Alphavimin 10ml Hadiphar medicine supplements vitamins in the nursing period, special diet (20 tubes)

Introducing the above factors can cause disorders such as depression, fatigue, reduced vitality, reducing resistance and reducing recovery speeds during the nursing period.

lysin hydrochloride: is an essential amino acid that plays an important role in creating a workshop. In children, Lysin is an amino acid that is often considered not to be provided.

B vitamins need for normal metabolic functions.

thiamin hydrochlorid (vitamin B1): thiamin is a water -soluble vitamin, belonging to group B. thiamin combined with adenosin triphosphate (ATP) in the liver, kidneys and leukocytes to form thiamin diphosphate (thiamin pyrophosphate) with physiological activity. Thiamin diphosphate is a carbohydrate metabolic coenzyme that is responsible for reducing the carboxyl of alpha-cetoacids such as pyruvat and alpha-cetoglutarat and in the use of pentose in the Hexose Monophosphate cycle.

Thiamin is often used in the form of hydrochloride or nitrate salt, in addition to using decamsylate, disulfid, monophosphate or pyrophosphate (cocarboxylase). Other forms that are considered as vitamin B1 can also be used instead of Thiamin such as benfotiamin, cycotiamin, octotiamin, ...

The daily amount of thiamin takes 0.9 - 1.5 mg for men and 0.8-1.1 mg for healthy women. Thiamin demand is directly related to carbohydrate and metabolic speed. This has practical significance in nourishing patients with intravenous tract and in patients with calorie energy taken mainly from Dexrose (Glucose).

riboflavin sodium phosphate (vitamin B2):

In the body, Riboflavin is transformed into 2 coenzymes, Flacin Mononucleotid (FMN) and Flavin Denin Dinucleotid (FAD), which are the active coezym forms needed for tissue respiration. These coenzymes are active as a hydrogen molecular molecule for other important coenzymes that affect the oxidation reaction to reducing organic substances and during intermediate metabolism and the formation of some vitamins and their coenzymes such as niacin, vitamin B6, vitamin B12. Riboflavin also indirectly involves maintaining the integrity of red blood cells.

is indicated for riboflavin deficiency and treatment, but riboflavin can also be useful in the treatment of normal red blood cell anemia occurs in people with family metabolic diseases with large spleen and glutathion deficiency. Although there are additional studies, some tests show that in people with a history of high -dose migraine (400mg riboflavin/day) can reduce frequency and time of prolonged pain, the most obvious benefit after 3 months of Room with riboflavin. Riboflavin is also used to treat acne, congenital blood methemoglobin, muscle contraction, leg burn syndrome. Because riboflavin excretion is fast, it is also used as an indicator in monitoring the elimination of drugs in the regimen using some other drugs.

Lack of riboflavin will have symptoms such as skin tan, momentary, dry lips, tongue inflammation and stomatitis, vision change, seborrheic dermatitis. Normal red blood cell anemia and neuritis in severe cases. Riboflavin deficiency is generally related to lack of other nutrients and can occur with lack of B vitamins, such as Pellagra's disease.

Diagnosis of riboflavin deficiency may be based on the results of glutathion reductase measurement, red blood cell flavin or riboflavin urine concentration. Although these tests are not diagnosed, the urine Riboflavin concentration results are less than 19 - 27 micrograms/g Creatinin is considered to be deficient in ribflvin. The demand for riboflavin is related to the body, the amount of protein and the metabolism of the body, depending on age; Special periods such as pregnancy, lactation ...

pyridoxin hydrochlorid (vitamin B6):

Vitamin B6 is a water -soluble B vitamin, which exists in 3 forms: pyridoxal, pyridoxin and pyridoxamin, when entering the body, it is transformed into pyridoxal phosphate and pyridoxamin phosphate. These two substances act as coenzymes in the metabolism of protein, glucid and lipid. Pyridoxin participates in the synthesis of gammaaminobutyric acid (GABA) in the central nervous system and participates in Hemoglobin synthesis.

Daily needs for children are 0.3-2 mg, adults about 1.6 -2 mg and pregnant or lactating mothers are 2.1-2.2 mg. It is rare for vitamin B6 deficiency in humans, but it may occur in the case of absorption disorders, congenital metabolic disorders or drug disorders caused by drugs. When there is a shortage due to nutrition, there is less difficult case of a B vitamins, so vitamin supplements in the form of a mixture are more effective than single use. The best is to improve the diet. Meat, fish, eggs, milk, liver, kidneys, vegetables, fruits are a rich source of natural pyridoxin. Increased body demand and vitamin B6 supplementation may be necessary in the following cases: alcoholism, burns, congestion heart, prolonged fever, stomach removal, dialysis, thyroid gland, bacterial infection, intestinal disease (such as diarrhea, intestinal inflammation), malabsorption related to liver disease. For patients treated with Isoniazid or women taking birth control pills, the demand for vitamin B6 is more daily than usual.

Pyridoxine deficiency can lead to iron -cell anemia, peripheral neuritis, seborrheic dermatitis, dry lips.

In some very rare babies with genetically dependent pyridoxin syndrome. A large amount of pyridoxin is needed in the first week after giving birth to prevent seizures. The genetic iron -cell anemia has been detected with pyridoxin.

Some metabolic disorders: xanthurenic acid, cystathioninin, hyalent oxalate (genetic): can respond to high doses of pyridoxin.

cholecalciferol (Vitamin D3):

Vitamin D works to maintain normal calcium and phosphorus concentrations in serum by increasing the absorption of these minerals from food in the small intestine. Calcitriol (vitamin D activated) increases the absorption of calcium in the small intestine, but mainly in the duodenum and rosary. Calcitriol also increases phosphorus absorption mainly in the nodes and ileum. The activity of ergocalciferol, doxercalciferol, and cholecalciferol mobilizes calcium from the bone into the bloodstream and boosts the reabsorption of phosphate in the renal tubules and directly acts on the bone cell cells to stimulate bone growth. Activated forms of ergocalciferol and colecalciferol have a reverse inhibitory effect on the formation of adjacent hormones (PTH).

d, L-A-Tocopheryl Acetate (Vitamin E):

Vitamin E is a common term for some natural and synthetic compounds. The most important group is Tocopherol, of which Alpha Tocopherol is most active, widely distributed in nature and is mainly used in treatment; Other substances of the Tocopherol group include Beta, Gamma and Delta Tocopherol, but these substances are not used in treatment. Other groups of compounds with vitamin E are tocotrienol.

Alpha Tocopherol is naturally in the form of isomers D (D-Alpha Tocopherol) has a stronger activity than Alpha Tocopherol's DL-Alpha Tocopherol.

Vitamin E is a fat -soluble vitamin, widely distributed in food. The richest vitamin E source is vegetable oil, especially wheat germ, sunflower oil, cotton seed oil; Cereals and eggs are also rich in vitamin E. The amount of vitamin E in food is lost due to storage and cooking. The daily demand for vitamin E is about 4 - 15 mg.

Vitamin E deficiency is very rare, only occurs in people who are unable to absorb vitamin E or suffer from a number of genetic diseases that prevent normal levels of vitamin E in the blood.

The exact biological function of vitamin E is not fully known in humans. Vitamin E is considered an antioxidant. Vitamin E prevents oxygen from unsaturated fatty acids (these acids are components of cell membranes, phospholipids and plasma lipoprotein) as well as other oxygen sensitive substances such as vitamin A and ascorbic acid (vitamin C). Free radicals generated by many reaction processes in cells are likely to harm the cell membrane, protein and nucleic acid, leading to dysfunction and cell disorders. Vitamin E reacts with free radicals, losing peroxyl roots (peroxyl root reactions with vitamin E 1000 times faster than unsaturated high molecular fatty acids). In the process of reaction, vitamin E does not create other free radicals.

Due to the antioxidant properties of vitamin E, there have been many studies using vitamin E to mitigate the memory loss of early alzheimer disease or due to aging, degenerative degeneration related to age, cancer, arteriosclerosis, coronary artery disease, cataract ... but so far has not been clearly proven. Some clinical houses have been treated to reduce the risk of macular degeneration related to age as follows: Vitamin C dose 500 mg/day in combination with Beta Caroten 15 mg/day, vitamin E 400 mg/day and zinc (zinc oxyd) 80 mg/day. Alzheimer's disease and coronary artery disease: dose from 200 - 800 ĐVAT/day. However, currently there is still not enough data to prove the effectiveness of the drug for these diseases and it should be noted that the dose of 400 mg/day or more can increase the mortality rate.

In vitro, vitamin E also works to prevent red blood cells due to oxidants and increase the immune response in healthy elderly people, reducing platelet capacitors.

nicotinamid (vitamin PP):

Nicotinamid is B vitamins, soluble in water. In the body, nicotinamid is made up of nicotinic acid. In addition, a part of tryptophan in oxidized food is made up of nicotinic acid and then nicotinamid. Nicotinamid converts to nicotinamid adenin Dinucleotid (NAD) and Nicotinamid Adenin Dinucleotid phosphate (NADP). NAD and NADP are coenzymes that have a survival role in metabolism, they are catalysts for oxidation - reducing reactions needed for cell respiration, glycogen resolution and lipid metabolism. Among these reactions, these coenzymes work as hydrogen transport molecules.

Daily needs of the body is about 15-20 mg of nicotinic acid. 60 mg Tryptophan feeds is about 1mg of nicotinic acid, so the protein full meal has met the needs, just a little from the source of vitamins. Nicotinic acid often lost very little during cooking.

nicotinamid is found in many foods such as yeast, meat, fish, potatoes, beans and cereal seeds; However, a small amount of these vitamins in cereals exists in a difficult form of absorption. Nicotinamid and nicotinic acid on the market are chemical -synthesized preparations.

Add nicotinamid to the diet: When the diet is deficient in nicotinamid, for example, in cereal and protein deficiency diet can lead to nicotinamide deficiency for the body. In that case and in the case of increased demand for nicotinamid, such as in thyroid disease, diabetes, cirrhosis, during pregnancy and lactation (but these people rarely deficiency of nicotinamid), it may be necessary to supplement nicotinamid.

Pellagra disease: Nicotinamid deficiency can cause pellagra disease, due to nicotinamid deficiency diet or due to Isoniazid treatment, or due to the reduction of tryptophan convert into nicotine acid in Hartnup, or malignant because these tumors need to use a large amount of tryptophan to synthesize 5-HydroxyryThan and 5-Hydroxytryptamine.

Nicotinamid deficiency can occur with the lack of other B vitamins.

The organs are mainly affected by Nicotinamid deficiency, the digestive tract, skin and the TKTW system, with symptoms such as: La melting, abdominal pain, tongue inflammation, stomatitis, anorexia, headache, sleep, mental illness. Using nicotinamid or nicotinic acid will lose symptoms caused by shortage. However, nicotinamid is more popular because it has no side effects causing vasodilation.

Symptoms of red and tongue swelling in patients with Pellagra will end within 24 - 72 hours after using nicotinamid. Mental symptoms, mouth infections and other mucous membranes will run out quickly. Symptoms in the gastrointestinal tract will end within 24 hours.

dexpanthenol:

Pantothenic acid, also known as vitamin B5, is a water -soluble antioxidant, necessary for intermediate metabolism of carbohydrates, proteins and lipids. Pantothenic acid is the precursor of Coenzym A needed for acetyl - chemical reaction (Acyl group activation) in the new glucose, releasing energy from carbohydrates, synthesizing and chemical fatty acids, sterol synthesis and steroid hormones, porphyrin, acetylcholins and other compounds. Pantothenic acid is also necessary for the normal function of epithelium.

In humans, pantothenic acid is needed from food. Food rich in pantothenic acid includes meat, vegetables, cereal seeds, eggs and milk. The appropriate amount for adults is about 5 mg/day, up to 6 mg in pregnant people and 7 mg in breastfeeding (US National Academy of Sciences recommended). The deficiency of pantothenic acid in humans is very rare because this acid is widely distributed in food, unless combined with Pellagra or other B vitamins. Lack of experimental pantothenic acid (by using omega methylpantothenic acid, a metabolic antagonist, or by a diet without pantothenic acid), showing symptoms such as sleeping chicken, fatigue, headache, abnormalities in the legs and arms accompanied by increased reflexes and lower limb muscle weakness, then cardiovascular disorders, digestive, changing gas, and increased sensitivity to bacteria.

Pantothenic acid does not have a prominent pharmacological effect when used for experimental animals or for humans, even when using high doses. When the high doses of dexpanthenol was reported, it was reported to increase the gastric gastric motility due to acetyl stimulation - chemical cholin into acetylcholin; However, the effect of the drug is not proven.

calcium (in the form of calcium lactat pentahydrate):

Calcium is an important cell ion, chemotherapy 2. Calcium will account for about 1-2% of body weight, and over 99% of calcium in the body are found in bones and teeth, the rest is present in extracellular fluids, and a small amount in the cell. Calcium in the bone is mainly in the form of hydroxyapatite. The amount of mineral salts in the workshop accounts for about 40% of bone weight. The bone is a dynamic tissue, which takes place in the process of elimination and bone creation. Annually part of the bone regenerated. Create bones faster than bone pepper in growing children, balanced in healthy adults and slow down in menopause and the elderly in both sexes. The ratio of solid bone regeneration (bone shell) can be up to 50% high annually in children and about 5% annually in adults; Regenerating foam bone about 5 times to regenerate solid bones in adults. In addition to supporting the body, the skeleton is also a place of calcium storage. Although practicing and providing calcium has an impact on bone volume, it is unclear whether the calcium provision has a good effect on bones due to training. Reducing estrogen at menopause increases calcium in the bone, especially in the spine for about 5 years; During this time, the annual loss of calcium in the bone is about 3%. Reducing estrogen levels reduces the effectiveness of calcium absorption and increases bone rotation speed.

It is not known the main effect of estrogen for calcium in bones or intestines. Additional calcium supplements for premenopausal women and the early postmenopausal period shows that increased calcium supply does not prevent fast porous bone loss in the first 5 years after menopause and the need to provide calcium for women does not show a strong change after menopause.

In human plasma, calcium concentration is about 8.5 mg to 10.4 mg/dL (2.1 - 2.6 mmol/lit) of which about 45% are associated with plasma proteins, mainly albumin and about 10% complex with anionic buffer (such as citrate and phosphate). The rest is calcium ionization (Ca ++). Ca ++ is essential for many biological processes: stimulating neuron, releasing neurotransmitters, muscle contraction, preserving membrane and participating in blood clotting. Ca2+ also helps the secondary communication function for the activity of many hormones.

On the cardiovascular system: Calcium ion is essential for stimulating and contracting myocardial muscle as well as for electrical impulse transmission on some areas of the heart muscle, especially through the atrial node. The reduction of myocardial fibers opens the Ca ++ channels to adjust the voltage and causes a slow Ca ++ current to enter, during the effect of the plateau potential. This Ca2+ line allows absorbing a sufficient amount of calcium ions to stimulate the release of calcium ions from the muscle grid, thus causing muscle contraction.

On the muscular nervous system: Calcium ions play an important role in stimulating and contraction. The muscle stimulation of calcium ions occurs when released from the mathematical net. Calcium ions release muscle stimulation by calcium ions attached to troponin, losing troponin inhibition on Actin -Myosin interaction. Muscle dilatation occurs when calcium ions are brought back to the mental mental, restoring the inhibition of troponin.

calcium lactat is a form of oral calcium salt. Oral calcium salt is used in preventive and treatment of calcium deficiency. Lack of calcium occurs when the daily diet does not provide enough calcium for the needs of the body, or in some conditions such as reducing the ability to the parathyroid gland, deficiency of hydrochloride gastric juice, chronic diarrhea, vitamin D deficiency, fat fertilizer, oral ulcerative disease (Sprue disease), pregnant and breastfeeding women, menopause, pancreatitis, alkaline infection, alkaline infection. Calcium demand in vegetarians may increase due to negative effects of oxalate and phytate (high concentrations in vegetarian diet) for calcium bioavailability. Using some drugs (such as diuretics, anti -convulsions ...) sometimes leads to lower blood calcium, requires additional calcium supplementation.

Dynamic pharmacokinetics

thiamin hydrochlorid (vitamin B1):

Thiamin absorption in daily eating through the gastrointestinal tract is due to the positive transportation of Na+. After taking low doses, Thiamin hydrochloride is quickly absorbed. However, when Thiamin concentration in the gastrointestinal tract, passive diffusion is also important, and the total amount of drug absorption when taken high doses is limited to 4 - 8 mg. Absorb through the gastrointestinal tract step when patients with chronic liver disease, reduce absorption. The speed of absorption through the gastrointestinal tract will decrease when taking the medication during meals. After intramuscular injection, Thiamin is also absorbed quickly and completely. Distribution into most tissues and milk.

In adults, Thiamin storage is estimated at 30 mg and about 1 mg of Thiamin is completely struck every day in tissues, this is the minimum amount of daily needed. When absorbed at this low level, there are very little or no thiamin excreted through the urine. When absorbed beyond the minimum demand, Thiamin storage in saturated tissues, the emissions through the urine in the form of intact thiamin molecules and metabolized form. When Thiamin's absorption increases further, excretion in the form of unprocessed thiamin will increase.

riboflavin sodium phosphate (vitamin B2):

riboflavin is absorbed mainly in the duodenum. Riboflavin metabolites are distributed throughout the tissue in the body and into milk. A small amount is stored in the liver, spleen, kidney and heart.

After drinking about 6% FAD and FMN attached to plasma proteins. Riboflavin is a water -soluble vitamin, quickly excreted through the kidneys. The amount of putting in excess of the need for the body will be discharged in the form of unchanged urine. Riboflavin is also discharged according to feces. In people with abdominal fertilizer and artificial dialysis, riboflavin is also eliminated, but slower in people with normal kidney function. Riboflavin has passed the placenta and excreted milk.

Riboflavin deficiency can occur due to many reasons as follows: Although available in food, due to the less durable with temperature and light, the process of improper storage and processing will quickly reduce this vitamin content.

Due to the increasing demand, but not enough: puberty, pregnancy, lactation, contraceptive users, long -term infections, liver disease, alcoholism, cancer, heart disease, diabetes and are using Probenecid or other drugs that reduce Riboflavin absorption.

Due to reduced absorption: prolonged diarrhea, elderly.

Due to the loss of this vitamin when the peritoneal fertilizer, artificial kidney.

pyridoxin hydrochlorid (vitamin B6):

Absorption: Vitamin B6 is easily absorbed through the gastrointestinal tract, which can be reduced in people with malabsorption syndrome or after gastric cutting. Normal concentration of plasma pyridoxine: 30-80 nanogam/ml.

Distribution: After injection or oral, the drug is mostly reserved in the liver, partly in the muscle and brain. Storage of Vitamin B6 body is estimated at about 167 mg. The main types of vitamin B6 in the blood are pyridoxal and pyridoxal phosphate, high links to protein. Pyridoxal through the placenta and concentration in fetal plasma is 5 times the concentration of the mother's plasma. The concentration of vitamin B6 in breast milk is about 150-240 nanogam/ml after the mother takes 2.5-5 mg of vitamin B6 daily. After the mother takes less than 2.5 mg of vitamin B6 daily, the level of vitamin B6 in breast milk on average 130 nanogam/ml.

Metabolism: In red blood cells, pyridoxin converts into pyridoxal phosphate and pyridoxamin converted into pyridoxamin phosphate. In the liver, pyridoxin phosphoryl turned into pyridoxin phosphate and transformed the amines into pyridoxal and pyridoxamin to quickly get phosphorylation. Riboflavin is necessary to convert pyridoxin phosphate into pyridoxal phosphate.

Elimination: Half of the biological life of pyridoxin is about 15-20 days. In the liver, pyridoxal transforms into 4-pyridoxic acid excreted into the urine. In cirrhosis, the rate of degradation may increase. Pyridoxal can be removed by hemolysis.

cholecalciferol (Vitamin D3):

is easily absorbed through the small intestine. Vitamin D and blood circulation metabolites in the blood are connected to specific globulin. Vitamin D is transformed in the liver due to hydrolyzed into 25-hydroxycolecalciferol. Then transform the kidney into 1.25-hydroxy-coecalciferol; 1.25-Hydroxycalciferol is a metabolic substance that increases calcium absorption. The amount of non -metabolic vitamin D stored in fat and muscle tissue. Vitamin D is excreted in feces and urine.

d, L-A-Tocopheryl Acetate (Vitamin E):

absorption: To vitamin E absorbed through the gastrointestinal tract, bile and pancreas must work normally. The amount of vitamin E is absorbed when the dose increases. About 20 - 60% of vitamins are absorbed from food sources. In patients with poor absorption syndrome and mild birth weight, vitamin E absorption can step away. Domestic dispersed preparations can be better absorbed through the intestine than oil -based preparations.

Distribution: The drug in the blood through the microorganisms in the lymph and is transported to the liver. Vitamin E is secreted from the liver as a low density lipoprotein (VLDL) and vitamin E in plasma depends on this period. Only one isolated form of R-A-Tocopherol is re-excreted by the liver thanks to the affinity of Alpha Tocopherol for the liver's A-Tocopherol transport protein (A-TTP: A-Tocopherol Transfer protein). Vitamin E is then widely in all the tissues and reserves in the adipose tissue. The normal concentration of plasma tocoferol in plasma is 6 - 14 micrograms/ml. Vitamin E concentration in plasma below 5 micrograms/ml or less than 800 micrograms of vitamin E/1 g lipid in plasma for several months is considered as reflecting the deficiency of vitamin E. After taking high doses of vitamin E, the soberol in plasma can be higher for 1-2 days. The total vitamin E reserve in the body is estimated at 3 - 8 g and can meet the body needs for 4 years or more when the diet is poor in vitamins. Alpha tocopherol is distributed into the eyes, achieving higher concentrations in the cornea compared to the vein or lens. This concentration may increase when vitamin supplements.

Vitamin E in milk, but very little through the placenta. The concentration of Tocopherol in newborn babies is equal to 20-30 % of the concentration in mothers, lightweight babies with lower concentrations.

Elimination: Vitamin E metabolizes the liver into glucuronides of tocopheronic acid and gamma-lactone of this acid, most of the dosage of slow excretion into the bile. Some excretion through urine.

nicotinamid (vitamin PP):

Nicotinamid is quickly absorbed through the gastrointestinal tract after drinking and widely distributed into the body tissue. Nicotinic acid is found in human milk. The sale time of the drug is about 45 minutes. Nicotinamid metabolizes the liver into n-methylnicotinamid, 2-pyridon and 4-pyridon derivatives, and also forming nicotinuric. After using nicotinamid at the usual doses, only a small amount of nicotinamid secreted the secretion into the urine in the form of unchanged; However, when taking large doses, the amount of excretion in the form of unchanged will increase.

dexpanthenol:

Absorption: After oral, pantothenic acid is easily absorbed through the gastrointestinal tract. The normal pantothenate concentration in serum is 100 micrograms/ml or more.

Father: Dexpanthenol easily converts into pantothenic acid, this substance is widely distributed in the body tissue, mainly in the form of coenzyme A. The highest degree of dexpanthenol is found in the liver, adrenal glands, heart and kidneys. Mother's milk is breastfeeding, eating a normal diet, containing about 2 micrograms of pantothenic acid in 1 ml.

Elimination: About 70% of the dosage of pantothenic acid oral deduction in the form of unchanged urine and about 30% in feces.

calcium (in the form of calcium lactat pentahydrate):

Absorption: Calcium absorbs in the gastrointestinal tract by active transportation and passive diffusion. Calcium is absorbed according to the active transportation mechanism in the duodenum, nodules and with less than the small intestine. The level of absorption depends on many factors; Calcium is never completely absorbed in the intestine. The intestinal absorption effect may increase when the amount of calcium is put into the body or during pregnancy and breastfeeding when calcium demand is higher than normal. However, when there is a decrease in blood calcium due to the deficiency of the hormone hormone or vitamin D, the absorption of calcium is reduced. Actively transferring calcium into intestinal cells and leaving the intestinal mucosa depending on the effect of active vitamin D (1.25-dihydroxyvitamind) and the receptors of the intestinal vitamin. This mechanism is mainly for the majority of calcium absorption from the gastrointestinal tract at a low and medium -sized calcium supply level. The intestine pH must be acid to ionize calcium, if the alkaline pH, the calcium absorption is reduced. The fraction of calcium absorption varies with age, the highest in childhood (about 60%), decreasing to about 28%at puberty and increasing at the beginning of the puberty period (about 34%); The fraction of calcium absorption is 25% in young adults, and increases in the last 6 months of pregnancy. When the age is high, this fraction decreases, the average annual decline is about 0.21% in postmenopausal women; In men, the same decrease.

Distribution: After absorption, the first calcium into extracellular fluid and then quickly into the bone tissue. However, the bone formation process is not irritated by using calcium. Bones contain 99% of the body's calcium; The remaining 1% is evenly distributed between inside and outside the cell. The total calcium concentration in serum usually ranges from 9 - 10.4 mg/dL (4.5 - 5.2 MEQ/liter; or 2.1 - 2.6 mmol/liter), but only ionized calcium is active. The total calcium concentration in the serum consists of 50% ionization, 5% complex form with phosphate, citrate, and with other anions. About 45% serum is associated with plasma proteins, when albumin serum changes 1g/dL, the serum calcium concentration changes about 0.8 mg/dL (0.04 Meq/liter). When increased blood protein, total calcium concentration in serum increases; Conversely, when reducing blood protein, the total calcium level in the serum decreases. Acidic infection increases the concentration of ionized calcium, and alkaline infections reduce the concentration of calcium ionization in serum. Calcium concentration in cerebrospinal fluid is about 50% of serum calcium concentration and tends to reflect in serum calcium concentration. Calcium through the placenta and achieve concentration in fetal blood is higher than the mother's blood. Calcium is distributed into breast milk.

Elimination: Calcium excreted mainly in stools including non -absorbing calcium and calcium excreted by bile and pancreatic fluid into the intestinal tube. The majority of calcium filtered by the glomerular reabsorbed, only a small amount of urine excreted. Armor hormones, vitamin D, thiazid diuretic reduces calcium secretion through urine, while other diuretics, calcitonin and growth hormone promote kidneys to excrete calcium. In healthy people, regular nutrition, calcium excretion through urine usually does not exceed 150 mg/day. Excretion of calcium through urine decreases during pregnancy and in the early stages of body failure, at high age. Calcium also eliminates through the sweat gland.

In case of emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double doses to compensate for missed dose.

There is no unwanted effect when using riboflavin. Using high doses of riboflavin, the urine will turn light yellow, causing deviations to some urine tests in the laboratory.

pyridoxin hydrochloride (vitamin B6):

pyridoxin is usually not toxic. Using pyridoxin lasts for 10 mg/day is considered safe but using pyridoxin for a long time at a dose of 200 mg or more daily can cause neurological diseases.

Use vitamin D at a dose not exceeding the physiological needs are often non -toxic. However, vitamin D overdose may occur when treated with high or prolonged doses or when increased sensitivity to drugs similar to vitamin D, and will lead to clinical manifestations of blood calcium hypercalcemia. Calcitriol (rocaltrol) has been used for 15 years with all indications, very rare ADR ratio (0.001%).

Risk of increasing calcium-increasing and increasing phosphorus:

Vitamin E is usually well tolerated. ADR can occur when high doses, prolonged, intravenously, especially when used for babies premature, light weight at birth.

Nicotinamide small dose is usually not toxic, but if high doses, as in the case of Pellagra treatment, some of the following side effects may occur (these side effects will go away after stopping the drug):

Common, ADR> 1/100

Be cautious when using

need to be very careful when taking the drug for patients in the following cases:

The effect of the drug on driving and operating machinery

There is no evidence of the effect of the drug on driving and operating machinery.

Using drugs for women during pregnancy and lactation

can use vitamins and mineral salts with doses equivalent to daily needs during pregnancy and lactation.

Drug interaction

thiamin hydrochloride (vitamin B1):

can increase the effects of neurotransmitter drugs.

riboflavin sodium phosphate (vitamin B2):

Meet a number of "lack of riboflavin" in people who used clepopromazin, imipramin, amitriptylin and adriamycin.

Wine can hinder the absorption of riboflavin in the intestine.

Probenecid used with riboflavin causes reduced absorption of riboflavin in the stomach, intestines.

pyridoxin hydrochloride (vitamin B6):

pyridoxin reduces the effect of levodopa in the treatment of Parkinson's disease; This does not happen with the preparation is a mixture of Levodopa-Carbidopa or Levodopa-Benserazid.

Dosage 200 mg/day may cause a decrease in 40-50% of the concentration of phenytoin and phenobarbital in the blood in some patients.

Some drugs may increase the demand for pyridoxin in hydralazin, isoniazid, penicilamine and oral contraceptives. Pyridoxin can lighten depression in women who take birth control pills.

cholecalciferol (Vitamin D3):

Do not simultaneously treat vitamin D with cholestyramine or colestipol hydrochloride, as it can lead to reduced absorption of vitamin D in the intestine.

Excessive use of mineral oil can hinder the absorption of vitamin D in the intestine.

Simultaneous treatment of vitamin D with diuretic gums for thyroid insiders can lead to hypercalcemia. In that case, it is necessary to reduce the dosage of vitamin D or stop taking vitamin D temporarily. Using thiazid diuretics in people with hypothyroidism causing hypercalcemia is probably due to bone release from bone release.

Do not simultaneously use vitamin D with phenobarbital and/or phenytoin (and may be with other drugs that cause liver enzyme induction) because these drugs can reduce the concentration of 25-hydroxyergocalciferol and 25-hydroxycoleciferol in plasma and increase vitamin D into non-active substances.

Do not simultaneously use vitamin D with corticosteroids because corticosteroids hinder the effect of vitamin D.

Do not simultaneously use vitamin D with cardiac glycosides because of the toxicity of glycosides that support cardiac increased due to hypercalcemia, leading to arrhythmia.

d, L-A-Tocopheryl Acetate (Vitamin E):

Vitamin E or metabolic form reduces the effectiveness of vitamin K and increases the effectiveness of anticoagulant drugs.

Simultaneous use of vitamin E and acetylsalicylic acid are at risk of bleeding.

Vitamin E can increase the absorption, use and storage of vitamin A. Vitamin E protects vitamin A from oxidation due to oxidation, causing the level of vitamin A in cells to increase; Vitamin E also protects against the effects of excess vitamin A. However, these effects are still arguing.

Vitamin E dose over 10 ĐVQ/kg can slow down the response of iron treatment in iron deficiency anemia children. Lightweight infants with iron supplements can increase hemolytic anemia due to vitamin E deficiency.

Excess use of mineral oil can reduce vitamin E absorption.

Colestyramin, Colestipol, Orlistat can hinder vitamin E. Used at least 2 hours apart.

nicotinamid (vitamin PP):

Nicotinamid use simultaneously with HGM-CoA reducing enzyme inhibitors may increase the risk of muscle eligibility.

Use nicotinamid simultaneously with A-adrenergic blockers to treat hypertension can lead to excessive hypotension.

Diet and/or dosage of hypoglycemic or insulin medication may need to be the main thing when used simultaneously with nicotinamid.

Nicotinamid use simultaneously with toxic drugs with the liver can increase the toxic effect of the liver.

Do not simultaneously use nicotinamid with carbamazepine because of increased plasma carbamazepine levels leading to increased toxicity.

dexpanthenol:

Do not use dexpanthenol along with Neostigmin or within 12 hours after using Neostigmin or other sympathetic nerve -like drugs.

Although it is not important in clinical, the pupils of anti -cholinesterase preparations for the eye (for example: Ecothiophat iodid, isoflurophate) may increase when combined with pantothenic acid.

Not Dung Dexpanthenol within 1 hour after using sucinylcholin, because dexpanthenol can extend the muscle relaxation effect of sucinylcholin.

Some rare cases of unexplained allergies are encountered when using dexpanthenol injections with antibiotics, opiat drugs or barbiturates.

calcium:

Hypercalcemia may occur when using calcium salts with thiazid diuretics (leading to reducing calcium excretion in urine) or vitamin D (leading to increased calcium absorption from the intestine).

corticosteroid: Reducing the absorption of calcium from the intestine.

Biphosphonate: Concomitant treatment of calcium salt with biPhosphonate (such as Alendronat, Etidronat, Ibandronat, Riseadronat) can lead to reducing biposphonate absorption from the digestive tract. To minimize the impact of this interaction, take at least 30 minutes of calcium salt after taking Alendronat or RISDEDRONAT; At least 60 minutes after taking ibandronat, and not used within 2 hours before and after taking Etidronat.

Cardiac glycosides: Calcium with myocardial organs and toxicity of cardiac glycosides; The consequences can cause arrhythmia if used simultaneously (especially when calcium uses intravenous, orally lower orally).

iron preparations: Concomitant use of calcium salt with oral iron preparations can lead to iron absorption, it is necessary to recommend patients to use these two preparations at different times.

Quinolones: Using calcium salt simultaneously with some quinolon antibiotics (such as ciprofloxacin) can reduce the bioavailability of quinolones, do not drink at the same time, should drink apart at least 3 hours,

Tetracyclin: The complex of calcium with tetracyclin antibiotics that activate antibiotics, so do not drink at the same time, should drink apart at least 3 hours.