trace metals for injection

Indications

• supplement to TPN solutions

Dosage

Table

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)

• chromium:
  • convulsions, coma, nausea/vomiting, GI ulcers, hepatic dysfunction, renal dysfunction
• copper:
  • peripheral edema, behavioral changes, hypotonia, progressive marasmus, diarrhea, hepatic dysfunction, photophonophobia
• manganese:
  • irritability, speech disturbances, headache, apathy, anorexia, impotence, abnormal gait
• molybdenum:
  • gout like syndrome associated with increased plasma levels of uric acid & xanthine oxidase
• selenium:
  • nervousness, depression, alopecia, weak nails, dermatitis, GI disorders, metallic taste, garlic odor of breath & sweat, dental defects
• zinc:
  • tachycardia, decreased consciousness, hypothermia, blurred vision, profuse diaphoresis

More general terms

• pharmacologic combination
• metabolic agent (metabolic modifier)