tricalcium phosphate


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tricalcium phosphate

Posture

Pharmacologic class: Mineral

Therapeutic class: Dietary supplement, electrolyte replacement agent

Pregnancy risk category C (calcium acetate, chloride, glubionate, gluceptate, phosphate), NR (calcium carbonate, citrate, gluconate, lactate)

Pregnancy risk category C (calcium acetate, chloride, glubionate, gluceptate, phosphate), NR (calcium carbonate, citrate, gluconate, lactate)

Action

Increases serum calcium level through direct effects on bone, kidney, and GI tract. Decreases osteoclastic osteolysis by reducing mineral release and collagen breakdown in bone.

Availability

Calcium acetate-

Gelcaps: 667 mg

Tablets: 667 mg

Calcium carbonate-

Capsules: 1,250 mg

Lozenges: 600 mg

Oral suspension: 1,250 mg

Powder: 6.5 g

Tablets: 650 mg, 1,250 mg, 1,500 mg

Tablets (chewable): 750 mg, 1,000 mg, 1,250 mg

Tablets (gum): 300 mg, 450 mg, 500 mg

Calcium chloride-

Injection: 10% solution

Calcium citrate-

Tablets: 950 mg

Calcium gluceptate-

Injection: 22% solution

Calcium gluconate-

Injection: 10% solution

Tablets: 500 mg, 650 mg, 975 mg

Calcium lactate-

Tablets: 325 mg, 650 mg

Tricalcium phosphate-

Tablets: 600 mg

Indications and dosages

Hypocalcemic emergency

Adults: 7 to 14 mEq I.V. of 10% calcium gluconate solution, 2% to 10% calcium chloride solution, or 22% calcium gluceptate solution

Children: 1 to 7 mEq calcium gluconate I.V.

Infants: Up to 1 mEq calcium gluconate I.V.

Hypocalcemic tetany

Adults: 4.5 to 16 mEq calcium gluconate I.V., repeated as indicated until tetany is controlled

Children: 0.5 to 0.7 mEq/kg calcium gluconate I.V. three to four times daily as indicated until tetany is controlled

Neonates: 2.4 mEq/kg calcium gluconate I.V. daily in divided doses

Cardiac arrest

Adults: 0.027 to 0.054 mEq/kg calcium chloride I.V., 4.5 to 6.3 mEq calcium gluceptate I.V., or 2.3 to 3.7 mEq calcium gluconate I.V.

Children: 0.27 mEq/kg calcium chloride I.V., repeated in 10 minutes if needed. Check calcium level before giving additional doses.

Magnesium intoxication

Adults: Initially, 7 mEq I.V.; subsequent dosages based on patient response

Exchange transfusions

Adults: 1.35 mEq calcium gluconate I.V. with each 100 ml of citrated blood

Hyperphosphatemia in patients with end-stage renal disease

Adults: Two tablets P.O. daily, given in divided doses t.i.d. with meals. May increase gradually to bring serum phosphate level below 6 mg/dl, provided hypercalcemia doesn't develop.

Dietary supplement

Adults: 500 mg to 2 g P.O. daily

Off-label uses

• Osteoporosis

Contraindications

• Hypersensitivity to drug
• Ventricular fibrillation
• Hypercalcemia and hypophosphatemia
• Cancer
• Renal calculi
• Pregnancy or breastfeeding

Precautions

Use cautiously in:
• renal insufficiency, pernicious anemia, heart disease, sarcoidosis, hyperparathyroidism, hypoparathyroidism
• history of renal calculi
• children.

Administration

When infusing I.V., don't exceed a rate of 200 mg/minute.
• Keep patient supine for 15 minutes after I.V. administration to prevent orthostatic hypotension.
• Administer P.O. doses 1 to 1½ hours after meals.
• Know that I.M. or subcutaneous administration is never recommended.
• Be aware that I.V. route is preferred in children.
• Be alert for extravasation, which causes tissue necrosis.

Adverse reactions

CNS: headache, weakness, dizziness, syncope, paresthesia

CV: mild blood pressure decrease, bradycardia, arrhythmias, cardiac arrest (with rapid I.V. injection)

GI: nausea, vomiting, diarrhea, constipation, epigastric pain or discomfort

GU: urinary frequency, renal calculi

Metabolic: hypercalcemia

Musculoskeletal: joint pain, back pain

Respiratory: dyspnea

Skin: rash

Other: altered or chalky taste, excessive thirst, allergic reactions (including facial flushing, swelling, tingling, tenderness in hands, and anaphylaxis)

Interactions

Drug-drug.Atenolol, fluoroquinolones, tetracycline: decreased bioavailability of these drugs

Calcium channel blockers: decreased calcium effects

Cardiac glycosides: increased risk of cardiac glycoside toxicity

Iron salts: decreased iron absorption

Sodium polystyrene sulfonate: metabolic alkalosis

Verapamil: reversal of verapamil effects

Drug-diagnostic tests.Calcium: increased level

Drug-food.Foods containing oxalic acid (such as spinach), phytic acid (such as whole grain cereal), or phosphorus (such as dairy products): interference with calcium absorption

Patient monitoring

• Monitor calcium levels frequently, especially in elderly patients.

Patient teaching

• Instruct patient to consume plenty of milk and dairy products during therapy.
• Refer patient to dietitian for help in meal planning and preparation.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.

tri·ba·sic cal·ci·um phos·phate

used as an antacid.
References in periodicals archive ?
If all the faces of the pseudo-apatitic unit ABCD are hydrated, this completely hydrated unit may be used as a possible model for ACP and/or for hydrated tricalcium phosphates, which also exhibit an apatitic x-ray diffraction pattern.
There is a great demand of this material in odontology and traumatology, together with other materials of calcium phosphate family such as beta tricalcium phosphate (a-TCP).
Many ceramic substances are in the market as bone substitutes, which include mono and biphasic calcium phosphate ceramics of tricalcium phosphate (TCP) and hydroxyapatite (HAp) (1-2).
Hydroxyapatite and tricalcium phosphate (TCP) stimulate cell proliferation (28).
Clinical application of pure bioactive hydroxyapatite can be improved with the bioresorbable tricalcium phosphate for better bone regeneration.
Hydrolysis of tricalcium phosphate (TCP) to HAp is particularly attractive for several reasons [3].
Most biocomposite implants utilize the osteoconductive properties of beta tricalcium phosphate ([eth]-TCP) to provide 18 months of sustained bone formation.
Formulated with five types of natural breath fresheners-chlorophyll, parsley, dill, peppermint oil and fennel-to counteract "dog breath" and breakdown odor-causing particles in the stomach, as well as Tricalcium Phosphate, an active teeth cleaning agent, to make proper dental hygiene easy and accessible
Both apatites and tricalcium phosphate will be addressed as the main calcium phosphates.
1 g, agar 15 g, dissolved in 1 L of distilled water supplemented by 5 g of Tricalcium Phosphate (TCP) as sole of phosphorus source that have the ability to releases soluble inorganic phosphate from TCP.
Commercially available P additives, MCP (BIOFOS, Plymouth, MN, USA), DCP (SICHUAN MIANJHUSANJIA FEED Co, Sichuan, China) and tricalcium phosphate (TCP, FOODCHEM, Shandong, China) were obtained from fish feed companies in Korea.