Calcium + Alfacalcidol + Beta Carotene Pharmacology

Calcium + Alfacalcidol + Beta Carotene

About Calcium + Alfacalcidol + Beta Carotene
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Mechanism of Action of Calcium + Alfacalcidol + Beta Carotene
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Pharmacokinets of Calcium + Alfacalcidol + Beta Carotene
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Onset of Action for Calcium + Alfacalcidol + Beta Carotene
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Duration of Action for Calcium + Alfacalcidol + Beta Carotene
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Half Life of Calcium + Alfacalcidol + Beta Carotene
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Side Effects of Calcium + Alfacalcidol + Beta Carotene
N/A
Contra-indications of Calcium + Alfacalcidol + Beta Carotene
N/A
Special Precautions while taking Calcium + Alfacalcidol + Beta Carotene
N/A
Pregnancy Related Information
Use with caution
Old Age Related Information
N/A
Breast Feeding Related Information
Use with caution
Children Related Information
N/A
Indications for Calcium + Alfacalcidol + Beta Carotene
1.Osteoporosis
2.Renal bone disease
3.Hypoparathyroidism
4.Rickets
5.Osteomalacia
Interactions for Calcium + Alfacalcidol + Beta Carotene
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Typical Dosage for Calcium + Alfacalcidol + Beta Carotene
2 capsule / day
Schedule of Calcium + Alfacalcidol + Beta Carotene
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Storage Requirements for Calcium + Alfacalcidol + Beta Carotene
N/A
Effects of Missed Dosage of Calcium + Alfacalcidol + Beta Carotene
N/A
Effects of Overdose of Calcium + Alfacalcidol + Beta Carotene
N/A

Calcium

About Calcium
Calcium 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 Calcium
Calcium 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 Calcium
Absorption: 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 Calcium
N/A
Duration of Action for Calcium
N/A
Half Life of Calcium
N/A
Side Effects of Calcium
1.Constipation
2.Bloating
3.Excess gas
4.Anorexia
5.Nausea
6.Vomiting
7.Abdominal pain
8.Thirst
9.Hypercalcaemia
10.Polyuria
11.Dry mouth
12.Delirium
13.Confusion
Contra-indications of Calcium
1.Renal calculi
2.Hypophosphataemia
3.Hypercalcaemia
4.Ventricular fibrillation.
Special Precautions while taking Calcium
1.Renal impairment
2.Cardiac diseases
3.Sarcoidosis
4.Cor pulmonale
5.Respiratory acidosis
6.Respiratory failure
7.End stage renal failure
8.Hypoparathyroid patients
9.Digitalized patients
10.Prolonged use of therapeutic amounts.
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
May be used
Children Related Information
Use with caution
Indications for Calcium
1.Hypocalcaemia
2.Calcium and vitamin D deficiency
3.Calcium deficiency during pregnancy and lactation
4.Rickets
5.Prevention of osteoporosis in postmenopausal women
6.Chronic renal failure.
Interactions for Calcium
N/A
Typical Dosage for Calcium
Oral: 500mg to 2g daily in two to four divided doses.
Hypocalcaemia:
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 Calcium
N/A
Storage Requirements for Calcium
Store in a well closed container in a cool and dry place. Protect from light.


Effects of Missed Dosage of Calcium
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 Calcium
Remove calcium from stomach by induced emesis and gastric lavage. Provide symptomatic treatment and supportive measures.

Alfacalcidol

About Alfacalcidol
Nutritional supplement,Vitamin D derivative, Antihypoparathyroid, Antihypocalcemic.
Mechanism of Action of Alfacalcidol
Alfacalcidol 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 Alfacalcidol
Absorption: 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 Alfacalcidol
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Duration of Action for Alfacalcidol
N/A
Half Life of Alfacalcidol
N/A
Side Effects of Alfacalcidol
1.Hypercalcaemia
2.Fatigue
3.Weakness
4.Diarrhoea
5.Vomiting
6.Sluggishness
7.Albuminuria
8.Polyuria
9.Calcification of soft tissues (blood vessels, parenchymal organs including heart)
10.Renal stones
11.Growh retardation in children
12.Hypertension
13.Anorexia
14.Nausea
15.Constipation
16.Hyperphosphataemia.
Contra-indications of Alfacalcidol
1.Hypercalcaemia
2.Hypervitaminosis D
3.Hyperphosphataemia (except when occurring with hypoparathyroidism
4.Hypermagnesaemia.
Special Precautions while taking Alfacalcidol
1 Renal impairment
2.Hypercalciurea
3.Renal stones
4.Coronary diseases.
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Alfacalcidol
1.Rickets and Osteomalacia
2.Hypoparathyroidism with bone disease
3.Renal osteodystrophy
4.Osteoporosis
Interactions for Alfacalcidol
Digitallis 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 Alfacalcidol
Oral:
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 Alfacalcidol
C1
Storage Requirements for Alfacalcidol
Store 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 Alfacalcidol
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 Alfacalcidol
Provide 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.

Beta Carotene

About Beta Carotene
A natural precursor to Vitamin A.
Mechanism of Action of Beta Carotene
Beta-carotene acts as the precursor of Vitamin A and in the body it is converted in to Vitamin A. Vitamin A is required for a variety of physiological functions in the body such as: - 1).Proper functioning of retina and formation of pigment Rhodopsin during dark adaptation. 2).promotes differentiation and maintains structural integrity of epithelia over the body and also retard the malignancies of epithelial structures.3).Promotes mucous secretion. 4).Inhibits keratinization, 5). Maintains proper bone growth, 6).Maintenance of spermatogenesis, 7).Supports foetal development, 8).Improves resistance to infection. It is required for proper antibody response, normal lymphocyte proliferation and killer cell function.
Pharmacokinets of Beta Carotene
Absorption: Completely absorbed normally. Steatorrhoea, bile deficiency, and protein poor diet adversely affects the absorption and absorption requires bile salts, pancreatic lipase, and dietary fat.
Distribution: Stored primarily as palmitate in kupffer`s cells in liver. Circulates in the form of specific alpha-1 protein; retinol binding protein and transported to cellular retinol binding protein of target cells.
Metabolism: Metabolized in the liver.
Excretion: Excreted mainly through bile and a small amount is excreted through urine.
Onset of Action for Beta Carotene
N/A
Duration of Action for Beta Carotene
N/A
Half Life of Beta Carotene
N/A
Side Effects of Beta Carotene
Adverse effects occurs only with higher doses and toxicity
1. Nausea
2. Vomiting
3. Itching
4. Dermatitis
5. Exfoliation
6. Alopecia
7. Bone and joint pain
8. Anorexia
9. Irritability
10. Increased intracranial pressure
11. Hepatic impairment
12. Anaphylactic shock
Contra-indications of Beta Carotene
1. Hypervitaminosis A
2. Hypersensitivity to Beta Carotene
Special Precautions while taking Beta Carotene
1. Oral form should not use in patients with malabsorption syndrome.
2. In inadequate bile secretion oral route may be used with concurrent administration of bile salts.
3. I. V. route is contraindicated except for special water miscible forms intended for infusion with large parenteral volumes and should not use I. V. push of vitamin A of any type.
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Beta Carotene
1. Vitamin A deficiency
2. Xerophthalmia
3. Acne
4. Ichthyosis
5. Bitot`s spots
6. Night blindness
Interactions for Beta Carotene
Cholestyramine: Absorption of Vitamin A is reduced due to reduced availability of fat stabilizing bile salts.
Mineral oil: Interferes with intestinal absorption of Vitamin A.
Oral Contraceptives: Plasma Vitamin A levels are significantly increased.
Typical Dosage for Beta Carotene
Severe vitamin A deficiency with xerophthalmia: 500000 IU daily for 3 days followed by 50000 IU daily for 14 days. Then maintenance dosage of 10000 to 20000 IU for 2months followed by adequate dietary nutrition and RDA vitamin A supplements.
Severe vitamin A deficiency: 100000 IU daily for 3 days followed by 50000 IU daily for 14 days. Then maintenance dosage of 10000 to 20000 IU for 2months followed by adequate dietary nutrition and RDA vitamin A supplements.
Children: 5000 to 10000 IU daily for 14 days.
Schedule of Beta Carotene
C1 (Oral)
C (Parenteral)
Storage Requirements for Beta Carotene
Store in a well closed, airtight container in a cool dry place.
Effects of Missed Dosage of Beta Carotene
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 Beta Carotene
Discontinue the vitamin A if hypercalcaemia persists and administer I.V. saline, prednisolone, and calcitonin if required. Monitor hepatic function tests to detect liver damage.

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