Ascorbic Acid-100

Indications

• Low blood volume
• Hypovolemic shock
• Burns
• Cardiopulmonary bypass

Dosage

Children: Initially 10-20 mL per kilogram. Adjust according to the patient's condition and response, using 3.5-4% solution. Use under specialist supervision to mitigate the risk of fluid overload.

Adults: Dose according to requirements, typically administered intravenously. Consult product literature for specific dosing guidance.

Mechanism of action

Gelatin acts as a plasma expander by increasing the oncotic pressure in the vascular compartment, which helps to retain fluid within the bloodstream and restore circulating blood volume. This mechanism aids in maintaining blood pressure and improving tissue perfusion.

Pharmacodynamics

Gelatin solutions increase blood volume and improve hemodynamic stability in patients experiencing hypovolemic conditions. By drawing water into the vascular space, they help to counteract the effects of low blood volume, such as hypotension and compromised organ perfusion.

Pharmacokinetics

Gelatin is administered intravenously, and its effects can be observed relatively quickly. The half-life and the metabolic clearance depend on the formulation and concentration of the solution. Gelatin is gradually metabolized by macrophages and eliminated by the renal system. Close monitoring of fluid balance is essential, particularly in patients with cardiac or renal impairment.

Contra-indications

• Severe liver disease
• History of circulatory disease
• Severe cardiac disease

Adverse effects

• Fever
• Flushing
• Nausea
• Urticaria
• Rare or very rare shock

Interactions

• Calcium salts

Precautions

• Monitor cardiovascular and respiratory function
• Correct dehydration when administering
• Administer slowly to avoid rapid rise in blood pressure and cardiac failure
• Increased capillary permeability

Pregnancy

Consult product literature for specific guidance regarding use in pregnancy.

Breast-feeding

Consult product literature for specific guidance regarding use in breastfeeding.

Storage

Store at controlled room temperature, protect from light. Refer to product-specific storage instructions.

Formulations

• 5% solution for infusion
• 20% solution for infusion
• Concentrated solution (15-25% protein)
• Isotonic solution (3.5-5% protein)

Indications

• Vitamin C deficiency
• Scurvy
• Adjunct therapy in iron overload conditions

Dosage

Children: Child 1 month–3 years: 125–250 mg daily in 1–2 divided doses; Child 4–11 years: 250–500 mg daily in 1–2 divided doses; Child 12–17 years: 0.5–1 g daily in 1–2 divided doses.

Adults: 500 mg daily, taken in 1-2 divided doses, depending on the clinical condition and dietary needs.

Mechanism of action

Ascorbic acid functions primarily as a reducing agent, facilitating enzymatic reactions in the body, including the hydroxylation of proline and lysine in collagen synthesis. It also plays a role in the absorption of iron from the gastrointestinal tract and enhances the immune response.

Pharmacodynamics

Ascorbic acid is crucial for the maintenance of connective tissue and is involved in the metabolism of several amino acids. Its antioxidant properties help to mitigate oxidative stress and may play a role in reducing the risk of chronic diseases.

Pharmacokinetics

Ascorbic acid is absorbed in the intestines and is widely distributed throughout the body. The renal clearance of ascorbic acid is dose-dependent, with higher doses leading to increased excretion. The half-life varies but is generally around 15 to 30 minutes in healthy individuals, with tissue saturation levels influencing its retention.

Contra-indications

• Hypercalcaemia
• Hyperoxaluria
• Patients with cardiac dysfunction

Adverse effects

• Abdominal pain
• Headache
• Nausea
• Vomiting
• Diarrhoea
• Constipation
• Weight loss
• Polyuria
• Sweating
• Thirst
• Vertigo

Interactions

• Increases risk of cardiovascular adverse effects with iron chelators
• Increases risk of cardiovascular adverse effects with deferiprone
• Increases risk of cardiovascular adverse effects with desferrioxamine

Precautions

• Use with caution in patients with iron overload
• Monitor for symptoms of overdose

Pregnancy

High doses teratogenic in animals but therapeutic doses unlikely to be harmful.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

• Ascorbic acid 50 mg tablets
• Ascorbic acid 100 mg tablets
• Ascorbic acid 200 mg tablets
• Ascorbic acid 250 mg tablets
• Ascorbic acid 500 mg capsules

Indications

• Lactose intolerance
• As a filler or excipient in pharmaceutical formulations

Dosage

Children: Refer to the BNF for Children for specific dosing information based on age and clinical context.

Adults: Refer to the BNF for specific dosing information based on clinical context.

Mechanism of action

Lactose is metabolized in the intestine by the enzyme lactase into its constituent monosaccharides, glucose and galactose. In individuals with lactase deficiency, unabsorbed lactose passes into the colon, where it is fermented by bacteria, leading to gas production and osmotic effects that contribute to diarrhea.

Pharmacodynamics

The pharmacodynamics of lactose are primarily related to its effects on gastrointestinal function. In healthy individuals, lactose is effectively broken down into glucose and galactose, which are absorbed and utilized for energy. In individuals with lactose intolerance, the unabsorbed lactose can cause osmotic diarrhea and colonic fermentation, leading to discomfort and symptoms associated with lactose intolerance.

Pharmacokinetics

Lactose is not absorbed in the gastrointestinal tract until it is hydrolyzed into glucose and galactose by lactase. The absorption of glucose and galactose occurs in the small intestine. The half-life is not applicable as lactose is not typically administered as a medication but is rather ingested as a natural component of food. Its metabolism primarily occurs in the intestine.

Adverse effects

• Bloating
• Diarrhea
• Abdominal pain
• Flatulence

Precautions

• Use with caution in patients with lactose intolerance.
• Consider potential for gastrointestinal upset in sensitive individuals.

Pregnancy

Lactose is generally considered safe for use during pregnancy. However, consult a healthcare professional for individual advice.

Breast-feeding

Lactose is safe to use while breastfeeding, as it is a natural sugar present in breast milk.

Storage

Store in a cool, dry place, away from direct sunlight.

Formulations

• Powder
• Granules
• Tablets
• Syrup

Indications

• Nutritional support
• Source of carbohydrates
• Dietary fiber source
• Animal feed

Dosage

Children: As with adults, there are no specific dosing recommendations for maize for children. It can be introduced into the diet in age-appropriate forms and quantities, keeping in mind the overall dietary balance.

Adults: There are no specific dosing recommendations for maize as it is typically consumed as part of a balanced diet. It can be included in daily meals in various forms such as whole kernels, flour, or as part of dishes.

Mechanism of action

Maize primarily acts as a source of energy due to its high carbohydrate content. The complex carbohydrates in maize are broken down into glucose, which is then utilized by the body for energy production. It also contributes to dietary fiber intake, which can aid in digestive health and regulation of blood sugar levels.

Pharmacodynamics

The consumption of maize influences blood glucose and insulin levels due to its carbohydrate content. It has a relatively low glycemic index when consumed in whole form, which can help in managing blood sugar levels. The dietary fiber present in maize can also promote satiety and aid in weight management.

Pharmacokinetics

The digestion of maize begins in the mouth with salivary amylase breaking down starches into simpler sugars. In the stomach and small intestine, enzymes further break down these carbohydrates. The resultant glucose is absorbed into the bloodstream, where it is transported to cells for energy production. The absorption rate can vary based on the form of maize consumed (e.g., whole kernels versus processed forms).

Pregnancy

Maize is generally considered safe for consumption during pregnancy as it is a staple food and provides essential nutrients.

Breast-feeding

Maize is safe to consume while breastfeeding and can provide important nutrients to both the mother and the infant.

Storage

Store in a cool, dry place, away from moisture and pests. Properly sealed containers can help prolong shelf life.

Formulations

• Whole maize grains
• Maize flour (cornmeal)
• Maize starch
• Maize oil

Indications

• Preoperative skin antisepsis
• Wound irrigation and cleansing
• Management of minor cuts and abrasions
• Treatment of minor skin infections
• Disinfection of mucous membranes

Dosage

Children: Refer to specific product guidelines for concentration and application method, as doses may vary by formulation.

Adults: Refer to specific product guidelines for concentration and application method, as doses may vary by formulation.

Mechanism of action

Povidone-iodine exerts its antiseptic effects primarily through the release of free iodine, which penetrates microbial cell walls and disrupts protein and nucleic acid synthesis. This leads to cell lysis and death of a wide variety of pathogens. The mechanism involves the oxidation of essential cellular components, thus rendering microorganisms inactive.

Pharmacodynamics

Povidone-iodine demonstrates rapid bactericidal activity, effectively reducing the microbial load on the skin and in wounds. The antimicrobial efficacy is influenced by factors such as concentration, exposure time, and the presence of organic matter. Its broad-spectrum action makes it effective against gram-positive and gram-negative bacteria, fungi, and viruses, making it a versatile antiseptic.

Pharmacokinetics

Povidone-iodine is not significantly absorbed through intact skin; however, some absorption may occur with large or prolonged applications, especially on compromised skin. The elimination half-life of iodide is approximately 24 hours, with the majority excreted unchanged in the urine. Iodine levels can be temporarily elevated in the serum after application, particularly in patients with pre-existing thyroid conditions.

Contra-indications

• Hypersensitivity to povidone-iodine or any of the excipients
• Thyroid dysfunction
• Use in infants less than 2 months of age

Adverse effects

• Skin irritation
• Burning sensation
• Allergic reactions
• Staining of skin and clothing
• Thyroid dysfunction
• Electrolyte imbalance (with prolonged use)

Interactions

• May interfere with thyroid function tests
• Incompatibility with other antiseptics or disinfectants

Precautions

• Avoid contact with eyes
• Use with caution in patients with thyroid disease
• Not for deep puncture wounds or serious burns

Pregnancy

Generally considered safe for topical use, but should be used with caution. Consult a healthcare professional for guidance.

Breast-feeding

Suitable for topical use, but excessive use should be avoided. Consult a healthcare professional for guidance.

Storage

Store at room temperature, away from direct sunlight. Keep container tightly closed.

Formulations

• Topical solution
• Ointment
• Surgical scrub
• Swab sticks

Indications

• Solvent for pharmaceuticals
• Preparation of tinctures
• Antiseptic applications
• Industrial uses

Dosage

Children: Refer to specific medical guidelines and consult a pediatric pharmacologist.

Adults: Refer to specific medical guidelines for appropriate use as a solvent or antiseptic.

Mechanism of action

Ethanol, the active component of rectified spirits, influences the central nervous system by acting primarily as a positive allosteric modulator of the GABA-A receptor, enhancing inhibitory neurotransmission. It also affects various neurotransmitter systems, including dopamine and serotonin pathways, which contributes to its psychoactive effects.

Pharmacodynamics

The pharmacodynamic effects of rectified spirits are dose-dependent, with low doses resulting in mild euphoria and relaxation, and higher doses leading to significant sedation, impaired motor function, and altered cognitive function. Chronic use can lead to tolerance and dependence, along with a range of health issues, including liver disease and neurological impairment.

Pharmacokinetics

Ethanol is absorbed rapidly through the gastrointestinal tract, with peak blood concentrations typically occurring within 30 to 90 minutes after ingestion. It is metabolized primarily in the liver by enzymes such as alcohol dehydrogenase and aldehyde dehydrogenase, and its elimination follows zero-order kinetics at higher concentrations. The half-life of ethanol can vary widely based on individual factors such as metabolic rate, age, and liver health.

Pregnancy

Data on the safety of rectified alcohol during pregnancy is limited. It is advisable to avoid use during pregnancy due to potential risks to the fetus.

Breast-feeding

Caution is advised when using rectified alcohol while breastfeeding, as it may affect lactation and the nursing infant.

Storage

Store in a cool, dry place away from direct sunlight. Keep tightly closed and out of reach of children.

Indications

• Preservation of food products
• Preservation of pharmaceutical formulations
• Antimicrobial agent in cosmetic products

Dosage

Children: Refer to specific product guidelines for dosage as it varies by formulation and intended use.

Adults: Refer to specific product guidelines for dosage as it varies by formulation and intended use.

Mechanism of action

Sorbate acts primarily by inhibiting the growth of fungi and some bacteria. It interferes with the microbial cell membrane, disrupting its integrity and function, which leads to cell death. The presence of sorbate alters the pH and osmotic balance within the microbial cell, inhibiting key metabolic processes necessary for reproduction and survival.

Pharmacodynamics

Sorbate exhibits its antimicrobial effects at relatively low concentrations. It is most effective in acidic environments, typically at a pH of 4.5 or lower. The compound is more effective against yeasts and molds compared to bacteria. Its mode of action is primarily through the inhibition of fatty acid synthesis and alteration of membrane permeability in target microorganisms.

Pharmacokinetics

Sorbate is generally regarded as having low toxicity and is rapidly metabolized in the human body. It is absorbed in the gastrointestinal tract when ingested and is then distributed throughout the body. The compound undergoes conversion to various metabolites and is primarily excreted via the urine. Its half-life and specific metabolic pathways can vary depending on the form of administration and individual patient factors.

Pregnancy

There is limited data on the safety of sorbate in pregnancy. Use only if clearly needed and potential benefits justify the risks.

Breast-feeding

There is insufficient information regarding the excretion of sorbate in human milk. Caution is advised when administering to nursing mothers.

Storage

Store in a cool, dry place away from direct sunlight.

Indications

• Antiseptic use
• Solvent in pharmaceutical preparations
• Management of alcohol withdrawal syndrome
• Treatment of methanol poisoning (as an antidote)

Dosage

Children: Refer to specific medical guidelines or formularies for dosing information, as it varies widely based on the indication and formulation used.

Adults: Refer to specific medical guidelines or formularies for dosing information, as it varies widely based on the indication and formulation used.

Mechanism of action

Ethanol acts primarily by enhancing the effects of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABA-A receptor, leading to increased inhibitory neurotransmission. It also inhibits the N-methyl-D-aspartate (NMDA) receptor, which contributes to its depressant effects. Additionally, ethanol affects the release of various neurotransmitters, including dopamine, which plays a role in the reward pathway and contributes to its addictive properties.

Pharmacodynamics

Ethanol's pharmacodynamic effects are dose-dependent. Low doses can produce mild euphoria, relaxation, and impaired motor coordination. As the dose increases, effects can progress to sedation, respiratory depression, and potentially coma or death in cases of severe intoxication. Chronic use can lead to tolerance and dependence, with withdrawal symptoms occurring upon cessation.

Pharmacokinetics

Ethanol is rapidly absorbed from the gastrointestinal tract, with peak blood concentrations occurring within 30 to 90 minutes after ingestion. It is distributed throughout body water, with a volume of distribution of approximately 0.5 to 0.7 L/kg. Ethanol is metabolized primarily by the liver through the action of alcohol dehydrogenase and aldehyde dehydrogenase, with a typical elimination rate of 10 to 20 mg/dL per hour. It is excreted in urine, breath, and sweat.

Adverse effects

• Nausea
• Vomiting
• Dizziness
• Headache
• Irritation of mucous membranes
• Depression of the central nervous system

Interactions

• Increased sedation with other CNS depressants
• Potential enhancement of effects of certain medications metabolized by the liver

Precautions

• Use with caution in patients with a history of substance abuse
• Monitor for signs of excessive sedation or respiratory depression
• Avoid use in patients with known hypersensitivity to alcohol or other ingredients

Pregnancy

Alcohol is generally advised against during pregnancy due to risks of fetal alcohol spectrum disorders and other complications.

Breast-feeding

Alcohol can pass into breast milk, and breastfeeding mothers should limit intake to avoid potential effects on the infant.

Storage

Store in a cool, dry place away from light and out of reach of children. Keep tightly closed.

Formulations

• Spirit (ethanol-based liquid)
• Spirit of ammonia
• Spirit of camphor
• Spirit of turpentine

Indications

• Nutritional supplementation
• Energy source in enteral nutrition
• Excipient in pharmaceutical formulations

Dosage

Children: Refer to specific guidelines or product inserts for dosing information, as it can vary based on the context of use.

Adults: Refer to specific guidelines or product inserts for dosing information, as it can vary based on the context of use.

Mechanism of action

Starch is broken down into glucose units by enzymes such as amylase during digestion. The glucose is then absorbed in the intestines and utilized for energy production in the body's cells. This pathway involves hydrolysis of the glycosidic bonds, converting starch into simpler sugars.

Pharmacodynamics

Starch primarily serves as an energy source. Its digestion and absorption lead to an increase in blood glucose levels, which provides energy for metabolic processes. In this context, it plays a crucial role in maintaining energy homeostasis in the body.

Pharmacokinetics

Starch is not absorbed in its polymeric form; it must first be enzymatically hydrolyzed into simpler sugars such as maltose and glucose. The digestion and absorption of starch occur predominantly in the small intestine, with glucose being readily absorbed into the bloodstream. The rate of absorption can vary depending on the type of starch and its physical form.

Adverse effects

• Allergic reactions
• Gastrointestinal discomfort
• Diarrhea
• Constipation

Precautions

• Use with caution in individuals with known allergies to starch or starch derivatives
• Monitor for gastrointestinal symptoms in patients with a history of digestive disorders

Pregnancy

Starch is generally considered safe for use during pregnancy. However, it should be consumed in moderation as part of a balanced diet.

Breast-feeding

Starch is deemed safe for nursing mothers when used in moderation as part of a balanced diet.

Storage

Store in a cool, dry place away from moisture and direct sunlight.

Formulations

• Powder
• Granules
• Tablets
• Suspensions

Dosage

Children: Refer to product-specific guidelines or consult a healthcare professional.

Adults: Refer to product-specific guidelines or consult a healthcare professional.

Pregnancy

There is limited data on the safety of Sunset during pregnancy, thus it should be used only if clearly needed and prescribed by a healthcare provider.

Breast-feeding

Due to the lack of sufficient studies, it is advised to consult a healthcare professional before using Sunset while breastfeeding.

Storage

Store in a cool, dry place, away from direct sunlight and out of reach of children.

Pregnancy

No specific data available, consult a healthcare professional.

Breast-feeding

No specific data available, consult a healthcare professional.

Storage

Store in a cool, dry place away from light.