Calciumzindo usa nic pharma soft capsules supplement calcium and vitamin D, prevent and treat osteoporosis (12 blisters x 5 tablets)

Calcium nutritional supplements are used to prevent or treat calcium deficiency in calcium balance, helping to prevent or reduce bone loss in osteoporosis. Calcium in calcium salts modifies for nerve activity and organs to adjust the stimulation threshold and allows the heart function to function normally. Calcium is necessary to maintain the function of the nervous system, muscle system and skeletal system and absorbent through cell membranes and capillaries.

Calcium gluconate can be used as an electrolyte compensation, a potassium anti -tank and blood magnesium. Some clinical physicians believe that calcium gluconate is a choice for cases of toxic to Magnesi in pregnant women with menstruation.

Lowering blood calcium occurs in the case of: Means of hypothyroidism and fake hypothyroidism, bone puree, rickets, chronic kidney failure, lowering blood calcium due to anti -convulsions, or when vitamin D. deficiency occurs when daily diet does not provide adequate calcium, especially in young women and elderly people, women before and after menopause, teenagers. Due to increased demand for calcium, children and women are the most risky.

Hypical calcium causes seizures, tetani, behavioral disorders and personality, growth retardation and brain growth retardation, bone deformation, most commonly rickets in children and bone finer in adults. The change occurs in the bone puree including soft bones, low -type pain in the leg bone and waist, weak body with discomfort and spontaneous fracture.

Calcium supplementation is used as part of the prevention and treatment of osteoporosis in a non -calcium -eating person. Drinking calcium gluconate in water is more beneficial than using calcium salts in acids, for patients with gastric acid reduction or use gastric acid reducing drugs such as H2 receptor resistant drugs.

vitamin D3 (Colecalciferol)

Vitamin D3 has prevention or treatment of rickets. Vitamin D works to maintain normal calcium and phosphor levels in serum by increasing the absorption of these minerals from food in the small intestine. Colecalciferol mobilizes calcium from the bone into the bloodstream and promotes the reabsorption of phosphate in the renal tubules and directly acts on bone -forming cells to stimulate bone growth. Activation of Colecalciferol has the opposite inhibitory effect on the formation of adjacent hormones (PTH).

Vitamin D deficiency causes rickets in children and bone puree in adults. Vitamin D deficiency reduces blood calcium ionic concentration, leading to an increase in PTH.

If the permanent deformation occurs in the bone, adults have the ability to absorb and activate ergocalciferol or colecalciferol, then use these compounds to completely run out of bone or bone puree signs.

Colecalciferol has a slow start, and the time -effective time is often used to prevent Viatmin D due to nutrition.

pharmacokinetic

calcium gluconate

The absorption of calcium in the intestine is inversely proportional to the amount of calcium eaten, so when a low -calcium diet will lead to increased compensation, partly due to the effects of vitamin D. In activation, vitamin D is needed for calcium absorption and increases the body's ability to absorb. Calcium is absorbed in the form of soluble ions, the solubility of calcium increases in the acidic environment (pH in the intestine is acidic, it is necessary for ionization of calcium, alkaline pH to prevent absorption).

The bioavailability of calcium oral from non -food sources and from supplements depends on the pH in the intestine, at the time of or without food and the dose of use. Using a high dose of calcium 250 mg with standard breakfast, biochemical calcium can be taken in adults from 25% to 35% with different types of calcium salts. Calcium absorption is reduced without food. The maximum level of calcium absorption from supplements when putting calcium into the body at a dose of 500 mg or less.

Calcium ion absorption varies with age, the highest absorption in childhood (about 60%), dropped to 28% in children before puberty and increased in the early period of puberty (about 34%), the remaining absorption of segments is about 25% in young adults, but increased in the last 2 quarters of pregnancy. Absorption decreases in high age, on average, about 0.21% annually in women after menopause. Similarly reduced absorption seems to occur in the age of a man.

Slow calcium absorption in some anions (such as oxalat, phytat, sulfate) and fatty acids, these substances precipitate or form a complex with calcium ions, but the intestinal pH from 5-7 facilitates the maximum of soluble and maximum dissipation of these complexes. Therefore, calcium can be absorbed very little from foods rich in oxalic acid or phytic acid. Although soybeans contain high content of phylic acid, but absorbing calcium in this food is relatively high. Glucocorticoid and low serum calcitonin levels can reduce calcium absorption. Absorbing calcium absorption in patients with gastric acidosis, malabsorption in the intestines, bone dysplasia in the kidneys, fat stools, diarrhea or blood urea.

After use, the amount of calcium ions discharged in the urine is the quantity difference filtered in the glomerular and the amount of reabsorption. The reabsorption in the renal tubules is very effective because up to 98% of the glomerular filtered calcium ion is steamed into the sample. The reabsorption efficiency is the main regulatory regulatory by the hormone and is also affected by the purification of Na+, the presence of non -reabsorbed anions, and the diuretic benefits. The diuretic is the impact at the upward branch of the Henle straps, increasing the urinary calcium. In contrast, only the diuretics are not attached to the excretion of Na+ and Ca+, leading to reducing calcium urinary. Armor hormone always regulates blood calcium ions by acting on the renal tubules.

After absorption, the calcium first entered the extracellular fluid, then quickly put into the skeleton tissue. However, using calcium does not stimulate bone formation. Bone contains 99% calcium of the body, the remaining 1% is evenly distributed between intracellular and extracellular fluids.

Total calcium concentration in normal serum 9 - 10.4 mg/decilite, but only calcium cans have a physiological activity. Calcium in the form of ions accounts for 50% and calcium in the form of a complex with phosphate, citrate and other anions that account for 5% of the total calcium concentration in the serum. About 45% of calcium in serum binds to plasma proteins. Hypertension hypertension associated with increased calcium concentration in serum; Lower blood protein, the total calcium concentration in the serum is reduced. Acid infections cause calcium levels to increase, while alkaline infections promote serum ionic concentration in serum. Calcium is only affected by calcium diet in normal people. Excess calcium excreted excreted mainly through the kidneys. The calcium part does not absorb excretion mainly in feces, enlisted in bile and pancreatic fluid; 20% of calcium excreted in the urine. A few excreted through sweat, skin, hair, nails. Calcium through the placenta and distribution into breast milk.

vitamin D3 (Colecalciferol)

absorption

Vitamin D is well absorbed through the gastrointestinal tract if absorbing normal fat. Vitamin D3 is well absorbed from the small intestine. Necessary bile for absorption of vitamin D in the intestine. Because vitamin D is soluble in lipids, it is concentrated with microorganisms, and is absorbed in the lymphatic system. Approximately 80% of vitamin D orally absorbed by this mechanism. Currently, it is unclear whether old age changes the physiological absorption of vitamin D in the gastrointestinal tract.

Normal concentration of 25 - hydroxyvitamin d (Ergocalciferol and colecalciferol metabolites in the liver) in plasma ranges from 8 - 80 nanogam/ml. The concentration of less than 11 nanogam/ml is considered a deficiency of vitamin D in infants, breastfed and young babies. Although the concentration is needed to maintain normal calcium metabolism and maintain the best bone mass in older children and middle -aged people who are unknown, but for the elderly may need to increase the amount of vitamin D put into the body to achieve the above goal.

Distribution

After absorbing ergocalciferol and colecalciferol into the blood through the microorganism of the white vein and then combined with the special alpha-globulin (protein with vitamin D). The metabolites (hydroxylation) of ergocalciferol and colecalciferol are also circulating in the blood combined with Alpha-globulin. 25-Hydroxylergocalciferol and 25-Hydroxylcolecoleciferol are stored in fat and muscle for a long time. When vitamin D is completely released from the body through the chest or from the skin, Vitamin D will accumulate in the liver for a few hours. 25-Hydroxyergocciferol can be distributed into milk after high doses of ergocalciferol.

Elimination

Vitamin D compounds and metabolites are mainly eliminated through bile and feces, only a small amount through water. A little through the intestinal circulation but plays a negligible role in the maintenance mechanism of vitamin D.

calcium gluconate

Blood calcium concentration exceeds 2.6 mmol/liter (10.5 mg/100 ml) is considered as a hypercalcemia:

Stop providing calcium or any drug that can cause hypercalcemia will be able to solve mild hypercalcemia in patients without clinical symptoms and normal kidney function.

When the serum concentration exceeds 2.9 mmol/liter (12mg/100ml) must immediately use the following measures:

Satrolena sodium chloride solution 0.9%. For forced diuretic benefits in Furosemid or ethacrynic acid to increase rapidly excretion of calcium and sodium when using too many sodium chloride solutions 0.9%.

Monitor the concentration of potassium and magnesium in the blood and replace blood early to prevent complications in treatment.

Monitor the electrocardiogram and can use the adrenergic beta blockers to prevent heavy arrhythmia. Hematopalysts can be used, can use calcitionin and adrenocorticoid during treatment.

Determine blood calcium concentration in a certain period of time regularly for orientation for treatment.

vitamin D3 (Colecalciferol)

Symptoms

The distance between the treatment dose and the toxic dose is very narrow. Vitamin D dose to overdose among patients.

Need to notify patients about the dangers and symptoms of Viatmin overdose D. Early symptoms of hypercalcemia include: muscle weakness, fatigue, sleeping, headache, anorexia, dry mouth, metal flavor, nausea, vomiting, constipation, dizziness, tinnitus, loss of movement, rash, muscle tone, muscle pain, bone. Late symptoms as a result of hypercalcemia: kidney calcification, kidney stones, kidney damage (urination, night urination, drinking, concentrated urine).

Handling

Regularly quantify blood calcium concentration and maintain blood calcium at 9 - 10 mg/dL (4.5 - 5 MEQ/L), not exceeding 11 mg/dL. Add plenty of water to increase the amount of urine, so to prevent kidney stones in humans with hypercalcium. While treating with medications similar to vitamin D, we must periodically quantify calcium, P, Mg, blood urea nitrogen (bun) and alkaline phosphatase in serum and calcium, phosphate concentration in urine 24 hours. The decrease in phosphatase levels often occur before hypercalcemia in people with bone puree or bone care due to kidney. Must stop the drug and calcium supplement, maintain a poor diet, oral or intravenous fluid. If necessary, use corticosteroids or calcium diuretics such as Furosemid and ethacrynic acid to reduce serum calcium concentration. Can give hemolysis or peritoneal.

If you first drink, give your stomach or cause vomiting. If the drug has passed the stomach, drink mineral oil to promote elimination through feces.

After calcium blood calcium returns to normal, can be treated again if necessary and lower dose.

In an 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 dose to compensate for missed dose.

Use vitamin D at a dose not exceeding the physiological needs are often non -toxic. However, vitamin D is overdose when treating high or prolonged doses or when increased sensitivity to medications similar to vitamin D and will lead to clinical manifestations of blood calcium hypercalcium.

However, there is an unwanted effect ratio (

Be cautious when using

calcium gluconate

Hyperculia hypercalcemia: Hypercalcemia rare when using solitary calcium, but may occur when taking high doses in patients with chronic renal impairment. Because hypercalcemia is more dangerous than lowering blood calcium, excessive calcium supplementation should be avoided, for cases of calcium lowering, so monitoring blood calcium concentration regularly, need to maintain blood calcium levels in the range of 9 - 10.4 mg/dl and blood calcium concentration in general must not exceed 12 mg/dl.

Be careful when using calcium salts in patients with sarcoidosis, heart disease or kidney disease and on patients who are taking cardiac glycosides.

Kidney stones: Due to the main component of kidney stones are calcium salts, the calcium diet has long been considered a cause contributing to the risk of kidney stones and limiting the amount of calcium has long been considered a reasonable measure to prevent the formation of kidney stones. However, some recent research has shown that there is a difference between a calcium -rich diet and using calcium supplements:

A diet rich in calcium may reduce the risk of kidney stones, whereas calcium supplements increase this risk. The reason may be related to oxalate, a diet rich in calcium can reduce the absorption of oxalate through the gastrointestinal tract and the large amount of calcium put into the body can reduce the oxalate output through the urine, leading to the risk of stone creation, in addition can be related to a number of other factors in foods derived from dairy (calcium supplements supplements), but not in calcium supplements.

vitamin D3 (Colecalciferol)

Must be very cautious when using vitamin D for people with kidney failure or kidney stones, heart disease, or atherosclerosis because if these people have hypercalcemia, the risk of the disease gets worse.

Be cautious when using vitamin D for people who are using glycosides aid because of hypercalcemia causes arrhythmia in this patient.

Monitor phosphate levels in plasma while treating vitamin D to reduce the risk of calcium peanuts. It is also necessary to steadily reduce the special blood calcium concentration initially and when there is a suspected toxic symptom.

The effect of the drug on the ability to drive and operate machinery

drugs can be used for drivers and operating machinery.

Use drugs for women during pregnancy and lactation

Pregnancy

No harm when using high doses according to the needs of everyday information. However, pregnant women should be provided with calcium by adequate diet. Use too many vitamins and calcium and other minerals that can be harmful to the mother or fetus.

Breastfeeding period

No harm when taking doses according to usual daily needs. Calcium in breast milk during breastfeeding.

Drug interaction

calcium gluconate

The following drugs inhibit calcium excretion of calcium: thiazid, clopamid, ciprofloxacin, chlorthalidon, anti -convulsions.

Calcium reduces the absorption of Demeclocyclin, Doxycyclin, Metacyclin, Minocyclin, Oxytetracyclin, Tetracyclin, Enoxacin, Fleroxacin, Levofloxacin, LomeFloxacin, Norfloxacin, ofloxacin, PeFloxacin, iron, Zinc and other essences.

Calcium increases the toxicity of the hearts of digitalis glycosides because increased blood calcium levels will increase the inhibition effect of Na+ and K+ ATPase of the cardiad.

Calcium Gluconate can reduce the effect of biphosphat derivatives, calcium, dobutamin, Eltrombopag estramustin, phosphate supplements, quinolones, thyroid products, trientins.

trientin can reduce the effects of calcium gluconate.

glucocorticoid, phenytoin reduces the absorption of calcium through the gastrointestinal tract. Diet with phytat, oxalate reduces calcium absorption because it forms difficult complexes to absorb.

Phosphate, calcitomin, sodium sulfate, Furosemid, Magnesi, Cholestyramin, Estrogen, some anticonvulsants also reduce blood calcium.

Diuria gums, on the contrary, increases blood calcium concentration.

vitamin D3 (colecalciferol)

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 hypothyroidism can lead to hypercalcemia. In that case, it is necessary to reduce the dose of vitamin D or stop using Viatmin 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 cardiovaemia due to blood calcium, leading to arrhythmia.