Ferrous ascorbate/folic acid Actions

How do you administer this medicine?
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Consists of ferrous ascorbate, folic acid

Actions of Ferrous ascorbate in details

The action of the drug on the human body is called Pharmacodynamics in Medical terminology. To produce its effect and to change the pathological process that is happening the body and to reduce the symptom or cure the disease, the medicine has to function in a specific way. The changes it does to the body at cellular level gives the desired result of treating a disease. Drugs act by stimulating or inhibiting a receptor or an enzyme or a protein most of the times. Medications are produced in such a way that the ingredients target the specific site and bring about chemical changes in the body that can stop or reverse the chemical reaction which is causing the disease.
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Ferrous ascorbate belongs to the class of medicines called antianemics and is an oral iron supplement. It is a synthetic form of iron (ferrous) and along with ascorbic acid (ascorbate), that helps increase the absorption of iron in the small intestine, it raises iron levels in blood which is essential for red blood cell or hemoglobin production.

Actions of Folic acid in details

The action of the drug on the human body is called Pharmacodynamics in Medical terminology. To produce its effect and to change the pathological process that is happening the body and to reduce the symptom or cure the disease, the medicine has to function in a specific way. The changes it does to the body at cellular level gives the desired result of treating a disease. Drugs act by stimulating or inhibiting a receptor or an enzyme or a protein most of the times. Medications are produced in such a way that the ingredients target the specific site and bring about chemical changes in the body that can stop or reverse the chemical reaction which is causing the disease.

Pharmacology: Pharmacodynamics: Folic acid is a member of the vitamin B group. It is reduced in the body to tetrahydrofolate, which is a co-factor for various metabolic processes including synthesis of purine and pyrimidine nucleotides and hence in the synthesis of DNA. It is involved in some amino acid conversions and in the formation and utilization of formate.

The terms folic acid and folate are often used interchangeably. Folic acid is the most stable form often used in vitamin supplements and fortified foods, while folate refers to the naturally occurring vitamin that is found in foods.

Folate cofactors are required for the metabolism of several important amino acids. The synthesis of methionine from homocysteine requires a folate co-factor. Thus a deficiency of folic acid can result to a decreased synthesis of methionine and build-up of homocysteine. Increased levels of homocysteine may be a risk factor for cardiovascular and other chronic diseases.

Neural Tube Defects (NTD): Fetal growth and development are characterized by widespread cell division. Adequate folic acid is critical because of its role in the DNA and RNA synthesis. NTD may result in anencephaly or spina bifida, which are devastating and sometimes fatal birth defects. These defects occur between the 21st and 27th days of conception, a time when many women do not realize they are pregnant.

Pharmacokinetics: Folic acid polyglutamates from food sources are enzymatically hydrolyzed in the GIT to monoglutamates prior to absorption which occurs mainly in the proximal small intestine. In the presence of malabsorption syndrome, folic acid from oral supplements will still be absorbed, whereas absorption of folic acid from food sources may be impaired.

Following absorption, folic acid is converted in the liver and plasma to its metabolically active form tetrahydrofolic acid, which is then distributed into all body tissues. Normal serum folate concentrations range from 0.016-0.021 mcg/mL.

The liver contains about 50% of total body folate stores. Larger doses of folic acid may escape metabolism by liver and appear in the blood mainly as folic acid. Following oral administration of single 0.1-0.2 mg doses of folic acid in healthy adults, only a trace amount of the drug appears in urine. Following administration of large doses, the renal tubular reabsorption maximum is exceeded, and excess folate is excreted unchanged in the urine. After doses of about 2.5-5 mg, about 50% of a dose is excreted in urine and after a 15-mg dose, up to 90% maybe recovered in urine. Small amounts of orally administered folic acid have been recovered from the feces. Folic acid is also actively excreted in human breast milk.

How should I take Folic acid?

This section provides information on the proper use of a number of products that contain folic acid. It may not be specific to Folic acid. Please read with care.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Missed Dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the dietary supplement in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Folic acid administration

Administration of drug is important to know because the drug absorption and action varies depending on the route and time of administration of the drug. A medicine is prescribed before meals or after meals or along with meals. The specific timing of the drug intake about food is to increase its absorption and thus its efficacy. Few work well when taken in empty stomach and few medications need to be taken 1 or 2 hrs after the meal. A drug can be in the form of a tablet, a capsule which is the oral route of administration and the same can be in IV form which is used in specific cases. Other forms of drug administration can be a suppository in anal route or an inhalation route.
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Oral preferred, but may also be administered by deep IM, SubQ, or IV injection.

IV administration: May administer ≤5 mg dose undiluted over ≥1 minute or may dilute ≤5 mg in 50 mL of NS or DW and infuse over 30 minutes. May also be added to IV maintenance solutions and given as an infusion.

Folic acid pharmacology

Pharmacokinetics of a drug can be defined as what body does to the drug after it is taken. The therapeutic result of the medicine depends upon the Pharmacokinetics of the drug. It deals with the time taken for the drug to be absorbed, metabolized, the process and chemical reactions involved in metabolism and about the excretion of the drug. All these factors are essential to deciding on the efficacy of the drug. Based on these pharmacokinetic principles, the ingredients, the Pharmaceutical company decides dose and route of administration. The concentration of the drug at the site of action which is proportional to therapeutic result inside the body depends on various pharmacokinetic reactions that occur in the body.

Folic Acid acts on megaloblastic bone marrow to produce a normoblastic marrow.

In man, exogenous source of folate is required for nucleoprotein synthesis and the maintenance of normal erythropoiesis. Folic Acid is a precursor of tetrahydroFolic Acid, which is involved as a cofactor for transformylation reactions in the biosynthesis of purines and thymidylates of nucleic acids. Impairment of thymidylate synthesis in patients with folic deficiency is thought to account for the defective deoxyribonucleic acid (DNA) synthesis that leads to megaloblast formation and megaloblastic and macrocytic anemia.

Folic Acid is absorbed rapidly from the small intestine, primarily from the proximal portion. Naturally occurring conjugated folates are reduced enzymatically to Folic Acid in the gastrointestinal tract prior to absorption. Folic Acid appears in the plasma approximately 15 to 30 minutes after an oral dose; peak levels are generally reached within 1 hour. After intravenous administration, the drug is rapidly cleared from the plasma. Cerebrospinal fluid levels of Folic Acid are several times greater than serum levels of the drug. Folic Acid is metabolized in the liver to 7, 8-dihydrofolic and eventually to 5, 6, 7, 8-tetrahydroFolic Acid with the aid of reduced diphosphopyridine nucleotide (DPNH) and folate reductases. TetrahydroFolic Acid is linked in the N5 or N10 positions with formyl, hydroxymethyl, methyl or formimino groups. N5-formyltetrahydroFolic Acid is leucovorin. TetrahydroFolic Acid derivatives are distributed to all body tissues but are stored primarily in the liver. Normal serum levels of total folate have been reported to be 5 to 15ng/mL; normal cerebrospinal fluid levels are approximately 16 to 21ng/mL. Normal erythrocyte folate levels have been reported to range from 175 to 316 ng/mL. In general, folate serum levels below 5 ng/mL indicate folate deficiency, and levels below 2 ng/mL usually result in megaloblastic anemia. After a single oral dose of 100 mcg of Folic Acid in a limited number of normal adults, only a trace amount of the drug appeared in the urine. An oral dose of 5 mg in 1 study and a dose of 40 mcg/kg of body weight in another study resulted in approximately 50% of the dose appearing in the urine. After a single oral dose of 15 mg, up to 90% of the dose was recovered in the urine. A majority of the metabolic products appeared in the urine after 6 hours; excretion was generally complete within 24 hours. Small amounts of orally administered Folic Acid have also been recovered in feces. Folic Acid is also excreted in the milk of lactating mothers.


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References

  1. DailyMed. "ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PHYTONADIONE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN 5'-PHOSPHATE SODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. NCIt. "Folic Acid: NCI Thesaurus (NCIt) provides reference terminology for many systems. It covers vocabulary for clinical care, translational and basic research, and public information and administrative activities.". https://ncit.nci.nih.gov/ncitbrowser... (accessed September 17, 2018).
  3. EPA DSStox. "Folic acid: DSSTox provides a high quality public chemistry resource for supporting improved predictive toxicology.". https://comptox.epa.gov/dashboard/ds... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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