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Calcium + Alfacalcidol + Magnesium Pharmacology
Calcium + Alfacalcidol + Magnesium
About Calcium + Alfacalcidol + MagnesiumN/AMechanism of Action of Calcium + Alfacalcidol + MagnesiumN/APharmacokinets of Calcium + Alfacalcidol + MagnesiumN/AOnset of Action for Calcium + Alfacalcidol + MagnesiumN/ADuration of Action for Calcium + Alfacalcidol + MagnesiumN/AHalf Life of Calcium + Alfacalcidol + MagnesiumN/ASide Effects of Calcium + Alfacalcidol + MagnesiumN/AContra-indications of Calcium + Alfacalcidol + MagnesiumN/ASpecial Precautions while taking Calcium + Alfacalcidol + MagnesiumN/APregnancy Related InformationUse with cautionOld Age Related InformationN/ABreast Feeding Related InformationUse with cautionChildren Related InformationN/AIndications for Calcium + Alfacalcidol + Magnesium1.Osteoporosis
2.Renal bone disease
3.Hypoparathyroidism
4.Rickets
5.Osteomalacia
Interactions for Calcium + Alfacalcidol + MagnesiumN/ATypical Dosage for Calcium + Alfacalcidol + Magnesium2 capsule / daySchedule of Calcium + Alfacalcidol + MagnesiumN/AStorage Requirements for Calcium + Alfacalcidol + MagnesiumN/AEffects of Missed Dosage of Calcium + Alfacalcidol + MagnesiumN/AEffects of Overdose of Calcium + Alfacalcidol + MagnesiumN/ACalcium
About 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
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 Calcium1.Renal calculi
2.Hypophosphataemia
3.Hypercalcaemia
4.Ventricular fibrillation.
Special Precautions while taking Calcium1.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 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
4.Rickets
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.
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 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.Alfacalcidol
About 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
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 Alfacalcidol1.Hypercalcaemia
2.Hypervitaminosis D
3.Hyperphosphataemia (except when occurring with hypoparathyroidism
4.Hypermagnesaemia.
Special Precautions while taking Alfacalcidol1 Renal impairment
2.Hypercalciurea
3.Renal stones
4.Coronary diseases.
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
3.Renal osteodystrophy
4.Osteoporosis
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.Magnesium
About MagnesiumMagnesium is essential for enzyme activity, calcium and potassium uptake, nerve transmission, bone formation and metabolism of carbohydrates and minerals. It is magnesium, not calcium, which helps form hard tooth enamel, resistant to decay. Like calcium and chloride, magnesium also plays a role in regulating the acid-alkaline balance in the body. High magnesium levels in drinking water have been linked to resistance to heart disease. Although it is found in many foods, including dairy products, nuts, vegetables, fish, meat and seafood, deficiencies are common in America due to soil depletion, poor absorption and lack of minerals in drinking water. A diet high in carbohydrates, oxalic acid in foods like raw spinach and phytic acid found in whole grains can cause deficiencies. An excellent source of usable magnesium is beef, chicken or fish broth. High amounts of zinc and vitamin D increase magnesium requirements. Magnesium deficiency can result in coronary heart disease, chronic weight loss, obesity, fatigue, epilepsy and impaired brain function. Chocolate cravings are a sign of magnesium deficiency.Mechanism of Action of MagnesiumN/APharmacokinets of MagnesiumN/AOnset of Action for MagnesiumN/ADuration of Action for MagnesiumN/AHalf Life of MagnesiumN/ASide Effects of MagnesiumN/AContra-indications of MagnesiumN/ASpecial Precautions while taking MagnesiumN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for MagnesiumN/AInteractions for MagnesiumN/ATypical Dosage for MagnesiumN/ASchedule of MagnesiumN/AStorage Requirements for MagnesiumN/AEffects of Missed Dosage of MagnesiumN/AEffects of Overdose of MagnesiumN/AHome Delivery for Calcium + Alfacalcidol + Magnesium in Your City
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