Vitamins and Electrolytes

Potassium chloride (electrolyte substance) MOA

replenishes K of the ICF, and K is responsible for nerve conduction, renal function, acid-base balance, carb metabolism, and gastric secretion

Potassium chloride indications

hypokalemia

Potassium chloride dosage forms

PO, IV

Potassium chloride administration

IV: do not administer undiluted or by IV push

PO: with meals and a full glass of water, do not crush/chew

Potassium chloride major side effects

nausea, flatulence, indigestion

Potassium chloride safety monitoring parameters

SCr, EKG

Potassium chloride efficacy monitoring parameters

serum K levels

Potassium chloride contraindications

hyperkalemia, hyperglycemia, reason for GI delay

Potassium chloride interactions

anticholinergics, K+ sparing diuretics, ACEI's, ARB's

Potassium chloride can cause

extravasation, hyperchloremia, hyperkalemia, hyponatremia

Caution Potassium chloride use in pts with

acid/base disorders, CV disease, hepatic or renal impairment

Cinacalcet (calcimimetic) MOA

increase sensitivity of the calcium sensing receptor on the parathyroid gland to lower PTH

Cinacalcet indications

-Hyperparathyroidism (primary & secondary)

-Parathyroid carcinoma hypercalcemia

Cinacalcet dosage forms

oral

Cinacalcet administration

with food and do not crush/chew

Cinacalcet major side effects

hypotension, hypocalcemia, abdominal pain, N/V/D, HA, back pain, muscle spasm, myalgia, cough, dyspnea

Cinacalcet safety monitoring parameters

signs of hypocalcemia, serum calcium, serum phosphorus, PTH, GI bleeding, QT interval

Cinacalcet efficacy monitoring parameters

serum calcium

Cinacalcet contraindications

hypocalcemia

Cinacalcet major interactions

doxorubicin, etecalcetide, mequitazine, thioridazine

Cinacalcet can cause

adynamic bone disease, CV effects, GI effects, hypocalcemia

Caution Cinacalcet use in pts w

hepatic impairment, seizure disorders

Ferrous sulfate (iron preparation) MOA

replaces iron to help the transportation of oxygen via hemoglobin

Ferrous sulfate indications

iron deficiency (including IDA)

Ferrous sulfate dosage forms

oral

Ferrous sulfate administration

on an empty stomach with water or juice; do not crush/chew ER preparations

Ferrous sulfate major side effects

abdominal pain, constipation, N/V/D, flatulence

Ferrous sulfate safety monitoring parameters

Hemoglobin and hematocrit; consider RBC count, RBC indices, serum ferritin, transferrin saturation, total iron-binding capacity, serum iron concentration, erythrocyte protoporphyrin concentration

Ferrous sulfate efficacy monitoring parameters

hemoglobin, hematocrit, RBC count

Ferrous sulfate contraindications

hemochromatosis, hemolytic anemia

Avoid Ferrous sulfate use in pts with

GI disease

Cyanocobalmin MOA

coenzyme for various metabolic functions like protein synthesis, fat and carb metabolism, and cell replication and hematopoiesis

Cyanocobalmin indications

vitamin B12 deficiency

Cyanocobalmin dosage forms

injection, oral, nasal

Cyanocobalmin major side effects

infection, asthenia, headache

Cyanocobalmin safety monitoring parameters

SOB, swelling, rash, hives

Cyanocobalmin efficacy monitoring parameters

B12 and folic acid levels, intrinsic factor, MCV, Hgb, no more anemia symptoms

Cyanocobalmin use can cause

CNS effects, hypokalemia, thrombocytosis

caution Cyanocobalmin use in pts with

leber disease, megaloblastic anemia, polycythemia vera

Folic acid MOA

Folic acid is required for the conversion of deoxyuridylate to thymidylate, which is a rate-limiting step in DNA synthesis

Folic acid indications

Megaloblastic and macrocytic anemias due to folate deficiency

Folic acid dosage forms

oral

Folic acid major side effects

loss of appetite

Folic acid safety monitoring parameters

SOB, rash, hives

Folic acid efficacy monitoring parameters

B12 and folic acid levels, MCV, Hgb, no more anemia symptoms

Folic acid major interactions

barbiturates, phenytoin

caution Folic acid use as

anemia monotherapy and pernicious anemia treatment in large doses