Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid Pharmacology

Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid

About Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Mechanism of Action of Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Pharmacokinets of Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Onset of Action for Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Duration of Action for Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Half Life of Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Side Effects of Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Contra-indications of Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Special Precautions while taking Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Interactions for Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Typical Dosage for Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Schedule of Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Storage Requirements for Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Effects of Missed Dosage of Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Effects of Overdose of Vitamin C + Vitamin E + Zinc + Selenium + Vit B6 + Folic Acid
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Vitamin C

About Vitamin C
Water soluble vitamin, antioxidant.
Mechanism of Action of Vitamin C
Vitamin C exerts it`s action by influencing the biologic oxidations and reductions used in cellular respirations. It directly stimulates collagen synthesis and maintains intracellular connective tissue. It involves in various metabolic reactions such as 1).Hydroxylation of praline and lysine residues of protocollagen which is essential for formation and stabilization of collagen triple helix, 2).hydroxylation of carnitine, 3).Conversion of folic acid to folinic acid, 4).biosynthesis of adrenal steroids, catecholamines, oxytocin, and ADH, 5).Metabolism of cyclic nucleotides and prostaglandins. Vitamin C is important in resistance to infections.
Pharmacokinets of Vitamin C
Absorption: Well absorbed orally.
Distribution: Widely distributed both extracellularly and intracellularly, It crosses the placenta and also distributed in to the breast milk.
Metabolism: Metabolized in the liver; partly oxidized in to active dehydroascorbic acid and inactive metabolites.
Excretion: Inactive metabolites and extra drug is excreted through urine.
Onset of Action for Vitamin C
N/A
Duration of Action for Vitamin C
N/A
Half Life of Vitamin C
N/A
Side Effects of Vitamin C
1. Discomfort at injection site
2. Acid urine
3. Renal calculi
4. Oxaluria
Contra-indications of Vitamin C
No known contraindications
Special Precautions while taking Vitamin C
1. Renal impairment
2. Ingestion of large doses during pregnancy has resulted in scurvy in neonates
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
May be used
Indications for Vitamin C
1. Scurvy
2. Prophylaxis and treatment of vitamin C deficiency
3. As an antioxidant to maintain natural colour and flavour of food items
4. For acidification of urine
5. Capillary fragility
6. Dental caries

Interactions for Vitamin C
Oral contraceptives and estrogens: Vitamin C increases serum levels of oestrogen resulting in adverse reactions .
Warfarin: The anticoagulant effects of warfarin is reduced.
Lab Tests: Large doses (>500 mg) of vitamin C may cause false negative urine glucose determinations. May result in false negative amine dependent stool occult blood tests.
Typical Dosage for Vitamin C
Oral:
Adults: 50 to 1000mg/day depending up on the requirement.
Pregnancy and lactation: 100 to 150mg/day
Children: 30 to 100mg/day.
Scurvy:
Oral:
Adults: 1000mg twice daily to thrice daily.
Children: 300mg to 1000mg daily.
Sub clinical scurvy:
Oral, S.C., I.M., or I.V.: 100 to 250mg once daily or twice daily depending up on the severity of the condition. Then give a maintenance dosage of 50mg/day.
Children: 100 to 300mg depending up on the severity. Then give a maintenance dose of 35mg/day.

Schedule of Vitamin C
C1 (Oral)
C (Parenteral)
Storage Requirements for Vitamin C
Store in a cool dry area in a well closed container. Protects from moisture, light and direct heat.
Effects of Missed Dosage of Vitamin C
Take 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 Vitamin C
Discontinue the therapy and provide symptomatic and supportive measures.

Vitamin E

About Vitamin E
N/A
Mechanism of Action of Vitamin E
Vitamin E acts as an antioxidant and protecting unsaturated lipids in the cell membrane, coenzyme Q, vitamin A, vitamin C etc. from free radical oxidation damage and generation of toxic peroxidation products. It also decreases platelet aggregation.
Pharmacokinets of Vitamin E
Absorption: Absorbed through lymph with the help of bile. Only 20 to 60% of vitamin from dietary sources is absorbed. As dose increases the fraction absorbed decreases.
Distribution: Widely distributed in a protein bound form and stored in adipose tissue.
Metabolism: Metabolized in liver by glucuronide conjugation.
Excretion: Excreted mainly through bile and also excreted through urine.
Onset of Action for Vitamin E
N/A
Duration of Action for Vitamin E
N/A
Half Life of Vitamin E
N/A
Side Effects of Vitamin E
1. Fatigue
2. Weakness
3. Headache
4. Nausea
5. Diarrhoea
6. Blurred vision
7. Flatulence


Contra-indications of Vitamin E
1. Hypersensitivity to the drug
2. Should not administer intravenously
Special Precautions while taking Vitamin E
1. Hepatic impairment
2. Gall bladder disease
3. Along with estrogens
Pregnancy Related Information
May be used
Old Age Related Information
N/A
Breast Feeding Related Information
May be used
Children Related Information
N/A
Indications for Vitamin E
1. Vitamin E deficiency
2. Intermittent claudication
3. Nocturnal muscle cramps
4. Coronary artery disease
5. Fibrocystic breast disease
6. Cystic fibrosis
7. In premature infants exposed to high concentration of oxygen
8. As antioxidant


Interactions for Vitamin E
Oral anticoagulants : Hypoprothrombinemic effect may be increased with possibility of bleeding.

Typical Dosage for Vitamin E
Oral:
Vitamin E deficiency:
Adults: 40 to 50mg/day or 60 to 75i.u. daily based on the severity of deficiency.
Children: 1 unit/kg/day.
Premature neonates: 5units daily.
Full term neonates: 5 units per liter of formula.
Intermittent claudication: 400mg/day for 12 to 18 weeks.
Nocturnal muscle cramps: 400mg/day for 8 to 12 weeks.
Coronary artery disease: 100 to 200mg/day for at least 2 years.
Fibrocystic breast disease: 600mg/day for at least 2years.
Cystic fibrosis: 100 to 200mg/day.
Children above 1 year: 100mg/day.
Children below 1year: 50mg/day.



Schedule of Vitamin E
C1
Storage Requirements for Vitamin E
Store in a well closed container in a cool dry place. Protect from light.
Effects of Missed Dosage of Vitamin E
Take 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 Vitamin E
Provide supportive measures and symptomatic treatment.

Zinc

About Zinc
Trance metal, Dietary mineral, Nutritional supplement,Treatment of zinc deficiency,in wound healing.
Mechanism of Action of Zinc
Zinc 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 Zinc
Absorption: 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 Zinc
N/A
Duration of Action for Zinc
N/A
Half Life of Zinc
N/A
Side Effects of Zinc
1. Nausea
2. Vomiting
3. Abdominal distress
4. Gastric ulceration
5. Rashes
Contra-indications of Zinc
N/A
Special Precautions while taking Zinc
1.Don`t exceed prescribed dose
2.Renal failure
3.Biliary obstruction

Pregnancy Related Information
Use with caution
Old Age Related Information
N/A
Breast Feeding Related Information
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Children Related Information
N/A
Indications for Zinc
1. Zinc deficiency
2. Acne vulgaris
3. Chronic skin ulcers
4. Adjunct to antimicrobials
5. Delayed wound healing
6. Alopecia
Interactions for Zinc
Fluoroquinolones, 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 Zinc
Adults: 25 to 50mg zinc daily or 1 to 2 tablets daily.
Children: 5mg/kg 1 to 3 times daily.
Schedule of Zinc
N/A
Storage Requirements for Zinc
Store at a temperature below 30 degree C
Effects of Missed Dosage of Zinc
Take 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 Zinc
Provide symptomatic treatment and supportive measures

Selenium

About Selenium
A vital antioxidant, selenium acts with vitamin E to protect the immune system and maintain healthy heart function. It is needed for pancreatic function and tissue elasticity and has been shown to protect against radiation and toxic minerals. High levels of heart disease are associated with selenium-deficient soil in Finland and a tendency to fibrotic heart lesions is associated with selenium deficiency in parts of China. Best sources are butter, Brazil nuts, seafood and grains grown in selenium-rich soil.
Mechanism of Action of Selenium
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Pharmacokinets of Selenium
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Onset of Action for Selenium
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Duration of Action for Selenium
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Half Life of Selenium
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Side Effects of Selenium
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Contra-indications of Selenium
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Special Precautions while taking Selenium
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Selenium
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Interactions for Selenium
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Typical Dosage for Selenium
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Schedule of Selenium
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Storage Requirements for Selenium
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Effects of Missed Dosage of Selenium
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Effects of Overdose of Selenium
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Vit B6

About Vit B6
Physiological functions: It is involved as a coenzyme (Pyridoxal phosphate) in metabolism of tryptophan, in several metabolic transformations of amino acids including transamination, decarboxylation & racemization.
Deficiency symptoms: Peripheral neuritis, seizures, stomatitis, glossitis, anaemia, seborrhea like lesions.
Mechanism of Action of Vit B6
Vitamin B6 is a collective term for Pyridoxine, Pyridoxal, Pyridoxamine and their phosphorylated derivatives such as Pyridoxine phosphate, Pyridoxal phosphate and Pyridoxamine derivatives respectively. Vitamin B6 is essential for the metabolism of amino acid, glycogen and fatty acids, for nerve functions, for the formation of red blood cells and also helps the skin healthy. Vitamin B6 is also used for the synthesis of nucleic acid, Haemoglobin, Sphingomyelin, other Sphingolipids, Serotonin, Dopamine, Noradrenaline and GABA.
Pharmacokinets of Vit B6
Absorption: Vitamin B6 is readily absorbed after oral administration.
Distribution: It is mainly distributed in the body in protein bound form. It is stored primarily in the liver and to a lesser extent muscle and brain.
Metabolism: It is metabolised in the liver
Onset of Action for Vit B6
N/A
Duration of Action for Vit B6
N/A
Half Life of Vit B6
15-20 days
Side Effects of Vit B6
1. Neuropathy
2. Unstable gait
3. Drowsiness
4. Perioral numbness
5. Paresthesia
6. Numbness of feet
7. Somnolence
8. Sensory neuropathy
9. Ataxia
Contra-indications of Vit B6
1. Hypersensitivity to Vitamin B6
Special Precautions while taking Vit B6
N/A
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
NEONATES: Contraindicated
Indications for Vit B6
1. Vitamin B6 deficiency including inadequate diet and drug induced causes
2. Neuropathy
3. Premenstrual syndrome
4. Hyperoxaluria type 1
5. Metabolic disorder
6. Isoniazid poisoning
Interactions for Vit B6
Cycloserine, Hydralazine, Isoniazide, Oral contraceptive, Penicillamine: Increase Pyridoxine requirement.
Levodopa: Pyridoxine reverses the therapeutic effect of Levodopa.
Phenobarbital, Phenytoin: Pyridoxine decreases serum level of these anticonvulsants.
Typical Dosage for Vit B6
Adult: 10 - 20 mg / day
Dietary deficiency: 2.5 -10 mg / day for effective therapeutic response is obtained.
Maintenance dose: 2 - 5 mg / day for several weeks.
Drug induced deficiency: 100 - 200 mg / day for 3 weeks.
Maintenance dose: 25 - 100 mg / day
Neuropathy: 50 - 200 mg /day
Premenstrual syndrome: 40 - 500 mg / day
Hyperoxaluria type 1: 25 - 300 mg / day
Metabolic disorder: 100-500 mg /day.
Isoniazid poisoning: Initial dose: 1 - 4 g as IV administration, then 1 g IM every 30 minute until Pyridoxine dose is equal to the Isoniazid dose has been given.
Schedule of Vit B6
N/A
Storage Requirements for Vit B6
Store it at 15 - 30 degree C. Protect from moisture and heat.
Effects of Missed Dosage of Vit B6
Take 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 Vit B6
Give supportive measures and symptomatic treatment. The signs of Pyridoxine overdose can be resolved by discontinuation (withdrawal) of Pyridoxine.

Folic Acid

About Folic Acid
Dietary supplement, Folate derivative( B9 ), Water Soluble Vitamin.
Mechanism of Action of Folic Acid
Folic acid reduced by enzymes folate reductase and dihydrofolate reductase and forms dihydrofolic acid tetrahydrofolic acid respectively. Tetrahydrofolic acid acts as a coenzyme which mediates a number of one carbon transfer reactions by carrying a methyl group as an adduct. It involves a number of reactions such as 1).conversion of homocysteine to methionine. 2).synthesis of thymidylate which is an essential constituent of DNA from methylene-tetrahydrofolic acid. 3). Conversion of serine to glycine by tetrahydrofolic acid and forms methylene-tetrahydrofolic acid. 4).to introduce carbon units at position 2 and 8 during de novo purine synthesis requires formyl-tetrahydrofolic acid and methenyl-tetrahydrofolic acid.5).generation and utilization of "formate pool". 6).For mediating formino group transfer in histidine metabolism. Folic acid is required to maintain normal erythropoiesis and nucleoprotein synthesis.
Pharmacokinets of Folic Acid
Absorption: Well absorbed orally
Distribution: Widely distributed in the body and highest concentration is seen in liver. It appears in the CSF and breast milk
Metabolism: Metabolized in to N-methyl tetrahydrofolic acid in liver
Excretion: Extra drug is excreted unchanged in urine. A small portion of folate is lost by a combination of urinary and fecal excretion and oxidative cleavage of molecule.
Onset of Action for Folic Acid
Oral: 20 to 30minutes
I.V.: 5 minutes
I.M.:10 to 20minutes
Duration of Action for Folic Acid
Oral: 3 to 6 hours
I.V.:3 to 6minutes
I.M.:3 to 6hours
Half Life of Folic Acid
N/A
Side Effects of Folic Acid
N/A
Contra-indications of Folic Acid
N/A
Special Precautions while taking Folic Acid
1. In patients with undiagnosed anaemia; because it may mask pernicious anaemia
2. In pernicious anaemia and other megaloblastic where vitamin B12 is deficient
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
May be used
Children Related Information
May be used
Indications for Folic Acid
1. Megaloblastic anaemia
2. Folic acid deficiency
3. Anaemias of pregnancy
4. Nutritional anaemia
5. Alcoholism
6. Tropical sprue
7. Non tropical sprue
Interactions for Folic Acid
1. Hypersensitivity reactions with injection form
2. Bronchospasm
Typical Dosage for Folic Acid
Oral: 5mg 1 to 4 times daily; depending up on the severity of deficiency.
Maintenance dosage: Half of the therapeutic dosage.
Children: 2.5 to 5mg 1 to 2 times daily.
Schedule of Folic Acid
C1 (Oral)
C (Parenteral)
Storage Requirements for Folic Acid
Store at controlled room temperature at a range of 15 to 25 degree C in a well closed container. Protect from excess heat, light and moisture.
Effects of Missed Dosage of Folic Acid
Take 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 Folic Acid
Relatively non toxic. Provide symptomatic treatment and supportive measures.

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