Vitamin C (When ATH A11GA01)

When ATH:
A11GA01

Characteristic.

Vitamins (витамин C). Ascorbic acid - a white crystalline powder sour taste. Easily soluble in water (1: 3,5), slowly soluble in ethanol (1:30), absolute ethanol (1:50), glycerin (1:100), propylene glycol (1:20). Solubility in water: 80,0% at 100 °C; 40,0% at 45 °C. Practically insoluble in ether, benzene, xloroforme, petroleum ether, oils, jirakh. Under the influence of air and light darkens. The dry form is stable in air, Aqueous solutions are rapidly oxidized in air. Molecular weight 176,13.

Sodium ascorbate - small crystals, freely soluble in water: 62 g / 100 ml at 25 °C, 78 g / 100 ml at 75 °C.

Most primates (including humans), Guinea pigs, some birds, fish can not synthesize vitamin C. In humans, the necessary reserve is replenished by receipts from food.

For medical purposes, ascorbic acid obtained synthetically.

Pharmacological action.
Makes up for the deficiency of vitamin C, metabolic, regulates redox processes, antioksidantnoe.

Application.

Гиповитаминоз C, gyemorragichyeskii diatyez, kapillyarotoksikoz, hemorrhagic stroke, bleeding (incl. Nasal, Pulmonary, Uterine), infectious diseases, idiopathic methemoglobinemia, intoxication, incl. chronic intoxication with iron, alcoholic delirium and infection, acute radiation sickness, post-transfusion complications, liver disease (Botkin's disease, chronic hepatitis and cirrhosis), gastrointestinal diseases (axilija, peptic ulcer, especially after the bleeding, enteritis, colitis), helminthiasis, cholecystitis, adrenal insufficiency (Addison's disease), sluggish healing wounds, ulcers, burns, fractures, dystrophy, physical and mental overload, the period of convalescence after illness, pregnancy (especially Multiple, against the backdrop of nicotine or drug dependence), lactation, hemosiderosis, melasma, erythroderma, psoriasis, common chronic dermatoses. In laboratory practice - for labeling of red blood cells (together with sodium chromate ⁵¹Cr).

Contraindications.

Hypersensitivity, tromboflebit, tendency to thrombosis.

Restrictions apply.

Diabetes, deficiency of glucose-6-fosfatdegidrogenazы, gemoxromatoz, sideroblastnaya anemia, Thalassemia, giperoksalurija, oksaloz, urolithiasis disease.

Pregnancy and breast-feeding.

The minimum daily need in ascorbic acid in II-III trimesters of pregnancy - about 60 mg. It will be appreciated, that the fetus can adapt to high doses of ascorbic acid, that takes pregnant woman, and then the newborn may develop withdrawal. It has been reported, that the treatment with high doses of vitamin C., taken during pregnancy, fraught with the risk of scurvy in infants, at / in the introduction of high doses - the threat of termination of pregnancy due estrogenemii (Nonteratogenic effects).

The minimum daily requirement for lactation - 80 mg. Mother's diet, containing an adequate amount of ascorbic acid, sufficient to prevent deficiency in an infant. Theoretically, there is a danger to the child's mother when applying high doses of ascorbic acid (Nursing mothers are advised not to exceed the daily requirement of ascorbic acid).

For injectable forms. Animal reproduction studies using injections of ascorbic acid is not carried out. Unknown, Can vitamin C while injecting pregnant women have embryotoxic action or disrupt reproductive capacity. Injectable forms may be administered during pregnancy only if absolutely necessary.

Category actions result in FDA - C (for injectables). (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

Side effects.

Cardio-vascular system and blood (hematopoiesis, hemostasis): thrombocytosis, giperprotrombinemiya, erythropenia, neutrophilic leukocytosis.

From the nervous system and sensory organs: if too rapid on / in the introduction - dizziness, weakness.

From the digestive tract: ingestion - Irritation of the gastrointestinal mucosa (nausea, vomiting, diarrhea), diarrhea (when taking more doses 1 g / day), damage tooth enamel (with intensive use of chewable tablets or resorption of oral forms).

Metabolism: metabolic disease, inhibition of glycogen synthesis, excessive formation of corticosteroids, sodium and water retention, kaliopenia.

With the genitourinary system: increased diuresis, glomerular kidney damage, the formation of calcium oxalate urinary stones (particularly chronic administration at doses more 1 g / day).

Allergic reactions: skin rash, dermahemia.

Other: soreness at the injection site (when i / m administration).

Cooperation.

It increases blood concentration of salicylates (It increases the risk of crystalluria), ethinyl estradiol, penicillin and tetracycline, It reduces - oral contraceptives. Acetylsalicylic acid, oral contraceptives, fresh juices and alkaline water reduce the absorption and assimilation. It increases the activity of norepinephrine. Reduces the anticoagulant effect of coumarin derivatives, geparina. It improves the intestinal absorption of iron supplements (by converting the ferric to ferrous). In an application with deferoxamine may increase tissue iron toxicity, incl. cardiotoxicity and development of heart failure. Increases total clearance of ethanol. It may affect the efficacy of disulfiram for the treatment of chronic alcoholism. Preparations quinoline series, calcium chloride, salicilaty, corticosteroids, long-term use of vitamin C deplete. A solution of ascorbic acid when mixed in the same syringe enters into chemical interaction with many drugs.

Overdose.

Symptoms: prolonged use of large doses (more 1 g) - Headache, increased excitability of the central nervous system, insomnia, nausea, vomiting, diarrhea, hyperacid gastritis, ulceration gastrointestinal mucosa, oppression of the insular apparatus of the pancreas (giperglikemiâ, glycosuria), giperoksalurija, nephrolithiasis (kalytsiya oxalate), glomerular kidney damage, moderate thamuria (upon receiving the dose more 600 mg / day).

The decrease in capillary permeability (possible deterioration of the trophic tissue, increased blood pressure, hypercoagulation, the development of microvascular complications).

The on / in the introduction of high doses - the threat of termination of pregnancy (due estrogenemii), hemolysis.

Dosing and Administration.

Inside, / m, I /. Inside, after meal. As a preventive measure (in winter and spring and malnutrition): adults - 50-100 mg / day (Children - 25-75 mg / day), Pregnancy and breast-feeding - 300 mg / day for 10-15 days, then - 100 mg / day. For therapeutic purposes,: adults - 50-100 mg 3-5 times a day (children - 50-100 mg 2-3 times a day). V / m and / in, 5-10% Solution - 1-5 ml, for poisoning - up 3 g (60 ml). Timing of treatment depend on the nature and course of the disease.

Precautions.

In appointing the solutions I / avoid too rapid introduction of. During long-term treatment is necessary to monitor renal function, Blood pressure and glucose levels (especially when high doses). With caution is prescribed for patients with high doses of urolithiasis, diabetes, tendency to thrombosis, receiving anticoagulant therapy, We are on a salt-free diet.

Vitamin C, as a reducing agent, may distort the results of the various laboratory tests (blood levels of glucose, bilirubin, Activity of transaminases, LDH, glucose in urine, incl. determining false-negative results fecal occult blood).

Cooperation