Drug Data Generic Name: Multivitamins + FeSO4 Trade Name: Mulvitron atient!

s Dose: 1 cap PO OD Minimum Dose: 125 mg Ma"imum Dose: 750 mg Contents: Fe sulfate 200 mg, folic aci 400 mcg, vit !1 2 mg, vit !2 2 mg, vit !" 2 mg, vit !12 10 mcg, vit # 100 mg Availabilit#: tablets: 150 mg, $00 mg, 500 mg capsules% $00 mg, 500 mg s#rups%250 mg&5ml Route$s for Administration: PO

Classifica tion Therapeu ti c vitamins a n minerals' antianemic s harmaco logic: (ater) s ol u *l e vitamins' ir o n supplemen ts regnanc # Categor# Ris%: +

Mechanism of Action harmacod#namics: Chemical Effects +n essential mineral foun in ,emoglo*in, m-oglo*in, an man- en.-mes/ 0nters t,e *loo stream an is transporte to t,e organs of t,e reticuloen ot,elial s-stem 1liver, spleen, *one marro(2, (,ere it is separate out an *ecomes part of iron stores/ Therapeutic Effects: Prevention&treatment of iron eficiencharmaco%inetics Absorption: 53104 of ietar- iron is a*sor*e 1up to $04 in eficienc- states2/ 5,erapeuticalla ministere PO iron ma- *e "04 a*sor*e via an active an passive transport process/ 6itamins (ell a*sor*e follo(ing a ministration Distribution: 7emains in t,e *o - for man- mont,s/ #rosses t,e placenta enters *reast mil8/ Protein !in ing% 9:04/ Metabolism & E"cretion: Mostl- rec-cle % small- ail- losses occurring via s(eat, es;uamation, urine an *ile/ Time Reaction Route PO rofile ea% 7)10 a-s Durati on 2)4 mo

Indication General Indication: Prevention an treatment of iron)vitamin an ietareficiencanemias/ <se in anemia ue to *loo loss uring menstruation, infections, surger-, eliver-, into=ications, parasitosis or ot,er causes an anemias uring pregnancatient!s Actual Indication: 5reatment of iron eficiencanemia follo(ing loss of ,ematopoietic factors in t,e 8i ne- ue to 8i ne- isease/

Contraindication Contraindicated in: >emoc,romatosis, ,emosi erosis, or ot,er evi ence of iron overloa ' +nemias not ue to iron eficienc-' some pro ucts contain alco,ol, tartra.ine or sulfites an s,oul *e avoi e in patients (it, 8no(n intolerance or ,-persensitivitrecaution: <se cautiousl- in peptic ulcer' ulcerative colitis or regional enteritis 1con ition ma- *e aggravate 2' +lco,olism' Severe ,epatic impairment' Severe renal impairment 1oral pro ucts2' Pre)e=isting car iovascular se' significant allergies or ast,ma' r,eumatoi art,ritis, pregnanc- or lactation/ Interaction: Drug)Drug: Antacids t,at contain calcium ma8es it ,ar er for t,e *o - to a*sor* certain ingre ients of t,e vitamins/ Oral iron supplements ecrease a*sorption of tetrac#clines+ bisphosphonates+ fluoro,uinolones+ levoth#ro"ine+ m#cophenoalte mofetil, an penicillamineDecrease a*sorption of an ma- ecrease effects of levodopa an meth#ldopa/ #oncurrent a min of (. antagonists+ proton) pump inhibitors an cholest#ramine maecrease a*sorption of iron/ Drug)/ood: ?ron a*sorption is ecrease $$)504 *concurrent a ministration of foo / 1ource: ,ttp%&&(((/ rugs/com&mt m&multivitamins)(it,) iron/,tml

Adverse Effect #@S% sei.ures, i..iness,,ea ac,e, s-ncope #6% ,-potension, ,-pertension, tac,-car ia

Nursing Responsibilities 0efore: Monitor *loo stu ies of pt/ +ssess for inta8e of ot,er multivitamin pro ucts (it,in 2 ,ours, ma- result to vitamin over ose/ O*serve proper osage of me ication to prevent over ose or to=ic effect of t,e rug/ +ssess for colostom- or ileostom-/ @ote ot,er rug t,at t,e pt are ta8ing to avoi possi*le interactions 6erif- pt/Cs i entit-

A?% nausea, constipation, ar8 stools, iarr,ea, epigastric pain, A? *lee ing, taste During: isor er, Most effectivel- a*sor*e if vomiting a ministere 1 ,our *efore or 2 ,rs after meal/ Derm% 5a8e ta*lets an capsules (it, a flus,ing, full glass of (ater or Duice/ urticaria Do not crus, or c,e( enteric) 7esp% coug,, coate ta*lets an o not open -spnea capsules/ +voi using antaci s, coffee, tea, MS% art,ralgia, air- pro ucts, eggs (it,in 1 ,r m-algia after a ministration/ ?nform pt/ a*out ar8, green or Misc% staining *lac8 stools to avoi panic/ of teet,, anap,-la=is, After: s(eating Monitor pt/Cs *loo stu ies Bocal% pain at ?M site

'nset 4 a-s

(alf)*ife: un8no(n

perio icall- t,ereafter to etermine t,e level of effectiveness/ ?nform pt of (,at t,e possi*le a verse effects t,at ma- occur/ Provi e *rief information a*out rug an its in ications to *e gui e an mo if- +DB an prevent an- ou*ts/ +ssess *o(el function for constipation or iarr,ea/ + vise pt/ to notif-/ ?nstruct pt to report imme iatelan- signs an s-mptoms of severe a verse effects t,at (oul arise for prompt intervention/

1ource: Mims/com 124t, 0 ition/ P,ilippines P?MS/ 2010 p/45:

1ource: Mims/com 124t, 0 ition/ P,ilippines P?MS/ 2010 p/45:

1ource: Deglin et al/DavisC Drug Aui e for @urses 12t, 0 ition/ 2011 pp/ 7$"

1ource: ,ttp%&&(((/ rug s/com&mtm&mul tivitamins)(it,) iron/,tml

1ource: ,ttp%&&(((/ ru gs/com&mtm& multivitamins) (it,)iron/,tml

1ource: ,ttp%&&(((/ rugs/com&mtm&multivi tamins)(it,)iron/,tml