trace metals for injection

Indication: - supplement to TPN solutions Dosage: trace metal infants (ug/kg) children <10 years (ug/kg) chromium 0.14-0.2 0.14-0.2 copper 20 20 manganese 2-10 2-10 selenium 3 3 (max 40 ug/day) zinc 300 (preterm) 100 - 100 (term) - Injection: zinc 0.8 mg, copper 0.2 mg, manganese 0.16 mg, chromium 2 ug/mL Adverse effects: (excessive trace metal) 1) chromium: - convulsions, coma, nausea/vomiting, GI ulcers, hepatic dysfunction, renal dysfunction 2) copper: - peripheral edema, behavioral changes, hypotonia, progressive marasmus, diarrhea, hepatic dysfunction, photophonophobia 3) manganese: - irritability, speech disturbances, headache, apathy, anorexia, impotence, abnormal gait 4) molybdenum: - gout like syndrome associated with increased plasma levels of uric acid & xanthine oxidase 5) selenium: - nervousness, depression, alopecia, weak nails, dermatitis, GI disorders, metallic taste, garlic odor of breath & sweat, dental defects 6) zinc: - tachycardia, decreased consciousness, hypothermia, blurred vision, profuse diaphoresis

General

pharmacologic combination metabolic agent (metabolic modifier)

References

Kaiser Permanente Northern California Regional Drug Formulary, 1998