Calcium carbonate/vitamin D3/zinc sulphate Actions
Calcium carbonate is a basic inorganic salt that acts by neutralizing hydrochloric acid in gastric secretions. It also inhibits the action of pepsin by increasing the pH and via adsorption. Cytoprotective effects may occur through increases in bicarbonate ion (HCO3-) and prostaglandins. Neutralization of hydrochloric acid results in the formation of calcium chloride, carbon dioxide and water. Approximately 90% of calcium chloride is converted to insoluble calcium salts (e.g. calcium carbonate and calcium phosphate).
Take Calcium carbonate exactly as directed by your doctor or follow the directions on the package. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
Swallow the calcium carbonate tablets and capsules with a full glass of water.
Chew the chewable forms of calcium carbonate completely before swallowing.
Use the calcium carbonate powder as directed. Allow the powder to dissolve completely, then consume the mixture.
Shake the calcium carbonate suspension well before measuring a dose. To ensure that you get the correct dose, use a dose-measuring spoon or cup, not a regular table spoon to measure the liquid. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
Take calcium with meals to increase its absorption by the body, unless otherwise directed by your doctor.
Store Calcium carbonate at room temperature away from moisture and heat.
Capsules may be swallowed whole or opened and the contents mixed with food or drink.
Gastric-peptic disease occurs as a result of an imbalance between protective factors, such as mucus, bicarbonate, and prostaglandin secretion, and aggressive factors, such as hydrochloric acid, pepsin, and Helicobacter pylori (H. pylori). Antacids work by restoring acid-base balance, attenuating the pepsin activity and increasing bicarbonate and prostaglandin secretion. The acid-neutralizing capacity of calcium carbonate is 58 mEq/15 ml. When used as a nutritional supplement, calcium carbonate acts by directly increasing calcium stores within the body.
Vitamin D3 increases the absorption of calcium and phosphorous that are vital in forming and maintaining strong bones. It is also required in regulating cell growth and maintaining a healthy immune system.
Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
The chewable tablet must be chewed before you swallow it.
The cholecalciferol wafer is usually taken only once per week or once per month. Follow your doctor's dosing instructions very carefully. The wafer must be chewed before you swallow it.
Cholecalciferol is only part of a complete program of treatment that may also include a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you must eat or avoid to help control your condition.
Store at room temperature away from moisture, light, and heat.
The first step involved in the activation of vitamin D3 is a 25-hydroxylation which is catalysed by the 25-hydroxylase in the liver and then by other enzymes. The mitochondrial sterol 27-hydroxylase catalyses the first reaction in the oxidation of the side chain of sterol intermediates. The active form of vitamin D3 (calcitriol) binds to intracellular receptors that then function as transcription factors to modulate gene expression. Like the receptors for other steroid hormones and thyroid hormones, the vitamin D receptor has hormone-binding and DNA-binding domains. The vitamin D receptor forms a complex with another intracellular receptor, the retinoid-X receptor, and that heterodimer is what binds to DNA. In most cases studied, the effect is to activate transcription, but situations are also known in which vitamin D suppresses transcription. Calcitriol increases the serum calcium concentrations by: increasing GI absorption of phosphorus and calcium, increasing osteoclastic resorption, and increasing distal renal tubular reabsorption of calcium. Calcitriol appears to promote intestinal absorption of calcium through binding to the vitamin D receptor in the mucosal cytoplasm of the intestine. Subsequently, calcium is absorbed through formation of a calcium-binding protein.
Vitamins are organic substances required by the body in small amounts for various metabolic processes. Vitamin deficiency may result from an inadequate diet, perhaps due to increased requirements eg, during pregnancy, or may be induced by disease or drugs. This formulation is a combination providing adequate quantities of all B-complex vitamins, vitamin C and zinc.
Thiamine/vitamin B1 is a water-soluble vitamin. It is an essential co-enzyme for carbohydrate metabolism in the form of the diphosphate (thiamine pyrophosphate, cocarboxylase). Thiamine deficiency leads to the development of beri-beri.
Riboflavin/Vitamin B2 is a water-soluble vitamin essential for the utilization of energy from food. It acts as co-enzyme in oxidative/reductive metabolic reactions. Riboflavin is also necessary for the functioning of pyridoxine and nicotinic acid. Deficiency of riboflavin leads to the development of ariboflavinosis.
Pyridoxine/vitamin B6 is a water-soluble vitamin, involved in amino acid, carbohydrate and fat metabolism. It is also required for the formation of haemoglobin and for normal antibody-mediated and cell-mediated immune responses. Its deficiency leads to the development of sideroblastic anaemia, dermatitis, cheilosis and neurological symptoms eg, peripheral neuritis and convulsions.
Cyanocobalamin/vitamin B12 is a water-soluble vitamin, occurs in the body mainly as mecobalamin and as cobamamide and hydroxycobalamin. Mecobalamin and cobamamide act as co-enzymes in nucleic acid synthesis. It is also required for the maturation of RBCs. It is also involved with folic acid in several important metabolic pathways. Deficiency leads to the development of megaloblastic anaemias and demyelination and other neurological damage.
Folic acid is a member of the vitamin B group. It is reduced in the body to tetrahydrofolate, which is a co-enzyme for various metabolic processes including the synthesis of DNA and maturation of RBCs in conjunction with vitamin B12. It is also involved in some amino acid conversions, and in the formation and utilization of formate. It also plays an important role in lymphocyte-mediated immune response. Deficiency of folic acid results in megaloblastic anaemia.
Nicotinamide is a water-soluble vitamin B substance, which is converted to NAD and NADP in the body. These co-enzymes are involved in the electron transfer reactions in the respiratory chain. Deficiency of nicotinamide leads to the development of pellagra.
Calcium pantothenate is a salt of pantothenic acid, a vitamin B substance. It is a component of co-enzyme A, which is essential in the metabolism of carbohydrate, fat and protein. It is also required for normal antibody response in conjunction with pyridoxine.
Ascorbic acid is a water-soluble vitamin, essential for the synthesis of collagen and intercellular material. Deficiency of ascorbic acid leads to the development of scurvy.
Zinc plays an important role in various biological activities particularly in numerous enzymatic pathways including synthesis of nucleic acids and metabolism of proteins, carbohydrates and lipids. It also helps in the development of cell-mediated immunity. Zinc deficiency is associated with growth retardation, defects of the skin, the immune system and the intestinal mucosa.
Thus, an adequate supply of these micronutrients is required for the optimum function of various cells and tissues.
Pharmacokinetics: All the ingredients of Zinc sulphate are absorbed rapidly following oral administration and distributed into various tissues. Except for vitamin B12, the water-soluble vitamins are not stored in the body to any significant extent, the excess quantities being excreted in the urine. The body pool of readily available zinc too, appears to be small and to have a rapid turnover rate. Therefore, a regular and adequate intake of these micronutrients is necessary to meet the metabolic requirements.
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Information checked by Dr. Sachin Kumar, MD Pharmacology