Folic Acid, Pyridoxine, and Cyanocobalamin Combination
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Dispensing of Vitamin Products by Retail Pharmacies in South Africa: Implications for Dietitians
South African Journal of Clinical Nutrition 2016; 29(4):133–138 http://dx.doi.org/10.1080/16070658.2016.1219468 SAJCN ISSN 1607-0658 EISSN 2221-1268 Open Access article distributed under the terms of the © 2016 The Author(s) Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 RESEARCH Dispensing of vitamin products by retail pharmacies in South Africa: Implications for dietitians Ilse Trutera* and Liana Steenkampb a Department of Pharmacy, Drug Utilisation Research Unit (DURU), Nelson Mandela Metropolitan University, Port Elizabeth, South Africa b HIV & AIDS Research Unit, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa *Corresponding author, email: [email protected] Objective: The objective of this study was to analyse the dispensing patterns of vitamins (Anatomical Therapeutic Chemical (ATC) group A11) over a one-year period in a group of community pharmacies in South Africa. Design and setting: A retrospective drug utilisation study was conducted on community pharmacy electronic dispensing records in South Africa recorded in 2013. Outcome measures: All products for ATC subgroup A11 were extracted and analysed. Results: A total of 164 233 vitamin products were dispensed to 84 805 patients (62.64% female patients). Males received on average 2.09 (SD = 2.63) vitamin products per year, compared to 1.84 (SD = 2.13) products for females. Ergocalciferol (A11CC01) was the most often dispensed (37.48% of all vitamin products), followed by plain Vitamin B-complex products (A11EA00) accounting for 32.77%. Ergocalciferol (vitamin D2) is only available on prescription (50 000 IU tablets or 50 000 IU/ml oily drops) in South Africa. -
R Graphics Output
Dexamethasone sodium phosphate ( 0.339 ) Melengestrol acetate ( 0.282 ) 17beta−Trenbolone ( 0.252 ) 17alpha−Estradiol ( 0.24 ) 17alpha−Hydroxyprogesterone ( 0.238 ) Triamcinolone ( 0.233 ) Zearalenone ( 0.216 ) CP−634384 ( 0.21 ) 17alpha−Ethinylestradiol ( 0.203 ) Raloxifene hydrochloride ( 0.203 ) Volinanserin ( 0.2 ) Tiratricol ( 0.197 ) trans−Retinoic acid ( 0.192 ) Chlorpromazine hydrochloride ( 0.191 ) PharmaGSID_47315 ( 0.185 ) Apigenin ( 0.183 ) Diethylstilbestrol ( 0.178 ) 4−Dodecylphenol ( 0.161 ) 2,2',6,6'−Tetrachlorobisphenol A ( 0.156 ) o,p'−DDD ( 0.155 ) Progesterone ( 0.152 ) 4−Hydroxytamoxifen ( 0.151 ) SSR150106 ( 0.149 ) Equilin ( 0.3 ) 3,5,3'−Triiodothyronine ( 0.256 ) 17−Methyltestosterone ( 0.242 ) 17beta−Estradiol ( 0.24 ) 5alpha−Dihydrotestosterone ( 0.235 ) Mifepristone ( 0.218 ) Norethindrone ( 0.214 ) Spironolactone ( 0.204 ) Farglitazar ( 0.203 ) Testosterone propionate ( 0.202 ) meso−Hexestrol ( 0.199 ) Mestranol ( 0.196 ) Estriol ( 0.191 ) 2,2',4,4'−Tetrahydroxybenzophenone ( 0.185 ) 3,3,5,5−Tetraiodothyroacetic acid ( 0.183 ) Norgestrel ( 0.181 ) Cyproterone acetate ( 0.164 ) GSK232420A ( 0.161 ) N−Dodecanoyl−N−methylglycine ( 0.155 ) Pentachloroanisole ( 0.154 ) HPTE ( 0.151 ) Biochanin A ( 0.15 ) Dehydroepiandrosterone ( 0.149 ) PharmaCode_333941 ( 0.148 ) Prednisone ( 0.146 ) Nordihydroguaiaretic acid ( 0.145 ) p,p'−DDD ( 0.144 ) Diphenhydramine hydrochloride ( 0.142 ) Forskolin ( 0.141 ) Perfluorooctanoic acid ( 0.14 ) Oleyl sarcosine ( 0.139 ) Cyclohexylphenylketone ( 0.138 ) Pirinixic acid ( 0.137 ) -
Applications
TN-1175 APPLICATIONS Xianrong (Jenny) Wei A Simple and Effective Method for HPLC Quantification Jenny is a Senior Scientist in Phenomenex’s PhenoLogix of Simultaneous Vitamin B1 (Thiamine Diphosphate) and applications laboratory. Vitamin B6 (Pyridoxal 5-Phosphate) from Whole Blood Xianrong (Jenny) Wei, Sean Orlowicz, Erica Pike, and Brian Rivera Phenomenex, Inc., 411 Madrid Ave., Torrance, CA 90501 USA Abstract The purpose of this experiment was to develop a simple and ro- 2. 25 % NaOH was prepared by adding 10 mL of 50 % NaOH to bust method for the simultaneous analysis of biologically active 10 mL DI Water. Vitamin B1 (TDP) and Vitamin B6 (PLP) from whole blood. 3. 25 mM Na2HPO4 (pH 7) was prepared by adding 6.7 g of Na2HPO4.7H2O to 1 L of DI water. pH was adjusted with 85 % Introduction H3PO4. Water-soluble B Vitamins are important cofactors in cell metabo- 4. 250/250 mg/mL semicarbazide/glycine was prepared by lism. Two water-soluble vitamins with clinical relevance are Vita- adding 500 mg of semicarbazide and 500 mg of glycine to mins B1 and B6. Thiamine Diphosphate (TDP) is the biologically 2 mL of DI water. active form of Vitamin B1 and is required for various metabolic functions. Prolonged deficiency can cause beriberi, a debilitating Sample Preparation neurological disease1. Pyridoxal 5-phosphate (PLP) is the biolog- All extraction steps were performed while protecting the sam- ically active form of Vitamin B6 and is a coenzyme for a number ple from light and under cold conditions, such as on ice. Human of transamination reactions. -
Randomised Controlled Trial of Nutritional Supplement on Bone Turnover Markers in Indian Premenopausal Women
nutrients Article Randomised Controlled Trial of Nutritional Supplement on Bone Turnover Markers in Indian Premenopausal Women Pramod B. Umarji 1, Pankaj Verma 2, Vivek Garg 2, Marian Schini 3,* and Richard Eastell 3 1 Umarji Healthcare, Pune, Maharashtra 411045, India; [email protected] 2 Hindustan Unilever Limited R&D, Gurugram, Haryana 122002, India; [email protected] (P.V.); [email protected] (V.G.) 3 Academic Unit of Bone Metabolism, University of Sheffield, Sheffield S10 2NR, UK; r.eastell@sheffield.ac.uk * Correspondence: m.schini@sheffield.ac.uk; Tel.: +44-0114-215-9667 Abstract: Young Indian women may be at risk of poor bone health due to malnutrition. The aim of this study was to examine the effects on bone metabolism of a nutritional supplement in women aged 25 to 44. The nutritional supplement was a protein-rich beverage powder fortified with multi- micronutrients including calcium (600 mg), vitamin D (400 IU), and vitamin K (55 mcg) per daily serving, while a placebo supplement was low-protein non-fortified isocaloric beverage powder. This 6-month randomised, controlled trial showed favorable changes in bone turnover markers (decreased) and calcium homeostasis; such changes in older adults have been associated with slowing of bone loss and reduced fracture risk. For example, serum CTX decreased by about 30% and PINP by about 20% as a result of the increase in calcium intake. There were also changes in the ratio of carboxylated to undercarboxylated osteocalcin and such changes have been linked to a slowing of bone loss in older subjects. For example, the ratio increased by about 60% after 3 months as a result in the improvement in vitamin K status. -
Optimal Foods
Optimal Foods 1. Almonds: high in monounsaturated and polyunsaturated fats, with 20% of calories coming from protein and dietary fiber. Nutrients include potassium, magnesium, calcium, iron, zinc, vitamin E and an antioxidant flavonoid called amygdlin also known as laetrile. 2. Barley: Like oat bran it is high in beta-glucan fiber which helps to lower cholesterol. Nutrients include copper, magnesium, phosphorous and niacin. 3. Berries : The darker the berry the higher in anti-oxidants. Nutritionally they are an excellent source of flavonoids, especially anthocyanidins, vitamin C and both soluble and insoluble fiber. 4. Brussels Sprouts : Similar to broccoli, and a member of the cabbage family, it contains cancer fighting glucosinolates. Nutritionally it is an excellent source of vitamin C and K, the B vitamins, beta-carotene, potassium and dietary fiber. 5. Carrots: It contains the highest source of proviatamin A carotenes as well as vitamin K, biotin, vitamin C, B6, potassium, thiamine and fiber. 6. Dark Chocolate: It is rich in the flavonoids, similar to those found in berries and apples, that are more easily absorbed than in other foods. It also provides an amino acid called arginine that helps blood vessels to dilate hence regulating blood flow and helping to lower blood pressure. Choose high-quality semisweet dark chocolate with the highest cocoa content that appeals to your taste buds. 7. Dark leafy greens : Kale, arugula, spinach, mustard greens, chard, collards, etc: low calorie, anti-oxidant dense food with carotenes, vitamin C, folic acid, manganese, copper, vitamin E, copper, vitamin B6, potassium, calcium, iron and dietary fiber. Kale is a particularly excellent bioavailable source of calcium while spinach is not. -
Guidelines on Food Fortification with Micronutrients
GUIDELINES ON FOOD FORTIFICATION FORTIFICATION FOOD ON GUIDELINES Interest in micronutrient malnutrition has increased greatly over the last few MICRONUTRIENTS WITH years. One of the main reasons is the realization that micronutrient malnutrition contributes substantially to the global burden of disease. Furthermore, although micronutrient malnutrition is more frequent and severe in the developing world and among disadvantaged populations, it also represents a public health problem in some industrialized countries. Measures to correct micronutrient deficiencies aim at ensuring consumption of a balanced diet that is adequate in every nutrient. Unfortunately, this is far from being achieved everywhere since it requires universal access to adequate food and appropriate dietary habits. Food fortification has the dual advantage of being able to deliver nutrients to large segments of the population without requiring radical changes in food consumption patterns. Drawing on several recent high quality publications and programme experience on the subject, information on food fortification has been critically analysed and then translated into scientifically sound guidelines for application in the field. The main purpose of these guidelines is to assist countries in the design and implementation of appropriate food fortification programmes. They are intended to be a resource for governments and agencies that are currently implementing or considering food fortification, and a source of information for scientists, technologists and the food industry. The guidelines are written from a nutrition and public health perspective, to provide practical guidance on how food fortification should be implemented, monitored and evaluated. They are primarily intended for nutrition-related public health programme managers, but should also be useful to all those working to control micronutrient malnutrition, including the food industry. -
Dietary Reference Intakes (Dris): Recommended Dietary Allowances and Adequate Intakes, Vitamins Food and Nutrition Board, Institute of Medicine, National Academies
Dietary Reference Intakes (DRIs): Recommended Dietary Allowances and Adequate Intakes, Vitamins Food and Nutrition Board, Institute of Medicine, National Academies Life Stage Vitamin A Vitamin C Vitamin D Vitamin E Vitamin K Thiamin Riboflavin Niacin Vitamin B6 Folate Vitamin B12 Pantothenic Biotin Choline Group (µg/d)a (mg/d) (µg/d)b,c (mg/d) d (µg/d) (mg/d) (mg/d) (mg/d)e (mg/d) (µg/d)f (µg/d) Acid (mg/d) (µg/d) (mg/d)g Infants 0 to 6 mo 400* 40* 10 4* 2.0* 0.2* 0.3* 2* 0.1* 65* 0.4* 1.7* 5* 125* 6 to 12 mo 500* 50* 10 5* 2.5* 0.3* 0.4* 4* 0.3* 80* 0.5* 1.8* 6* 150* Children 1–3 y 300 15 15 6 30* 0.5 0.5 6 0.5 150 0.9 2* 8* 200* 4–8 y 400 25 15 7 55* 0.6 0.6 8 0.6 200 1.2 3* 12* 250* Males 9–13 y 600 45 15 11 60* 0.9 0.9 12 1.0 300 1.8 4* 20* 375* 14–18 y 900 75 15 15 75* 1.2 1.3 16 1.3 400 2.4 5* 25* 550* 19–30 y 900 90 15 15 120* 1.2 1.3 16 1.3 400 2.4 5* 30* 550* 31–50 y 900 90 15 15 120* 1.2 1.3 16 1.3 400 2.4 5* 30* 550* 51–70 y 900 90 15 15 120* 1.2 1.3 16 1.7 400 2.4h 5* 30* 550* > 70 y 900 90 20 15 120* 1.2 1.3 16 1.7 400 2.4h 5* 30* 550* Females 9–13 y 600 45 15 11 60* 0.9 0.9 12 1.0 300 1.8 4* 20* 375* 14–18 y 700 65 15 15 75* 1.0 1.0 14 1.2 400i 2.4 5* 25* 400* 19–30 y 700 75 15 15 90* 1.1 1.1 14 1.3 400i 2.4 5* 30* 425* 31–50 y 700 75 15 15 90* 1.1 1.1 14 1.3 400i 2.4 5* 30* 425* 51–70 y 700 75 15 15 90* 1.1 1.1 14 1.5 400 2.4h 5* 30* 425* > 70 y 700 75 20 15 90* 1.1 1.1 14 1.5 400 2.4h 5* 30* 425* Pregnancy 14–18 y 750 80 15 15 75* 1.4 1.4 18 1.9 600j 2.6 6* 30* 450* 19–30 y 770 85 15 15 90* 1.4 1.4 18 1.9 600j 2.6 6* 30* 450* 31–50 y 770 85 15 15 90* 1.4 1.4 18 1.9 600j 2.6 6* 30* 450* Lactation 14–18 y 1,200 115 15 19 75* 1.4 1.6 17 2.0 500 2.8 7* 35* 550* 19–30 y 1,300 120 15 19 90* 1.4 1.6 17 2.0 500 2.8 7* 35* 550* 31–50 y 1,300 120 15 19 90* 1.4 1.6 17 2.0 500 2.8 7* 35* 550* NOTE: This table (taken from the DRI reports, see www.nap.edu) presents Recommended Dietary Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). -
Vitamin B12 Vitamin D Iodine and Selenium
Frequently Asked Questions for VEG 1 General 1. Why has VEG 1 been developed? VEG 1 was developed to provide a convenient way of avoiding the most common weak points in a varied vegan diet: vitamin B12, iodine, vitamin D and selenium. Vitamin B12 Vitamin B12 is almost entirely absent from modern plant foods which are not contaminated by bacteria and insects. Even unwashed, organically grown plants do not contain a significant amount of B12. Vegans often have intakes of vitamin B12 well below recommended intakes. Low vitamin B12 intake by vegans routinely leads to reduced activity of some important enzymes and increased levels of homocysteine and methylmalonic acid (MMA). Even moderately elevated homocysteine is associated with increased risk of death, depression, stroke, dementia and birth defects, though it remains unclear how many of these associations reflect true cause and effect. Vegans who do not get vitamin B12 from fortified food or supplements are at increased risk of clinical deficiency symptoms such as anaemia and nervous system damage. The most common early symptoms of vitamin B12 deficiency are tiredness (from anaemia), numbness and tingling (from nervous system damage) and sore tongue. VEG 1 is designed to provide sufficient absorbed vitamin B12 to match national and international recommended intakes. It is designed to be chewed as this increases the reliability of vitamin B12 absorption by dispersing and dissolving the tablet. Vitamin D In the winter – whenever our shadows at midday are more than twice as long as we are – our skin cannot produce vitamin D effectively and even small dietary intakes may become important to avoid deficiency. -
Cyanocobalamin-A Case for Withdrawal
686 Journal of the Royal Society of Medicine Volume 85 November 1992 Cyanocobalamin- a case for withdrawal: discussion paper A G Freeman MD FRCP Meadow Rise, 3 Lakeside, Swindon SN3 IQE Keywords: anaemia, pernicious; optic neuropathies; chronic cyanide intoxication; hydroxocobalamin; cyanocobalamin It seems evident that controversy still surrounds the reduced ability to detoxify the cyanide in the tobacco- treatment of pernicious anaemia and other vitamin smoke to which they are exposed'0. B12 deficiency disorders. The long quest for the 'anti- Patients with tobacco amblyopia who have normal pernicious anaemia factor' in the liver seemed to serum vitamin B12 levels need not continue therapy have ended in 1948 when pure cyanocobalamin was with intramuscular hydroxocobalamin once their isolated. This was found to be very active thera- visual acuity and visual fields have returned to peutically when given by intramuscular injection and normal providing they abstain from further smoking. was non-toxic in extremely high doses'. However, those patients who have low serum vitamin Lederle, in a recent commentary2, advocates that B12 levels or evidence of -defective vitamin B12 patients with pernicious anaemia should now be absorption will need to continue-indefinitely with treated with oral cyanocobalamin. He is not without hydroxocobalamin irrespective of their smoking support in that 40% of patients with pernicious habits as will all patients with pernicious anaemia anaemia in Sweden are being similarly treated3. and other vitamin B12 deficiency disorders who are He further states that such!- treatment is cheap at risk of developing- optic neuropathy if they and effective, produces clinical and haematological are smokers. -
Leucine Improved Growth Performance, Muscle Growth, And
cells Article Leucine Improved Growth Performance, Muscle Growth, and Muscle Protein Deposition Through AKT/TOR and AKT/FOXO3a Signaling Pathways in Hybrid Catfish Pelteobagrus vachelli × Leiocassis longirostris 1, 1, 1, 2,3 2,3 2,3 Ye Zhao y, Jin-Yang Li y, Qin Jiang y, Xiao-Qiu Zhou , Lin Feng , Yang Liu , Wei-Dan Jiang 2,3, Pei Wu 2,3, Jian Zhou 4, Juan Zhao 2 and Jun Jiang 1,3,* 1 College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China; [email protected] (Y.Z.); [email protected] (J.-Y.L.); [email protected] (Q.J.) 2 Animal Nutrition Institute, Sichuan Agricultural University, Chengdu 611130, China; fi[email protected] (X.-Q.Z.); [email protected] (L.F.); [email protected] (Y.L.); [email protected] (W.-D.J.); [email protected] (P.W.); [email protected] (J.Z.) 3 Fish Nutrition and Safety Production University Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu 611130, China 4 Fisheries Institute of Sichuan Academy of Agricultural Science, Chengdu 611731, China; [email protected] * Correspondence: fi[email protected]; Tel.: +86-28-8629-1133 These authors contributed equally to this work. y Received: 25 October 2019; Accepted: 29 January 2020; Published: 30 January 2020 Abstract: (1) Background: l-leucine (Leu) plays a positive role in regulating protein turnover in skeletal muscle in mammal. However, the molecular mechanism for the effects of Leu on muscle growth and protein deposition is not clearly demonstrated in fish. This study investigated the effects of dietary Leu on growth performance and muscle growth, protein synthesis, and degradation-related signaling pathways of hybrid catfish (Pelteobagrus vachelli Leiocassis longirostris ). -
These Highlights Do Not Include All the Information Needed to Use M.V.I. Pediatric® Safely and Effectively
M.V.I. PEDIATRIC- ascorbic acid, retinol, ergocalciferol, thiamine hydrochloride, riboflavin 5- phosphate sodium, pyridoxine hydrochloride, niacinamide, dexpanthenol, .alpha.-tocopherol acetate, dl-, biotin, folic acid, cyanocobalamin, and phytonadione injection, powder, lyophilized, for solution Hospira, Inc. ---------- HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use M.V.I. Pediatric® safely and effectively. See full prescribing information for M.V.I. Pediatric. M.V.I. Pediatric (multiple vitamins for injection), for intravenous use Initial U.S. Approval: 1983 RECENT MAJOR CHANGES Dosage And Administration, Dosage Information (2.2) 2/2019 INDICATIONS AND USAGE M.V.I. Pediatric is a combination of vitamins indicated for the prevention of vitamin deficiency in pediatric patients up to 11 years of age receiving parenteral nutrition (1) DOSAGE AND ADMINISTRATION M.V.I. Pediatric is a combination product that contains the following vitamins: ascorbic acid, vitamin A, vitamin D, thiamine, riboflavin, pyridoxine, niacinamide, dexpanthenol, vitamin E, vitamin K, folic acid, biotin, and vitamin B12 (2.1) Supplied as a single-dose vial of lyophilized powder for reconstitution intended for administration by intravenous infusion after dilution. (2.1) Recommended daily dosage is based on patient's actual weight (2.2) Less than 1 kg: The daily dose is 1.5 mL 1 kg to 3 kg: The daily dose is 3.25 mL 3 kg or more: The daily dose is 5 mL One daily dose of the reconstituted solution (1.5 mL, 3.25 mL or 5 mL) is then added directly to the intravenous fluid (2.2,2.3) See Full Prescribing Information for reconstitution instructions (2.3) Monitor blood vitamin concentrations (2.4) See Full Prescribing Information for drug incompatibilities (2.5) DOSAGE FORMS AND STRENGTHS M.V.I. -
Becosules Junior
For the use of a Registered Medical Practitioner or a Hospital or a Laboratory only Multivitamin with Vitamin A and Vitamin D3 Liquid BECOSULES JUNIOR 1. NAME OF THE MEDICINAL PRODUCT BECOSULES JUNIOR 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each 5 ml (1 teaspoonful) contains: Vitamin A Concentrate Oil I.P. (as Palmitate) 2500 IU Cholecalciferol I.P. 200 IU Thiamine Hydrochloride I.P. 2 mg Riboflavin Sodium Phosphate I.P. 2.54 mg Pyridoxine Hydrochloride I.P. 1 mg Niacinamide I.P. 20 mg D-Panthenol I.P. 5 mg Ascorbic Acid I.P. 50 mg For Pediatric Use For a full list of excipients, see section 6.1. 3. PHARMACOLOGICAL FORM Liquid Trademark Owner: Pfizer Products Inc. USA; Licensed User: Pfizer Limited, India BECOSULES JUNIOR Page 1 of 9 LPDBECJR122017 4. CLINICAL PARTICULARS 4.1 Indications Becosules Junior is indicated in the treatment of patients with deficiencies of, or increased requirement for vitamins A, B complex, C and D. Such patients and conditions include: • Decreased intake because of restricted or unbalanced diet as in anorexia, diabetes mellitus and obesity, and insufficient sunlight exposure.1 • Reduced availability during treatment with antimicrobials which alter normal intestinal flora, and anticonvulsants and glucocorticoids which alter vitamin D metabolism1, in prolonged diarrhea and in chronic gastrointestinal disorders. • Increased requirements due to increased metabolic rate as in fever and tissue wasting, e.g. febrile illness, acute or chronic infections, surgery, burns and fractures. • Stomatitis, glossitis, cheilosis, paraesthesias, neuralgia and dermatitis. 4.2 Posology and Method of Administration For children from 1-3 years - 1.25 ml, 4-9 years - 2.5 ml; and 10-13 years - 5 ml or as directed by physician.