A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Mte 5 Pharmacology, Pharmacokinetics, Studies, Metabolism - Trace Metal-5 Combination
Mte 5 Pharmacology, Pharmacokinetics, Studies, Metabolism - Trace Metal-5 Combination
CLINICAL PHARMACOLOGY
Zinc has been identified as a cofactor for over 70 different enzymes,
including alkaline phosphatase, lactic dehydrogenase and both RNA and
DNA polymerase. Zinc facilitates wound healing, helps maintain normal
growth rates, normal skin hydration and senses of taste and smell.
Providing zinc during TPN prevents development of the following deficiency
symptoms: Parakeratosis, hypogeusia, anorexia, dysosmia, geophagia, hypogonadism,
growth retardation and hepatosplenomegaly. At plasma levels below 20 mcg
zinc/100 mL, dermatitis followed by alopecia has been reported for TPN
patients.
Copper is essential as a cofactor for serum ceruloplasmin, and oxidase
necessary for proper formation of the iron carrier protein, transferrin.
Copper also helps maintain normal rates of red and white blood cell formation.
Scorbutic type bone changes seen in infants fed exclusively with copper-
poor cow’s milk are believed due to decreased activity of ascorbate oxidase,
a cuproenzyme.
Providing copper during TPN prevents development of the following deficiency
symptoms: leukopenia, neutropenia, anemia, depressed ceruloplasmin levels,
impaired transferrin formation and secondary iron deficiency.
Manganese is an activator for enzymes such as polysaccharide polymerase,
liver arginase, cholinesterase and pyruvate carboxylase.
Providing manganese during TPN prevents development of the following
deficiency symptoms: nausea and vomiting, weight loss, dermatitis, and
changes in growth and color of hair.
Chromium (trivalent) is party of glucose tolerance factor, and activator
of insulin-mediated reactions. Chromium helps to maintain normal glucose
metabolism and peripheral nerve function.
Providing chromium during TPN prevents development of the following deficiency
symptoms: impaired glucose tolerance, ataxia, peripheral neuropathy and
a confusional state similar to mild/moderate hepatic encephalopathy.
Selenium is party of glutathione peroxidase which protects cell components
from oxidative damage due to peroxides produced in cellular metabolism.
Prolonged TPN support in humans has resulted in selenium deficiency symptoms
which include muscle pain and tenderness. The symptoms have been reported
to respond to supplementation of TPN solutions with selenium.
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