Skip to main content

Watch for the kind of vitamin D your elderly patients are taking...The limitations of vitamin D therapy

Cholecalciferol is converted to active form, calcitriol (1,25-dihydroxyvitamin D3 ) in the kidneys. 

 The active form of vitamin D3, 1,25-dihydroxyvitamin D3, is the major regulator of bone and calcium metabolism in the body.

 What happens when kidney function has declined? Production of active form declines.

 Calcitriol is available as tablets, capsules and liquid formulations

 Calcitriol is 1,25-dihydroxycholecalciferol. It is the active metabolite of vitamin D (cholecalciferol). Increases the levels of calcium in the blood by improving its absorption.

 Calcitriol is used in patients with kidney disease.
  • Contraindicated in patients with hypercalcemia, vitamin D toxicity; Concurrent use of magnesium-containing antacids or other vitamin D supplements;

  • Side effects include weakness, headache, constipation, vomiting, arrthythmia, hypertension, hypotonia, polydipsia, polyuria, myalgia, metastatic calcification, etc. Allergic reactions, including anaphylaxis, have been reported. 
  • Interactions Drug-Drug: Cholestyramine, colestipol, or mineral oil, vitamin D analogues. Use with thiazide diuretics like hydrochlorothiazide may result in hypercalcemia. Corticosteroid decrease the effectiveness of vitamin D analogues. Use with digoxin increases risk of arrhythmias. Concurrent use of magnesium-containing drugs may lead to hypermagnesemia. Calcium-containing drugs may increase risk of hypercalcemia. Concurrent use of other Vitamin D supplements(increases risk of hypercalcemia).
  • Route/Dosage: Hypocalcemia During Dialysis PO (Adults): 0.25 mcg/day or every other day; if needed, may increase by 0.25 mcg/day at 4– 8 wk intervals (typical dosage 0.5– 1 mcg/day).
  • May increase serum creatinine levels in predialysis patients.
package insert

Ref: https://davisplus.fadavis.com/3976/meddeck/pdf/calcitriol.pdf

Comments

Post a Comment

Popular posts from this blog

Mounjaro, Is it a game changer for weight loss and diabetes?

  MOUNJARO™ ( Tirzepatide) was approved for medical use in the United States in May 2022 WEIGHT LOSS: (Not approved by FDA for weight loss) Eli Lilly and Company is  finalizing an application to the U.S. Food and Drug Administration for fast-track approval to sell tirzepatide for chronic weight management. MOUNJARO™ is a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist indicated in adults for type 2 diabetes mellitus management. CONTRAINDICATIONS Personal or family history of medullary thyroid carcinoma or in patients with Multiple Endocrine Neoplasia syndrome type 2  Known serious all to tirzepatide or any of the excipients in MOUNJARO                                                                    ...
Post a Comment
Read more

Thyroid health- Quality of Life

  Let's get a TSH blood test for our family and friends Normal serum TSH ranges are higher in the  people age 70 to 80 years ; based on this, higher serum TSH goals may be needed as a patient ages.  The American Thyroid Association (ATA) suggests raising the target serum TSH to 4-6 m IU/L for 70 years-old and up The thyroid is a small, butterfly-shaped hormone-producing gland located at the front of the neck. The thyroid gland secretes two main hormones:  thyroxine (T-4) and triiodothyronine (T-3).   These hormones regulate energy levels, metabolism of fats, proteins and carbohydrates, body temperature, heart rate.  Hypothyroidism happens when the underactive thyroid gland doesn't make enough hormones. Hypothyroidism affects up to 10% of the general population (5% undiagnosed) . A n autoimmune disease called Hashimoto's diseas e where our body  makes antibodies that attack healthy thyroid tissues  is the most common cause of hypothyroidism in soc...
Post a Comment
Read more

Heart healthy

*Clinical atherosclerotic cardiovascular disease (ASCVD) includes acute coronary syndrome (ACS), those with history of myocardial infarction (MI), stable or unstable angina or coronary or other arterial revascularization, stroke, transient ischemic attack (TIA), or peripheral artery disease (PAD) including aortic aneurysm, all of atherosclerotic origin. Should I initiate statins or not? The 2014 National Lipid Association (NLA) recommendations provides a more comprehensive, patient-centered approach to identifying ASCVD risk.   In 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) issued guidelines to use the intensity of statin therapy as the treatment goal instead of LDL-C or non–HDL-C targets, as in previous guidelines, to reduce atherosclerotic cardiovascular disease (ASCVD) risk (  Andrus & Lacaille, 2014  )  The guideline classifies statin therapy as  high-intensity (lowers LD...
7 comments
Read more