteoporosis in postmenopausal women
6.Chronic renal failure.
Interactions for CalciumN/ATypical Dosage for CalciumOral: 500mg to 2g daily in two to four divided doses.
Adults: 1g daily. Increases to 2g daily if required.
Prevention of osteoporosis: 1 to 1.5g daily.
Children: 45 to 65mg/kg daily.
Neonates: 50 to 150mg/kg and should not exceed 1g.
Schedule of CalciumN/AStorage Requirements for CalciumStore in a well closed container in a cool and dry place. Protect from light.
Effects of Missed Dosage of CalciumTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of CalciumRemove calcium from stomach by induced emesis and gastric lavage. Provide symptomatic treatment and supportive measures.
AlfacalcidolAbout AlfacalcidolNutritional supplement,Vitamin D derivative, Antihypoparathyroid, Antihypocalcemic.Mechanism of Action of AlfacalcidolAlfacalcidol is a prodrug of Vitamin D and is rapidly hydroxylated in the liver in to calcitriol. Vitamin D exerts it`s action by influencing calcium homoeostasis. It increases the intestinal absorption of calcium and phosphate. It binds to the cytoplasmic Vitamin D receptor and translocates to the nucleus and thus increases the synthesis of specific m RNA and regulates protein synthesis. It increases the synthesis of a carrier protein for calcium called "calbindin" or calcium binding protein. Activation of Vitamin D receptor enhances endocytotic capture of calcium and it`s transport across duodenal mucosal cells in a vesicular form. Vitamin D promotes resorption of calcium and phosphate from bone by enhancing recruitment and differentiation of osteoclast precursors in the bone remodeling units. It helps in bone mineralization.Pharmacokinets of AlfacalcidolAbsorption: Well absorbed orally, Distribution: Widely distributed in a protein bound form. It is stored in adipose tissue and liver. Metabolism: It is hydroxylated in to calcitriol in liver. Excretion: Excreted mainly through bile.
Onset of Action for AlfacalcidolN/ADuration of Action for AlfacalcidolN/AHalf Life of AlfacalcidolN/ASide Effects of Alfacalcidol1.Hypercalcaemia
9.Calcification of soft tissues (blood vessels, parenchymal organs including heart)
11.Growh retardation in children
Contra-indications of Alfacalcidol1.Hypercalcaemia
3.Hyperphosphataemia (except when occurring with hypoparathyroidism
Special Precautions while taking Alfacalcidol1 Renal impairment
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with cautionIndications for Alfacalcidol1.Rickets and Osteomalacia
2.Hypoparathyroidism with bone disease
Interactions for AlfacalcidolDigitallis preparations: Cardiac arrhythmias precipitated.
Thiazide Diuretics: Hypercalcaemic response enhanced.
Barbiturates & other enzyme inducing anticonvulsants: Reduce efficacy.
Minteral Oil: Prolonged use reduces efficacy.
Cholestyramine, Cholestipol, Sucralfate, Aluminium based Antacids: Reduced efficacy by decreasing absorption of alfacalcidol.
Magnesium based Antacids or Laxatives: Hypermagnesaemia in those on chronic renal dialysis.Typical Dosage for AlfacalcidolOral:
Starts with 1mcg daily. Adjusted based on patients response to 2mcg daily if required.
Children over 20kg: Starts with 1mcg daily. Adjusted based on patient`s response.
Children under 20kg: 0.5mcg daily or 0.05mcg/kg/day
Schedule of AlfacalcidolC1Storage Requirements for AlfacalcidolStore in a well closed container in a cool place. Protect from light and excess heat. Keep out of reach of children.Effects of Missed Dosage of AlfacalcidolTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of AlfacalcidolProvide supportive and symptomatic treatment. Stops the treatment and starting a low calcium diet. Increases the fluid intake and administer Loop diuretics like furosemide may be given with saline I.V. infusion to increase calcium excretion. Calcitonin may decrease hypercalcaemia.
ZincAbout ZincTrance metal, Dietary mineral, Nutritional supplement,Treatment of zinc deficiency,in wound healing.Mechanism of Action of ZincZinc acts as a cofactor for more than 70 different enzymes. Zinc dependent enzymes are involved in the metabolism of carbohydrates, lipids, and proteins. Zinc facilitates wound healing, normal growth rates, normal skin hydration and maintains senses of taste and smell. It provides normal growth and tissue repair. It also helps in development of cell mediated immunity.Pharmacokinets of ZincAbsorption: Poorly absorbed orally, Distribution: Zinc is distributed mainly in to skeletal muscle, skin, bone, pancreas, kidney, liver, retina, prostate, RBC, and WBC. Excretion: Excreted mainly through intestine; only 2% loss in the urine.Onset of Action for ZincN/ADuration of Action for ZincN/AHalf Life of ZincN/ASide Effects of Zinc1. Nausea
3. Abdominal distress
4. Gastric ulceration
Contra-indications of ZincN/ASpecial Precautions while taking Zinc1.Don`t exceed prescribed dose
Pregnancy Related InformationUse with cautionOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Zinc1. Zinc deficiency
2. Acne vulgaris
3. Chronic skin ulcers
4. Adjunct to antimicrobials
5. Delayed wound healing
Interactions for ZincFluoroquinolones, Tetracyclines: Decreased GI absorption and serum levels of some fluoroquinolone.
Pencillamine: Reduced absorption of zinc.
Iron: Reduced absorption of iron and vice versa.
Typical Dosage for ZincAdults: 25 to 50mg zinc daily or 1 to 2 tablets daily.
Children: 5mg/kg 1 to 3 times daily.
Schedule of ZincN/AStorage Requirements for ZincStore at a temperature below 30 degree CEffects of Missed Dosage of ZincTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of ZincProvide symptomatic treatment and supportive measures
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