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10 Cards in this Set

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Ferrous Sulfate
1. Brand name
2. Dosage forms?
1. Slow FE
FeSO4
2. Tab immediate release 325mg ferrous sulfate provides 65mg Fe

Tab ER (Slow FE): 160mg dried ferrous sulfate provides 50mg Fe

Some also list 324mg.
Ferrous Sulfate
1. Category?
2. FDA indications/dosage
Blood modifier
2. Tx of IDA:
usual therapeutic dose of Fe is 200mg per day (2-3mg per kg body weight).
- Start tx at low dose, titrate up to minimize SE.

- Ferrous sulfate immediate release tabs should be given at fasting state to maximize absorption

- ER tabs should be given c food
Ferrous Sulfate

1. Pharmacology
2. Pharmacokinetics
1. Fe is essential for normal erythropoiesis
- Fe deficiency in humans can lead o low Hgb and hypochromic anemia
- Can result from inade. intake, interference of iron absorption or from loss of blood.
-2/3 of Fe in body is found in Hgb and myoglobin; the rest is stored in ferritin
- Normal dietary Fe of 14mg/day --> absorption of 1mg/day.
-Absorption through duodenum and upper small intestine
-Foods high in Fe = liver, heart, wheat germ, egg yolks, oysters, dried beans and fruit.
Ferrous Sulfate

1. Drug Interactions
2. Contraindications/precautions
Antacids decrease absorption of iron. Fe decreases absorption of tetracyclines, quinolones, and levodopa
2. use with caution in nursing mothers. No nursing category established.
Ferrous Sulfate

1. Adverse effects
2. Pt Consultation
1. most common incl: constipation, nausea, vomiting, heartburn, diarrhea
2. Immediate release should be taken on an empty stomach; but take c food if GI upset occurs

- ER are taken c food
- store in cool dry place away from sunlight & children
-contact MD if SE are severe or persistent
- if a dose is missed, take it as soon as possible and return to normal dosing.
Vitamin D, Ergocalciferol
1. Brand name
2. Dosage form
1. Drisdol
2. Capsule: each softgel contains 1.25mg in vegetable oil (50,000IU of VitD)

Drops: 200IU of ergocalciferol per drop (8,000 IU per mL)
Vitamin D, Ergocalciferol

1. FDA indications/dosages
2. non-FDA approved indications
1. For tx of refractory rickets (Vit D resistant rickets): 12000 - 500,000 IU daily.

- Tx of hypoparathyroidism: 50,000 to 200,000IU daily concomitantly w/ calcium lactate 4gm, 6x/day
2. For tx of Vit D deficiency in adults (25-hydroxyvitamin D3 <20ng/ml)
give 50,000 IU weekly for 8 weeks w/ supplemental calcium followed by 1,000 IU daily w/ suppl calcium
Vitamin D, Ergocalciferol

1. Pharmacology
2. Kinetics
UV light converts 7-dehydrocholesterol in the skin to cholecalciferol (Vit D3). Both cholecalciferol and ergocalciferol (VitD2) are converted in liver to 25-hydroxyvitamin D forms then in the kidney to 1,25-dihydroxyvit D forms. D2 and D3 are essential for the proper regulation of calcium in plasma and activity of PTH.
2. Vit D is involved in the absorption of calcium and phosphorous from small intestine -- provides Ca and P in the plasma to promote bone mineralization. Ergocalciferol is effective in treating hypocalecemia and hyperphosphatemia seen in hypoPTH
Vitamin D, Ergocalciferol

1. Drug interactions
2. contraindications/precautions
1. mineral oil interferes w/ absorption of fat soluble vitamins (ie VIt D). Addition of thiazide diuretics to hypoPTH pt concurrently taking Vitamin D, Ergocalciferol may cause hypercalcemia
Contraindicated in pts w/ hypercalcemia, malabsorption syndrome, and hypervitaminosis D. Idiopathic hypercalcemia may be caused by hypersensitivity to vit D. Vit D should be restricted in these cases.
Vitamin D has a narrow therapeutic index - dosage levels must be individualized to prevent toxic effects. Frequent blood calcium levels should be taken. Adequate dietary calcium is necessary for clinical response to Vit D therapy.
Vitamin D, Ergocalciferol

1. AE
2. Pt consulation
1. therapeutic range is narrow
- toxicity may result in renal function impairment, mental retardation, bone demineralization, calcification of soft tissues, nausea, anorexia, constipation, anemia, weight loss
2. may be take w/ or w/o food
-closely follow prescribed calcium supplementation
-do not exceed prescribed dose
-contact MD if above side effects are severe or persist
-store in cool dry place away from light or kids
-if dose is missed, SKIP it then return to normal schedule