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- Pharmacology For Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid
Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic Acid Pharmacology
Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidAbout Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/AMechanism of Action of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/APharmacokinets of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/AOnset of Action for Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/ADuration of Action for Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/AHalf Life of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/ASide Effects of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/AContra-indications of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/ASpecial Precautions while taking Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/APregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with cautionIndications for Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/AInteractions for Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/ATypical Dosage for Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/ASchedule of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/AStorage Requirements for Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/AEffects of Missed Dosage of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/AEffects of Overdose of Thyroxine + Vitamin E + Vit B1 + Vit B2 + Vit B6 + Folic AcidN/A
ThyroxineAbout ThyroxineThyroid hormone, Replacement or supplemental therapy in hypothyroidism.
Mechanism of Action of ThyroxineThyroid hormones; Thyroxine (T4) and Triiodothyronine (T3) exert the therapeutic action by regulating protein synthesis. T4 and T3 enter the cells and combine with nuclear receptor. T3 receptor complex binds to specific DNA sequence called "thyroid hormone response elements" present in the regulatory region of specific genes and causes derepression of gene transcription or direct activation of gene transcription. Thus causes expression of predetermined genetically coded pattern of protein synthesis. It causes induction of adenylyl cyclase and proliferation of ?-adrenoceptors and a better coupling of these two. It regulate growth, development, improves carbohydrate utilization and BMR.
Pharmacokinets of ThyroxineAbsorption: Well absorbed orally, Distribution: Widely distributed in a protein bound form, Metabolism: Metabolized primarily in liver by deiodination, glucuronide and sulfate conjugation. Also metabolized in salivary glands and kidneys. Excretion: Excreted through faeces and urine.Onset of Action for ThyroxineN/ADuration of Action for ThyroxineN/AHalf Life of ThyroxineT4: 6 to 7days
T3: 1 to 2 days
Side Effects of Thyroxine1. Tachycardia
3. Increased BP
8. Cardiac arrest
13. Weight loss
14. Allergic reactions
20. Heat intolerance
22. Menstrual irregularities
Contra-indications of Thyroxine1. Hypersensitivity
3. Cardiac disease
4. Acute myocardial infarction
5. Adrenal insufficiency
Special Precautions while taking Thyroxine1. Angina pectoris
2. Coronary artery diseases
5. Renal impairment
6. ECG changes
7. In adrenal insufficiency give corticosteroid therapy prior to Thyroxine therapy
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with in cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with cautionIndications for Thyroxine1. Cretinism
4. Nontoxic goiter
5. Benign functioning thyroid nodule
6. Temporary regression of papillary carcinoma of thyroid
Interactions for ThyroxineN/ATypical Dosage for ThyroxineOral: Starts with 50 to 100mcg. Increased by increments of 25 to 50mcg at intervals of 3 to 4 weeks; as required by the patient.
Maximum daily dose: 0.15 to 0.3mg
Children: 25 to 150 mcg/day depending up on the requirement of the patient. Increased by increments of 25mcg every 2 to 4 weeks.
Children over 1year: Initially 2. to 5mcg/kg/day
Schedule of ThyroxineC1Storage Requirements for ThyroxineStore in a refrigeratorEffects of Missed Dosage of ThyroxineTake 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 ThyroxineTreatment is supportive and symptomatic. Remove drug from the body by gastric lavage and induced emesis. Administer activated charcoal to reduce absorption. If patient is in a coma state inflate cuff on endotrachaeal tube to prevent aspiration. Assist and support respiration if required. Take appropriate measures to control heart failure and control fever, hypoglycaemia and fluid loss. Propranolol or any other beta blocker may be used to correct increased sympathetic activity.
Vitamin EAbout Vitamin EN/AMechanism of Action of Vitamin EVitamin 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 EAbsorption: 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 EN/ADuration of Action for Vitamin EN/AHalf Life of Vitamin EN/ASide Effects of Vitamin E1. Fatigue
6. Blurred vision
Contra-indications of Vitamin E1. Hypersensitivity to the drug
2. Should not administer intravenously
Special Precautions while taking Vitamin E1. Hepatic impairment
2. Gall bladder disease
3. Along with estrogens
Pregnancy Related InformationMay be usedOld Age Related InformationN/ABreast Feeding Related InformationMay be usedChildren Related InformationN/AIndications for Vitamin E1. 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 EOral anticoagulants : Hypoprothrombinemic effect may be increased with possibility of bleeding.
Typical Dosage for Vitamin EOral:
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 EC1Storage Requirements for Vitamin EStore in a well closed container in a cool dry place. Protect from light.Effects of Missed Dosage of Vitamin ETake 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 EProvide supportive measures and symptomatic treatment.About N/AMechanism of Action of N/APharmacokinets of N/AOnset of Action for N/ADuration of Action for N/AHalf Life of N/ASide Effects of N/AContra-indications of N/ASpecial Precautions while taking N/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for N/AInteractions for N/ATypical Dosage for N/ASchedule of N/AStorage Requirements for N/AEffects of Missed Dosage of N/AEffects of Overdose of N/A
Vit B2About Vit B2N/AMechanism of Action of Vit B2Riboflavin exerts it`s action by influencing metabolic reactions. Riboflavin functions in the forms of flavin adenine dinucleotide (FAD), and flavin mononucleotide (FMN) which are coenzymes for flavoproteins involved in many oxidation-reduction reactions. Both FMN and FAD play a vital metabolic role in numerous tissue respiration systems. Riboflavin also directly involves in maintaining erythrocyte integrity.Pharmacokinets of Vit B2Absorption: Well absorbed orally; bioavailability increases when administer along with food.
Distribution: Widely distributed in the tissues and limited amount is stored in the liver, spleen, kidneys, and heart. It crosses the placenta and also secreted in to the breast milk.
Metabolism: Phosphorylated in the intestine, liver and other tissues to FMN and metabolized in to FAD the liver.
Excretion: Larger doses are excreted unchanged in urine.
Onset of Action for Vit B2N/ADuration of Action for Vit B2N/AHalf Life of Vit B266 to 84 minutesSide Effects of Vit B21. Bright yellow urine with higher dosesContra-indications of Vit B2No known contraindications.Special Precautions while taking Vit B2N/APregnancy Related InformationMay be usedOld Age Related InformationMay be usedBreast Feeding Related InformationMay be usedChildren Related InformationMay be usedIndications for Vit B21. Ariboflavinosis
9. Dermatitis of trunk and extremities
10. Other riboflavin deficiency symptoms
Interactions for Vit B2Oral contraceptive:Dose of Riboflavin may need to be increased
Propantheline Bromide:Delays absorption rate of Riboflavin
Typical Dosage for Vit B2Oral:
Adults: 20 to 40mg three times daily or depending up on the severity.
Children: 20mg daily.
Adults and children over 12 years: 5 to 30mg/day depending up on the severity .
Children (below 12years): 3 to 10mg/day depending up on the severity.
Schedule of Vit B2C1Storage Requirements for Vit B2Store in a well closed container; in a cool place and protect from light.Effects of Missed Dosage of Vit B2Take 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 doseEffects of Overdose of Vit B2Provide symptomatic treatment and supportive measures.
Vit B6About Vit B6Physiological 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 B6Vitamin 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 B6Absorption: 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 B6N/ADuration of Action for Vit B6N/AHalf Life of Vit B615-20 daysSide Effects of Vit B61. Neuropathy
2. Unstable gait
4. Perioral numbness
6. Numbness of feet
8. Sensory neuropathy
Contra-indications of Vit B61. Hypersensitivity to Vitamin B6Special Precautions while taking Vit B6N/APregnancy Related InformationMay be usedOld Age Related InformationMay be usedBreast Feeding Related InformationUse with cautionChildren Related InformationUse with caution
Indications for Vit B61. Vitamin B6 deficiency including inadequate diet and drug induced causes
3. Premenstrual syndrome
4. Hyperoxaluria type 1
5. Metabolic disorder
6. Isoniazid poisoning
Interactions for Vit B6Cycloserine, 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 B6Adult: 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 B6N/AStorage Requirements for Vit B6Store it at 15 - 30 degree C. Protect from moisture and heat.Effects of Missed Dosage of Vit B6Take 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 B6Give supportive measures and symptomatic treatment. The signs of Pyridoxine overdose can be resolved by discontinuation (withdrawal) of Pyridoxine.
Folic AcidAbout Folic AcidDietary supplement, Folate derivative( B9 ), Water Soluble Vitamin.Mechanism of Action of Folic AcidFolic 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 AcidAbsorption: 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 AcidOral: 20 to 30minutes
I.V.: 5 minutes
I.M.:10 to 20minutes
Duration of Action for Folic AcidOral: 3 to 6 hours
I.V.:3 to 6minutes
I.M.:3 to 6hours
Half Life of Folic AcidN/ASide Effects of Folic AcidN/AContra-indications of Folic AcidN/ASpecial Precautions while taking Folic Acid1. 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 InformationMay be usedOld Age Related InformationMay be usedBreast Feeding Related InformationMay be usedChildren Related InformationMay be usedIndications for Folic Acid1. Megaloblastic anaemia
2. Folic acid deficiency
3. Anaemias of pregnancy
4. Nutritional anaemia
6. Tropical sprue
7. Non tropical sprue
Interactions for Folic Acid1. Hypersensitivity reactions with injection form
Typical Dosage for Folic AcidOral: 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 AcidC1 (Oral)
Storage Requirements for Folic AcidStore 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 AcidTake 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 AcidRelatively non toxic. Provide symptomatic treatment and supportive measures.
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