Name /bks_53161_deglins_md_disk/multiplevitamins
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MULTIPLE VITAMINS
multiple vitamins (oral)
Adavite, Certagen, Dayalets, Hexavitamin, LKV Drops, Multi-75, Multi-Day, Nutrox,
One-A-Day, Optilets, Poly-Vi-Sol, Quintabs, Ru-lets, Sesame Street Vitamins,
Sigtab, Syrvite, Tab-A-Vite, Therabid, Theragran, Thera Multi-Vitamin, Theravee,
Theravim, Theravite, Therems, Unicaps, Vita-Bob, Vita-Kid, Zymacap
multivitamin infusion (intravenous)
B complex with C and B, Cernevit-12, Multi Vitamin Concentrate, M.V.I.-12, M.V.I.
Pediatric
Classification
Therapeutic: vitamins
Pregnancy Category UK
Indications
Plate # 0-Composite
increases in deficiency states. Absorption of some lipid-soluble vitamins may require
bile acids.
Distribution: Widely distributed; cross the placenta and enter breast milk. Fat-soluble vitamins (A, D, E, and K) are stored in fatty tissues and the liver.
Metabolism and Excretion: Utilized in various biologic processes. Excess
amounts of water-soluble vitamins (B vitamins, vitamin C, and folic acid) are excreted unchanged by the kidneys.
Half-life: Unknown.
TIME/ACTION PROFILE
ROUTE
PO
IV
ONSET
unknown
unknown
Action
levodopa.
Contain fat-soluble vitamins (A, D, and E) and most water-soluble vitamins (B-complex vitamins B1, B2, B3, B5, B6, B12, vitamin C, biotin, and folic acid). These vitamins
are a diverse group of compounds necessary for normal growth and development.
Many act as coenzymes or catalysts in numerous metabolic processes. Liquid products do not contain folic acid. Therapeutic Effects: PO: Prevention of deficiency
or replacement in patients whose nutritional status is questionable. IV: Replacement
in patients who are unable to ingest oral feedings or vitamins.
Route/Dosage
⫽ Canadian drug name.
⫽ Genetic Implication.
DURATION
unknown
unknown
cluding tartrazine, saccharin, and aspartame (oral forms); Some products contain
alcohol and should be avoided in patients with known intolerance.
Use Cautiously in: Patients with anemia of undetermined cause.
Adverse Reactions/Side Effects
cesses are active, some are passive. Absorption of water-soluble vitamins generally
PEAK
unknown
unknown
Contraindications/Precautions
Contraindicated in: Hypersensitivity to preservatives, colorants, or additives, in-
PO: Treatment and prevention of vitamin deficiencies. Special formulations are available for patients with particular needs, including: Prenatal multiple vitamins (with
larger doses of folic acid), Preconceptional multiple vitamins, Multiple vitamins with
iron, Multiple vitamins with fluoride, Multiple vitamins with other minerals or trace
elements. IV Treatment and prevention of vitamin deficiencies in patients who are unable to ingest oral feedings or vitamins.
Pharmacokinetics
Absorption: Well absorbed from the GI tract after oral administration; some pro-
pg 1 # 1
In recommended doses, adverse reactions are extremely rare GU: urine discoloration (preparations with B vitamins). Misc: allergic reactions to preservatives, additives, or colorants.
Interactions
Drug-Drug: Large amounts of vitamin B may interfere with the beneficial effect of
PO (Adults and Children): 1 dose unit (tablet/capsule/dropperful)/day or amount
recommended by individual manufacturer.
IV (Adults and Children): Amount sufficient to meet RDA for age group. Usually
added to large-volume parenteral or total parenteral nutrition (hyperalimentation)
solution.
NURSING IMPLICATIONS
Assessment
● Assess patient for signs of nutritional deficiency before and throughout therapy.
Patients at risk include geriatric patients and those who are debilitated, burned, or
CAPITALS indicate life-threatening, underlines indicate most frequent.
Strikethrough ⫽ Discontinued.
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unable to take oral nutrition and those with malabsorption syndromes or chronic
alcoholism.
● Toxicity and Overdose: Toxicity rarely occurs with multivitamin preparations
because of the small amounts per unit of fat-soluble vitamins. For symptoms, see
individual vitamin entries.
● If overdose occurs, treatment includes induction of emesis or gastric lavage, calcium gluconate IV if hypocalcemic, and maintenance of high urine output.
Potential Nursing Diagnoses
Imbalanced nutrition: less than body requirements (Indications)
Implementation
● Vitamins are usually given orally but may be given parenterally to patients in whom
●
●
●
●
oral administration is not feasible.
Combinations with ⬎1 m g folic acid require a prescription.
PO: Forms are not standardized.
Chewable tablets should be crushed or chewed before swallowing.
Liquid preparations may be dropped directly into the mouth or mixed with juice
or cereal.
IV Administration
Plate # 0-Composite
pg 2 # 2
bine, folic acid, furosemide, gentamicin, glycopyrrolate, heparin, hydrocortisone,
imipenem cilastatin, indomethacin, isoproterenol, ketorolac, labetalol, lidocaine,
magnesium sulfate, mannitol, meperidine, metaraminol, methicillin, methoxamine, methyldopate, methylprednisolone, metoclopramide, metoprolol, miconazole, midazolam, minocycline, morphine, nafcillin, nalbuphine, naloxone, nitroprusside, norepinephrine, ondansetron, oxacillin, oxytocin, papaverine,
penicillin G, pentamidine, pentazocine, pentobarbital, phenobarbital, phentolamine, phenylephrine, phytonadione, potassium chloride, procainamide, prochlorperazine, propranolol, protamine, pyridoxime, ranitidine, sodium bicarbonate, streptokinase, succinylcholine, sufentanil, tacrolimus, theophylline,
thiamine, ticarcillin/clavulanate, tobramycin, tolazoline, vasopressin, verapamil.
● Y-Site Incompatibility: azathioprine, dantrolene, diazepam, diazoxide, ganciclovir, hydralazine, phenytoin, trimethoprim/sulfamethoxazole.
● Additive Incompatibility: Incompatible in solution with many antibiotics.
Patient/Family Teaching
● Encourage patient to comply with recommendations of health care professional.
Explain that the best source of vitamins is a well-balanced diet with foods from the
4 basic food groups.
● Advise parents not to refer to chewable multivitamins for children as candy.
Evaluation/Desired Outcomes
● IV: Administer multivitamin infusion by infusion only; do not use direct IV injec-
● Prevention or decrease in the symptoms of vitamin deficiency.
tion.
● Solution is bright yellow and will color IV solutions and stain clothing.
● Continuous Infusion: Diluent: Dilute each 5- or 10-mL ampule in 500– 1000
mL of D5/LR, D5/0.9% NaCl, D5W, D10W, D20W, lactated Ringer’s injection,
0.9% NaCl, 3% NaCl, or 1/6 M sodium lactate. Do not administer solution that has
crystallized.
● Y-Site Compatibility: acyclovir, alfentanil, amikacin, aminophylline, ascorbic
acid, atracurium, atropine, aztreonam, benztropine, bumetanide, buprenorphine, butorphanol, calcium choride, calcium gluconate, cefazolin, cefoperazone, cefotaxime, cefotetan, cefoxitin, ceftazidime, ceftriaxone, cefuroxime,
chloramphenicol, chlorpromazine, cimetidine, clindamycin, cyanocobalamin,
cyclosporine, dexamethasone sodium phosphate, digoxin, diltiazem, diphenhydramine, dobutamine, dopamine, enalapril, ephedrine, epinephrine, epoetin alfa,
erythromycin lactobionate, esmolol, famotidine, fentanyl, fluconazole, fludara-
Why was this drug prescribed for your patient?
䉷 2015 F.A. Davis Company
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