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- Pharmacology For Calcium + Vitamin D3 + Phosphorus + Magnesium
Calcium + Vitamin D3 + Phosphorus + Magnesium Pharmacology
Calcium + Vitamin D3 + Phosphorus + Magnesium
About Calcium + Vitamin D3 + Phosphorus + MagnesiumN/AMechanism of Action of Calcium + Vitamin D3 + Phosphorus + MagnesiumN/APharmacokinets of Calcium + Vitamin D3 + Phosphorus + MagnesiumN/AOnset of Action for Calcium + Vitamin D3 + Phosphorus + MagnesiumN/ADuration of Action for Calcium + Vitamin D3 + Phosphorus + MagnesiumN/AHalf Life of Calcium + Vitamin D3 + Phosphorus + MagnesiumN/ASide Effects of Calcium + Vitamin D3 + Phosphorus + MagnesiumN/AContra-indications of Calcium + Vitamin D3 + Phosphorus + MagnesiumN/ASpecial Precautions while taking Calcium + Vitamin D3 + Phosphorus + MagnesiumN/APregnancy Related InformationUse with cautionOld Age Related InformationN/ABreast Feeding Related InformationUse with cautionChildren Related InformationN/AIndications for Calcium + Vitamin D3 + Phosphorus + Magnesium1.Calcium deficiency
2.Osteoporosis in males
3.Post-menopausal osteoporosis.
4.Rickets
5.Osteocalcaemia
6.Phosphorous deficiency
Interactions for Calcium + Vitamin D3 + Phosphorus + MagnesiumN/ATypical Dosage for Calcium + Vitamin D3 + Phosphorus + MagnesiumAdult: 1 capsule / day and if needed dose can be increased by 1 capsule every 2 weekSchedule of Calcium + Vitamin D3 + Phosphorus + MagnesiumN/AStorage Requirements for Calcium + Vitamin D3 + Phosphorus + MagnesiumN/AEffects of Missed Dosage of Calcium + Vitamin D3 + Phosphorus + MagnesiumN/AEffects of Overdose of Calcium + Vitamin D3 + Phosphorus + 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.Vitamin D3
About Vitamin D3N/AMechanism of Action of Vitamin D3Vitamin D3 is a form of vitamin D. It is also called as Cholecalciferol.7-Dehydrocholesterol is the precursor of vitamin D3 and only forms the vitamin after being exposed to UV radiation.After exposure to the sun, cholecalciferol is sent to the liver to be hydroxylated where it becomes 25-Hydroxyvitamin D3.Next, it is sent to the kidney and once again hydroxylated becoming 1,25-Hydroxyvitamin D3. 1,25-Hydroxyvitmain D3 is the active form of vitamin D3, for this reason vitamin D is often referred to as a prohormone.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 Vitamin D3Absorption: Well absorbed orally in the presence of bile salts, Malabsorption and steatorrhoea interfere with it`s absorption.
Distribution: Widely distributed in a protein bound form. It is stored in adipose tissue and liver.
Metabolism: It is hydroxylated in to both active and inactive metabolites and also metabolized in kidney.
Excretion: Metabolites are excreted mainly through bile.
Onset of Action for Vitamin D3N/ADuration of Action for Vitamin D3N/AHalf Life of Vitamin D3N/ASide Effects of Vitamin D31. 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. Arrhythmias
11. Renal stones
12. Growh retardation in children
13. Hypertension
14. Anorexia
15. Nausea
16. Constipation
17. Elevated liver enzymes
Contra-indications of Vitamin D31. Hypercalcaemia
2. Hypervitaminosis D
3. Renal osteodystrophy with hyperphosphatemia
4. Renal impairment
Special Precautions while taking Vitamin D31. Renal diseases
2. Renal stones
3. Cardiac diseases
4. Arteriosclerosis
5. Coronary diseases
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with cautionIndications for Vitamin D31. Rickets and Osteomalacia
2. Hypoparathyroidism
3. Fanconi`s syndrome
4. Osteoporosis
Interactions for Vitamin D3Antacids: Hypermagnesemia may develop in patients on renal dialysis who take magnesium containing antacids.
Digitalis glycosides: May precipitate cardiac arrhythmias due to hypercalcemia.
Verapamil: Atrial fibrillation may occur.
Cholestyramine: Intestinal absorption of Vitamin D may be reduced.
Mineral Oil: Prolonged use of mineral oil may result in reduced absoprtion of Vitamin D.
Phenytoin, Barbiturates: Half life of vitamin D may be reduced.
Thaizide diuretics: Hypoparathyroid patients on Vitamin D may develop hypercalcemia due to thiazide diuretics.
Typical Dosage for Vitamin D3Oral:
Adults:
Nutritional Rickets and Osteomalacia: 25 to 125mcg daily in normal gastrointestinal absorption. In severe malabsorption; 250mcg to 7.5mg orally or 250mcg I.M.
Vitamin dependent Rickets: 250mcg to 1.5mg daily
Hypoparathyroidism: 625mcg to 5mg daily with calcium supplements
Fanconi`s syndrome: 1.25 to 5mg daily
Osteoporosis: 25 to 250mcg daily or 1.25mg once weekly with calcium and fluoride supplements.
Hypophosphatemia: 250mcg to 1.5mg along with phosphate supplements
Children:
Nutritional Rickets and Osteomalacia: 25 to 125mcg daily in normal gastrointestinal absorption. In severe malabsorption; 250mcg to 625mcg orally
Vitamin dependent Rickets: 75 to 125mcg daily.
Fanconi`s syndrome: 625mcg to 1.25mg daily
Hypophosphatemia: 1 to 2mg daily with phosphate supplements. Increase the dose in increments of 250 to 500mcg at intervals of 3 to 4months until desired therapeutic response is obtained.
Schedule of Vitamin D3N/AStorage Requirements for Vitamin D3Store 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 Vitamin D3Take 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 D3Provide 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. Phosphorus
About PhosphorusEssential nutritional element , Mineral.Mechanism of Action of PhosphorusThe second most abundant mineral in the body, phosphorus is needed for bone growth, kidney function and cell growth. It also plays a role in maintaining the body`s acid-alkaline balance. Phosphorus is found in many foods, but in order to be properly utilized, it must be in proper balance with magnesium and calcium in the blood. Excessive levels of phosphorus in the blood, often due to the consumption of soft drinks containing phosphoric acid, can lead to calcium loss and to cravings for sugar and alcohol; too little phosphorus inhibits calcium absorption and can lead to osteoporosis. Best sources are animal products, whole grains, legumes and nuts.Pharmacokinets of PhosphorusN/AOnset of Action for PhosphorusN/ADuration of Action for PhosphorusN/AHalf Life of PhosphorusN/ASide Effects of PhosphorusN/AContra-indications of PhosphorusN/ASpecial Precautions while taking PhosphorusN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for PhosphorusN/AInteractions for PhosphorusN/ATypical Dosage for PhosphorusN/ASchedule of PhosphorusN/AStorage Requirements for PhosphorusN/AEffects of Missed Dosage of PhosphorusN/AEffects of Overdose of PhosphorusN/AMagnesium
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 + Vitamin D3 + Phosphorus + Magnesium in Your City
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