trace metal combination additive
(redirected from MulTE-PAK-4)trace metal combination additive
,Concentrated Multiple Trace Element
(trade name),ConTE-PAK-4
(trade name),M.T.E.-4
(trade name),M.T.E.-4 Concentrated
(trade name),M.T.E.-5
(trade name),M.T.E.-5 Concentrated
(trade name),M.T.E.-6
(trade name),M.T.E.-6 Concentrated
(trade name),M.T.E.-7
(trade name),MulTE-PAK-4
(trade name),MulTE-PAK-5
(trade name),Multiple Trace Element
(trade name),Multiple Trace Element Neonatal
(trade name),Multiple Trace Element Pediatric
(trade name),Neotrace 4
(trade name),PedTE-PAK-4
(trade name),Pedtrace-4
(trade name),P.T.E.-4
(trade name),P.T.E.-5
(trade name)Classification
Therapeutic: mineral electrolyte replacements supplementsIndications
Administered as a component in total parenteral nutrition (TPN, parenteral hyperalimentation).May contain any or all of the following:
- Chromium,
- Copper,
- Iodine,
- Manganese,
- Molybdenum,
- Selenium,
- Zinc.
Action
Trace metals serve as cofactors or catalysts for numerous diverse homeostatic processes.
Therapeutic effects
Replacement in deficiency states when oral ingestion is not feasible.
Pharmacokinetics
Absorption: Administered IV only, resulting in complete bioavailability.
Distribution: Widely distributed.
Metabolism and Excretion: Excretion depends on individual trace element.
Half-life: Unknown.
Time/action profile (replacement)
ROUTE | ONSET | PEAK | DURATION |
IV | rapid | unknown | unknown |
Contraindications/Precautions
Contraindicated in: Hypersensitivity to iodine (iodine-containing products only).
Use Cautiously in: Obstetric / Lactation: Pregnancy or lactation; NG suction, fistula drainage, prolonged vomiting or diarrhea (may increase requirements); Renal impairment or biliary obstruction (may increase risk of toxicity); Isolated trace element deficiency (other additives may be excessive—use only those required).
Adverse Reactions/Side Effects
Listed for individual trace metals—usually associated with toxicityMiscellaneous
- Chromium:
- coma (life-threatening)
- seizures (life-threatening)
- GI ulceration
- hepatic damage
- nausea
- renal damage
- vomiting Copper:
- behavioral changes
- diarrhea
- peripheral edema
- photophobia
- progressive marasmus
- weakness Iodine:
- acneiform skin lesions
- headache
- increased salivation
- metallic taste
- parotitis
- runny nose
- sneezing
- sore mouth
- swelling of eyelids Manganese:
- anorexia
- apathy
- gait disturbances
- headache
- erectile dysfunction
- irritability
- speech difficulties Molybdenum:
- gout-like syndrome Selenium:
- garlic-like breath
- garlic-like sweat
- GI discomfort
- hair loss
- mental depression
- metallic taste
- nervousness
- vomiting
- weak nails Zinc:
- blurred vision
- hypotension
- jaundice
- loss of consciousness
- oliguria
- pulmonary edema
- tachycardia
- toxicity poorly defined but may include hypothermia
- vomiting
Interactions
Drug-Drug interaction
None significant in replacement doses.Route/Dosage
Intravenous (Adults and Children) Amount necessary to maintain normal trace element levels.
Availability
All must be diluted in large-volume parenterals prior to useInjection: Each mL contains 0.85–4 mcg chromium, 0.1–0.4 mg copper, 0.025–0.16 mg manganese, and 0.5–1.5 mg zinc. Some products also contain iodide, selenium, and molybdenum
Concentrated injection: Each mL contains 10 mcg chromium, 1 mg copper, 0.5 mg manganese, and 5 mg zinc. Some products also contain iodide and selenium
Nursing implications
Nursing assessment
- Assess nutritional status by 24-hr recall prior to therapy.
- Monitor patient for signs and symptoms of trace metal deficiencies prior to and throughout therapy, as follows:.
- Chromium—glucose intolerance, ataxia, peripheral neuropathy, confusion.
- Copper—leukopenia, neutropenia, anemia, iron deficiency, skeletal abnormalities, defective tissue formation.
- Iodine—impaired thyroid function, goiter, cretinism.
- Manganese—nausea, vomiting, weight loss, dermatitis, changes in hair.
- Molybdenum—tachycardia, tachypnea, headache, night blindness, nausea, vomiting, edema, lethargy, disorientation, coma, hypouricemia, hypouricosuria.
- Selenium—cardiomyopathy, muscle pain, kwashiorkor, Keshan disease.
- Zinc—diarrhea, apathy, depression, anorexia, hypogonadism, growth retardation, anemia, hepatosplenomegaly, impaired wound healing, decreased sense of taste and smell.
- Lab Test Considerations: Serum trace metal concentrations should be monitored periodically throughout TPN therapy.
Potential Nursing Diagnoses
Imbalanced nutrition: less than body requirements (Indications)Implementation
Intravenous Administration
- Intravenous: Solution usually does not contain preservatives; discard unused portion.
- Continuous Infusion: Diluent: Must be diluted prior to administration. Dilute each dose in at least 1 liter of IV solution.
- Rate: Administer at prescribed rate for TPN infusion.
- Additive Compatibility: Usually compatible with other trace metals, electrolytes, and dextrose/amino acid combinations used for TPN.
Patient/Family Teaching
- Explain purpose of infusion of TPN and components to patient.
Evaluation/Desired Outcomes
- Prevention or treatment of trace metal deficiencies.
Drug Guide, © 2015 Farlex and Partners