OGNIS TABLETS

Indications

• Skin aging and wrinkle reduction
• Joint pain and osteoarthritis
• Tendon and ligament injuries
• Bone health
• Wound healing

Dosage

Children: Refer to specific product guidelines or consult a healthcare professional for appropriate dosing based on the indication and formulation used.

Adults: Refer to specific product guidelines or consult a healthcare professional for appropriate dosing based on the indication and formulation used.

Mechanism of action

Collagen exerts its effects primarily by providing the necessary amino acids, such as glycine, proline, and hydroxyproline, that are crucial for the synthesis of new collagen in the body. It is thought to stimulate fibroblast proliferation, which leads to increased collagen production and improved tissue repair. Additionally, collagen may enhance the hydration of the skin and improve its elasticity.

Pharmacodynamics

Collagen supplementation may promote the synthesis of new collagen and improve the integrity of the extracellular matrix. This can lead to improved skin hydration, elasticity, and the reduction of wrinkles. In joint health, collagen may help reduce inflammation and pain, contributing to improved mobility and function. The effects can vary based on the source of collagen (bovine, porcine, marine) and the form of administration (powder, liquid, capsules).

Pharmacokinetics

After oral administration, collagen peptides are absorbed in the gastrointestinal tract and enter the bloodstream. They can be transported to various tissues where they may be incorporated into the extracellular matrix. The half-life of collagen peptides is relatively short, and they are metabolized in the liver and other tissues. The bioavailability of collagen can vary based on the formulation and the presence of other dietary components.

Adverse effects

• Allergic reactions
• Skin rash
• Itching
• Gastrointestinal disturbances
• Nausea

Precautions

• Use with caution in individuals with fish allergies if derived from fish sources
• Monitor for allergic reactions

Pregnancy

Collagen is generally considered safe during pregnancy, but consult a healthcare professional before use.

Breast-feeding

Collagen is likely safe during breastfeeding, but consult a healthcare professional before use.

Storage

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

Formulations

• Powder
• Capsules
• Liquid

Indications

• Primary adrenal insufficiency (Addison's disease)
• Congenital adrenal hyperplasia
• Orthostatic hypotension
• Heart failure
• Hypertension associated with hyperaldosteronism

Dosage

Children: Refer to the BNF for Children for appropriate dosing recommendations based on age and weight.

Adults: Refer to specific guidelines in the BNF for adequate dosing. Dosing should be individualized based on the condition being treated and patient response.

Mechanism of action

Mineralocorticoids exert their effects by binding to mineralocorticoid receptors (MR) in target tissues such as the kidneys, colon, and heart. This binding leads to the activation of genes responsible for sodium reabsorption, potassium secretion, and water retention, ultimately resulting in increased blood volume and blood pressure.

Pharmacodynamics

The pharmacodynamic effects of mineralocorticoids include increased renal tubular reabsorption of sodium and increased urinary excretion of potassium. These actions lead to fluid retention and increased blood pressure. Additionally, they have roles in electrolyte balance and the regulation of cardiovascular function.

Pharmacokinetics

Mineralocorticoids are typically administered orally or intravenously and are well absorbed from the gastrointestinal tract. They have variable half-lives depending on the specific compound used. The metabolism occurs primarily in the liver, and elimination is predominantly via renal excretion. The pharmacokinetics can be affected by various drug interactions, as seen with certain medications that alter their metabolism or clearance.

Interactions

• cobicistat+mineralocorticoidreceptorantagonists: Severe (increases exposure)
• dabrafenib+mineralocorticoidreceptorantagonists: Severe (decreases exposure)
• bosentan+mineralocorticoidreceptorantagonists: Severe (decreases exposure)
• idelalisib+mineralocorticoidreceptorantagonists: Severe (increases exposure)
• clarithromycin+mineralocorticoidreceptorantagonists: Severe (increases exposure)
• mitotane+mineralocorticoidreceptorantagonists: Severe (decreases exposure)
• rifampicin+mineralocorticoidreceptorantagonists: Severe (decreases exposure)
• stjohn’swort+mineralocorticoidreceptorantagonists: Severe (decreases exposure)
• cenobamate+mineralocorticoidreceptorantagonists: Moderate (decreases exposure)
• amiodarone+mineralocorticoidreceptorantagonists: Unknown (increases exposure)

Pregnancy

null

Breast-feeding

null

Storage

null

Indications

• Hypophosphatemia
• Bone disorders (e.g., osteomalacia, rickets)
• Nutritional supplementation in deficiency states

Dosage

Children: Refer to BNF for Children for specific paediatric dosing guidance based on the condition being treated.

Adults: Refer to BNF for specific adult dosing guidance based on the condition being treated.

Mechanism of action

Phosphorus decreases the absorption of intercellular calcified cartilage matrix by osteoclasts in the metaphyseal region of growing bones, leading to increased bone density and thickness, observable as 'phosphorus bands' on radiographs. Additionally, exposure to white phosphorus damages the rough and smooth endoplasmic reticulum, impairing protein synthesis and lipid transport, particularly affecting the synthesis of very low-density lipoproteins (VLDL) and causing hepatic steatosis and fibrosis.

Pharmacodynamics

Phosphorus is involved in bone metabolism and energy transfer within cells. It contributes to the structural framework of bones and teeth, and its role in ATP formation is crucial for energy metabolism. The balance of phosphorus with calcium and vitamin D is essential for maintaining bone health and preventing disorders such as osteomalacia and rickets.

Pharmacokinetics

Phosphorus is absorbed in the gastrointestinal tract, with absorption rates affected by factors such as dietary composition and the presence of other minerals. It is distributed throughout body tissues, particularly in bones and teeth. Phosphorus is primarily excreted through the kidneys, and its serum levels are regulated by hormonal influences, including parathyroid hormone and calcitriol.

Pregnancy

Phosphorus is essential for fetal development; however, excessive intake should be avoided. Consult healthcare professionals for appropriate supplementation.

Breast-feeding

Phosphorus is secreted in breast milk; adequate maternal intake is important for infant health. Consult healthcare professionals for guidance.

Storage

Store in a cool, dry place, away from direct sunlight and moisture. Ensure it is kept out of reach of children.

Indications

• Nutritional supplementation
• Enzyme replacement therapy
• Hormonal therapies
• Immune modulation

Dosage

Children: Dosage of proteins for pediatric patients should be determined based on individual needs, specific conditions, and

Adults: Dosage of proteins varies widely based on the specific type of protein and its intended use. Refer to specific product guidelines for detailed dosing information.

Mechanism of action

Proteins function primarily as enzymes, structural components, signaling molecules, and transporters. Each protein has a unique sequence of amino acids that determines its specific shape and function. Enzymes, a class of proteins, facilitate biochemical reactions by lowering the activation energy required for the reactions to occur, thereby accelerating metabolic processes. The interaction of proteins with other molecules is often mediated through specific binding sites that recognize and bind to substrates, ligands, or other proteins.

Pharmacodynamics

The pharmacodynamic effects of proteins depend on their specific roles in biological systems. For instance, enzymes can enhance the rate of reactions, while structural proteins provide support and shape to cells and tissues. Hormonal proteins can influence various physiological processes by acting as signaling molecules that trigger specific cellular responses. The effectiveness of proteins in therapeutic applications often relies on their ability to bind specifically to target sites, leading to a desired physiological effect.

Pharmacokinetics

The pharmacokinetics of proteins can vary widely depending on their size, structure, and the presence of post-translational modifications. Generally, proteins are absorbed through the gastrointestinal tract when ingested, but their bioavailability may be limited due to digestion. When administered parenterally, proteins may have a more direct and rapid effect. They are typically metabolized by the liver and excreted primarily by the kidneys. The half-life of proteins can range significantly based on their molecular weight and the specific mechanisms of clearance.

Adverse effects

• Allergic reactions
• Anaphylaxis
• Gastrointestinal disturbances
• Immunogenic reactions

Precautions

• Use with caution in individuals with allergies to specific protein sources
• Monitor for allergic reactions when administered
• Consider potential interactions with other medications that may affect protein metabolism

Pregnancy

Proteins are essential nutrients during pregnancy, and adequate intake is necessary for fetal development. However, the source of protein should be carefully considered.

Breast-feeding

Proteins are vital for lactating mothers and their infants. Adequate protein intake supports both maternal health and milk production.

Storage

Store at room temperature in a cool, dry place away from direct sunlight. Refrigerate if specified for certain protein formulations.

Formulations

• Powdered protein supplements
• Liquid protein supplements
• Protein bars
• Intravenous protein formulations

Indications

• Therapeutic drug monitoring
• Assessment of drug accumulation
• Management of potential drug toxicity
• Adjustment of dosing in renal or hepatic impairment

Dosage

Children: Refer to specific drug guidelines and clinical protocols for dosing recommendations.

Adults: Refer to specific drug guidelines and clinical protocols for dosing recommendations.

Mechanism of action

Residual effects may arise from the drug's active metabolites or its binding to target receptors, which may not be fully reversible. The exact mechanism depends on the specific drug in question and its pharmacokinetics.

Pharmacodynamics

The pharmacodynamics of a drug describes its effects on the body, including the relationship between drug concentration and effect. Residual effects can lead to prolonged action or adverse effects even after the drug has been cleared from the bloodstream.

Pharmacokinetics

Pharmacokinetics involves the absorption, distribution, metabolism, and excretion (ADME) of a drug. Residual levels may be influenced by factors such as half-life, bioavailability, and clearance rates. Monitoring residual levels is crucial in determining the need for dosage adjustment in certain populations.

Pregnancy

Safety during pregnancy has not been established. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Unknown if excreted in human milk. Use with caution and consider the benefits versus risks.

Storage

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

Indications

• Electrolyte replacement
• Treatment of hyponatremia
• Management of hypokalemia
• Acid-base balance correction
• Nutritional supplementation

Dosage

Children: Refer to specific pediatric dosing references for appropriate salt formulations and dosages.

Adults: Refer to specific product information for dosing guidelines, as it varies widely depending on the type of salt and indication.

Mechanism of action

Salts exert their effects primarily through the dissociation of cations and anions in solution, which can influence osmotic balance, acid-base status, and cellular function. For example, sodium salts can increase plasma sodium levels, affecting fluid balance and nerve transmission, while potassium salts can help maintain cellular excitability and muscle contraction.

Pharmacodynamics

The pharmacodynamics of salts varies depending on the specific cation or anion involved. Electrolyte salts help maintain homeostasis by regulating the movement of water across cell membranes, influencing nerve impulse transmission, and facilitating muscle contraction. The balance of electrolytes is critical for normal physiological function, and deviations can lead to conditions such as dehydration, muscle cramps, and arrhythmias.

Pharmacokinetics

Salts are absorbed in the gastrointestinal tract, with the rate of absorption varying by the specific salt and its formulation. Once in the bloodstream, they distribute throughout the body and are utilized in various metabolic processes. Excretion typically occurs via the kidneys, with renal function playing a key role in maintaining electrolyte balance. The half-life of salts depends on the specific compound and the body’s needs for that particular electrolyte.

Contra-indications

• Hypersensitivity to the specific salt
• Severe renal impairment
• Hyperkalemia for potassium salts
• Hypernatremia for sodium salts

Adverse effects

• Gastrointestinal upset
• Nausea
• Diarrhea
• Abdominal cramps
• Electrolyte imbalance
• Cardiac arrhythmias (especially with potassium salts)

Interactions

• Potassium salts may interact with ACE inhibitors, potassium-sparing diuretics, and certain non-steroidal anti-inflammatory drugs (NSAIDs)
• Sodium salts may interact with diuretics and corticosteroids, affecting fluid and electrolyte balance

Precautions

• Use with caution in patients with cardiovascular disease
• Monitor electrolyte levels regularly in patients receiving large doses
• Assess renal function before initiating therapy

Pregnancy

Consult with a healthcare provider. Some salts may be used, but caution is advised due to potential effects on electrolyte balance.

Breast-feeding

Consult with a healthcare provider. Most salts are considered safe, but monitoring for any adverse effects in the infant is recommended.

Storage

Store in a cool, dry place, away from light. Ensure containers are tightly closed.

Formulations

• Oral tablets
• Oral solutions
• Powder for reconstitution
• Intravenous solutions

Mechanism of action

Phosphorus apparently decreases the absorption of intercellular calcified cartilage matrix by osteoclasts, in the metaphyseal region of growing bones. Administration of phosphorus to growing animals or children produces "phosphorus bands" of increased bone density and thickness that are visible grossly or from radiograms. The "phosphorus bands" are observed in the metaphyseal region of growing bones, and represent areas of decreased absorption of the calcified cartilage matrix. Exposure to white phosphorus has been shown to damage the rough endoplasmic reticulum and cause a disaggregation of polyribosomes. This damage results in impairment of protein synthesis, in particular, a decrease in the synthesis of the apolipoprotein portion of very low density lipoproteins (VLDL), which are required for the transport of triglycerides. A significant decrease in protein synthesis has been detected as early as 3 hours after oral exposure. The smooth endoplasmic reticulum is also involved in the formation of the VLDLs, and damage to the smooth endoplasmic reticulum also impairs the formation of VLDLs. The net result of these ultrastructural changes is an accumulation of triglycerides in the liver. This results in steatosis and fibrosis, which is one of the mechanisms involved in the hepatotoxicity of white phosphorus. The mechanism behind the damage to the endoplasmic reticulum is not known; also, it is not known whether white phosphorus itself or a metabolite of white phosphorus is the damaging agent. In addition to these damages, white phosphorus or a metabolite causes damage to the mitochondria and nuclei in the livers of animals orally exposed to white phosphorus. The damage to the mitochondria may impair the cell's ability to produce ATP, thus resulting in necrosis of the cell. Fatty infiltration and/or cellular damage has also been observed in the kidney, brain, and heart. It is possible that white phosphorus (or a metabolite) also impairs the ability of cells in these organs to produce ATP. The mitochondrial damage may also inhibit fatty acid oxidation (also contributing to the decreased availability of ATP) which could result in an accumulation of fat in the organs.