Calcinor 44%

Indications

• Vulvovaginal candidiasis
• Fungal infections
• Antiseptic for minor cuts and abrasions
• Ocular antiseptic
• Insecticide in pest control

Dosage

Adults: Refer to specific guidelines for formulations. Commonly used as a 2-3% solution

Mechanism of action

Boric acid exerts its antifungal effects by disrupting the cell membrane integrity of fungi. It interferes with the synthesis of essential cellular components, leading to cell lysis and death. The acid also has mild antibacterial properties, which can help in reducing bacterial load in infected areas. The exact molecular pathways involved in these actions are not fully elucidated, but it is known to alter the pH of the environment, making it less conducive for fungal growth.

Pharmacodynamics

Boric acid demonstrates a low toxicity profile in humans when used appropriately. Its antifungal activity is primarily effective against Candida species, and it can be used as a second-line treatment for vulvovaginal candidiasis, particularly in cases of recurrent infections. The effectiveness of boric acid is also attributed to its ability to maintain an acidic environment, which is unfavorable for the growth of many pathogens. Its antiseptic properties help in reducing inflammation and promoting healing in infected tissues.

Pharmacokinetics

Boric acid is poorly absorbed through the gastrointestinal tract but can be absorbed through the skin and mucous membranes. Once absorbed, it is distributed throughout the body, with a tendency to accumulate in various tissues, including the liver and kidneys. The elimination half-life of boric acid is variable, depending on dosage and route of administration. It is primarily excreted unchanged in the urine. Due to its potential for toxicity with high systemic exposure, it is important to adhere to recommended dosages.

Contra-indications

• Hypersensitivity to boron or any component of the formulation
• Severe renal impairment

Adverse effects

• Skin irritation or rash
• Nausea
• Vomiting
• Diarrhea
• Headache
• Fatigue
• Tremors
• Confusion

Interactions

• May interact with other topical medications
• Caution with nephrotoxic agents

Precautions

• Use with caution in patients with renal insufficiency
• Careful monitoring is advised in long-term use
• Not recommended for use in large areas of broken skin

Pregnancy

Boric acid is classified as category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Limited data available. It is advisable to avoid use while breastfeeding.

Storage

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

Formulations

• Topical ointment
• Powder
• Solution

Indications

• Vitamin B12 deficiency
• Megaloblastic anemia
• Neuropathy
• Erythropoiesis stimulation

Dosage

Children: Refer to the BNF for Children for specific dosing guidance.

Adults: Refer to the BNF for specific dosing guidance.

Mechanism of action

Cobalt functions as a key component in the structure of vitamin B12, which is necessary for the normal functioning of cells. It acts as a cofactor in enzymatic reactions, particularly in the metabolism of homocysteine to methionine and in the synthesis of nucleic acids. Cobalt also plays a role in the regulation of erythropoiesis (production of red blood cells) and contributes to the overall cellular metabolism.

Pharmacodynamics

Cobalt is crucial for various biochemical processes, including DNA synthesis and the metabolism of carbohydrates, fats, and proteins. It is primarily known for its role in hematopoiesis and neurological function. Adequate levels of cobalt are essential for preventing megaloblastic anemia, a condition characterized by the production of large, abnormal red blood cells due to impaired DNA synthesis.

Pharmacokinetics

Cobalt is absorbed in the gastrointestinal tract, with better absorption occurring when dietary intake is adequate. Once absorbed, it is distributed throughout the body, particularly in the liver, kidneys, and bone marrow. Cobalt is primarily excreted through the urine. The half-life of cobalt in the body can vary based on the form and the physiological state of the individual. Excess cobalt can lead to toxicity, particularly affecting the thyroid and causing cardiomyopathy.

Pregnancy

Cobalt is classified as a trace element necessary for human health, but excessive exposure may pose risks. Consult specific resources for detailed guidance.

Breast-feeding

Cobalt is excreted in breast milk. The effects on the nursing infant are not well established.

Storage

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

Indications

• Iron deficiency anemia
• Chronic blood loss
• Nutritional iron deficiency
• Pregnancy-related anemia

Dosage

Children: Refer to the BNF for Children for specific dosing information as it may vary based on the formulation and clinical context.

Adults: Refer to the BNF for specific dosing information as it may vary based on the formulation and clinical context.

Mechanism of action

Ferric ions participate in various biological processes, including oxygen transport and electron transfer. They facilitate the formation of hemoglobin in red blood cells, allowing for efficient oxygen delivery throughout the body. Ferric compounds can also promote the absorption of iron from the gastrointestinal tract by providing a more bioavailable form of iron.

Pharmacodynamics

Ferric compounds exhibit their effects primarily through the restoration of iron levels in the body. This leads to improved synthesis of hemoglobin and overall enhancement of oxygen-carrying capacity. The pharmacological action is dose-dependent, with higher doses leading to more pronounced effects on hemoglobin levels and erythropoiesis. Additionally, ferric ions can influence various metabolic pathways involved in cellular respiration and energy production.

Pharmacokinetics

Ferric is absorbed in the gastrointestinal tract, with absorption rates influenced by dietary factors and the presence of other substances in the gut. Once absorbed, ferric ions are transported in the bloodstream bound to transferrin, a transport protein. The body regulates iron levels primarily through absorption rather than excretion, and excess iron can be stored in the liver, spleen, and bone marrow. The elimination of ferric compounds is generally slow, as they are incorporated into various biological systems or stored for future use.

Contra-indications

• Hypersensitivity to ferric compounds
• Iron overload conditions such as haemochromatosis or haemosiderosis
• Chronic liver disease
• Active peptic ulcer disease

Adverse effects

• Gastrointestinal disturbances including nausea, vomiting, and constipation
• Diarrhea
• Abdominal pain
• Black stools
• Allergic reactions including rashes and anaphylaxis
• Staining of teeth (with oral formulations)

Interactions

• Antacids may reduce the absorption of oral ferric preparations
• Tetracyclines and quinolone antibiotics may have reduced absorption when taken with iron
• Ascorbic acid may enhance the absorption of iron

Precautions

• Caution in patients with a history of gastrointestinal disease
• Monitor for signs of iron overload in patients receiving repeated doses
• Use with caution in patients with renal impairment

Pregnancy

Ferric compounds are generally considered safe in pregnancy when used as directed to treat iron deficiency, but should be used under medical supervision.

Breast-feeding

Ferric compounds are excreted in breast milk in small amounts, usually considered safe but should be used under medical supervision.

Storage

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

Formulations

• Oral tablets
• Oral solution
• Intravenous injection

Indications

• Constipation
• Topical moisturizer for dry skin
• Ocular lubricant in eye drops

Dosage

Children: Refer to BNF for Children for specific dosing based on age and weight.

Adults: Refer to clinical guidelines for specific dosing based on the formulation and indication.

Mechanism of action

Glycerol acts as an osmotic agent, drawing water into the intestines, which helps to soften stools and promote bowel movements. It increases the osmotic pressure in the intestinal lumen, aiding in the treatment of constipation. Additionally, glycerol may provide hydration to the skin and mucous membranes due to its hygroscopic properties.

Pharmacodynamics

Glycerol has a low molecular weight and is easily absorbed by the body. Its osmotic effects help to increase the water content in the intestines, facilitating stool passage. In topical applications, glycerol enhances skin hydration, improving skin barrier function and reducing transepidermal water loss.

Pharmacokinetics

Glycerol is absorbed from the gastrointestinal tract and distributed throughout the body. It is metabolized primarily in the liver, where it can be converted into glucose or fatty acids. The elimination of glycerol occurs mainly through renal excretion, with a half-life of approximately 1.5 to 3 hours. It has a volume of distribution of about 0.4 to 0.6 L/kg.

Pregnancy

Glycerol is generally considered safe for use during pregnancy, but it is advisable to consult a healthcare provider before use.

Breast-feeding

Glycerol is excreted in breast milk in small amounts, and caution should be exercised when administering it to nursing mothers.

Storage

Store at room temperature, away from light and moisture. Keep out of reach of children.

Formulations

• Glycerol oral solution
• Glycerol suppositories
• Glycerol topical preparations

Indications

• Nutritional supplementation
• Support in metabolic disorders
• Potential use in sports nutrition

Dosage

Children: Refer to the BNF for Children for appropriate dosing recommendations.

Adults: Refer to the BNF for specific dosing guidelines.

Mechanism of action

Glycerophosphate serves as a substrate for the synthesis of phospholipids and triglycerides. It is metabolized to dihydroxyacetone phosphate, which is involved in glycolysis and gluconeogenesis, thereby participating in energy production. It may also promote the formation of ATP, enhancing cellular energy availability.

Pharmacodynamics

Glycerophosphate functions in cellular metabolism as a key intermediate in the synthesis of nucleotides and phospholipids. It aids in the regulation of osmotic balance and may influence cell signaling pathways, including those associated with growth and differentiation.

Pharmacokinetics

Glycerophosphate is absorbed in the gastrointestinal tract and is distributed throughout body tissues. It is metabolized primarily in the liver and muscle tissues, with its metabolites being excreted through urine. The half-life of glycerophosphate is variable based on tissue distribution and metabolic demand.

Pregnancy

There is no established safety profile for glycerophosphate use in pregnancy. Consult relevant guidelines and literature before prescribing.

Breast-feeding

Safety during breastfeeding has not been established. Caution is advised when administering to nursing mothers.

Storage

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

Formulations

• {'formulation': 'Glycerophosphate oral solution', 'strength': None}
• {'formulation': 'Glycerophosphate injection', 'strength': None}

Indications

• Manganese deficiency
• Bone health and development
• Antioxidant support
• Enzyme cofactor in metabolic processes

Dosage

Children: Refer to the BNF for Children for appropriate dosing recommendations.

Adults: Refer to specific clinical guidelines or the BNF for appropriate dosing recommendations.

Mechanism of action

Manganese serves as a cofactor for several enzymes, including manganese superoxide dismutase (MnSOD), which protects cells from oxidative stress by catalyzing the dismutation of superoxide radicals into oxygen and hydrogen peroxide. It also participates in the activation of enzymes involved in carbohydrate, fat, and protein metabolism.

Pharmacodynamics

Manganese plays a role in various biochemical pathways, particularly in the metabolism of amino acids, cholesterol, glucose, and carbohydrates. It is crucial for bone formation and the maintenance of cartilage. Manganese also aids in the synthesis of glycosyltransferases, which are important for the formation of glycoproteins and proteoglycans.

Pharmacokinetics

Manganese is absorbed primarily in the small intestine, with absorption efficiency influenced by dietary factors and the presence of competing minerals. It is transported in the bloodstream bound to proteins such as alpha-2-macroglobulin and transferrin. Manganese is stored in the liver, pancreas, and bones, and is excreted primarily through bile and to a lesser extent in urine. Its half-life in the human body is not well defined due to its trace nature and variable absorption.

Pregnancy

Manganese is classified as a dietary mineral that is essential for human health, but excessive intake should be avoided during pregnancy as it may affect fetal development.

Breast-feeding

Manganese is present in breast milk, and normal dietary intake is considered safe during breastfeeding. However, excessive supplementation should be avoided.

Storage

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