trace metal combination additive

REMS

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.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to iodine (iodine-containing products only).

Use Cautiously in:

OB: 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).

Adv. Reactions/Side Effects ⬆ ⬇

Listed for individual trace metals—usually associated with toxicity

Misc: ChromiumCOMA, SEIZURES, GI ulceration, hepatic damage, nausea, renal damage, vomiting, Copperbehavioral changes, diarrhea, peripheral edema, photophobia, progressive marasmus, weakness, Iodineacneiform skin lesions, headache, increased salivation, metallic taste, parotitis, runny nose, sneezing, sore mouth, swelling of eyelids, Manganeseanorexia, apathy, gait disturbances, headache, erectile dysfunction, irritability, speech difficulties, Molybdenumgout-like syndrome, Seleniumgarlic-like breath, garlic-like sweat, GI discomfort, hair loss, mental depression, metallic taste, nervousness, vomiting, weak nails, Zincblurred vision, hypotension, jaundice, loss of consciousness, oliguria, pulmonary edema, tachycardia, toxicity poorly defined but may include hypothermia, vomiting

Interactions ⬆ ⬇

Drug-drug:

None significant in replacement doses.

Availability ⬆ ⬇

All must be diluted in large-volume parenterals prior to use

Injection: 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

Route/Dosage ⬆ ⬇

IV (Adults and Children ): Amount necessary to maintain normal trace element levels.

US Brand Names ⬆ ⬇

Concentrated Multiple Trace Element, ConTE-PAK-4, M.T.E.-4, M.T.E.-4 Concentrated, M.T.E.-5, M.T.E.-5 Concentrated, M.T.E.-6, M.T.E.-6 Concentrated, M.T.E.-7, MulTE-PAK-4, MulTE-PAK-5, Multiple Trace Element, Multiple Trace Element Neonatal, Multiple Trace Element Pediatric, Neotrace 4, PedTE-PAK-4, Pedtrace-4, P.T.E.-4, P.T.E.-5

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.

Classifications ⬆ ⬇

Therapeutic Classification: mineral and electrolyte replacements/supplements

Pharmacokinetics ⬆ ⬇

Absorption: Administered IV only, resulting in complete bioavailability.

Distribution: Widely distributed.

Metabolism/Excretion: Excretion depends on individual trace element.

Half-Life: Unknown.

ROUTE	ONSET	PEAK	DURATION
IV	rapid	unknown	unknown

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Indications ⬇