zinc (Rx, OTC)

Frequency Not Defined

Nausea/vomiting

Gastric irritation

Elevations of serum alkaline phosphatase, amylase, and lipase that may return to high normal within 1-2 years of therapy

Neurologic deterioration

Contraindications

Hypersensitivity

Cautions

Not for direct injection into peripheral vein (may cause infusion phlebitis)

Injection contains aluminum, which may cause toxicity in prolonged parenteral administration if renal function impaired

Do not use zinc intranasally (as in Zicam)-risk of permanent loss of smell

Lozenges sweetened with citric acid, mannitol, or sorbitol have decreased efficacy; should only be sweetened with glycine

Wilson disease

• Not recommended for initial therapy of symptomatic patients with because of the delay required for zinc-induced increase in enlerolyhc metallothionein and blockade of copper uptake; may be used as maintenance therapy after patient has stabilized on initial chelation therapy
• Symptomatic patients should be treated initially, using chelating agents for initial therapy; neurological deterioration may occur as copper stores are mobilized

Pregnancy Category: A (Galzin); C (injction or gluconate)

Lactation: Present in breast milk, use caution

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Source: shellfish, fish, red meat; plant sources (whole grains, legumes, nuts) less bioavailable d/t phytic acid binding

Mechanism of action

Cofactor in over 100 enzymes; plays a role in DNA synthesis; supports a healthy immune system; helps maintain a sense of smell and taste; may assist in porper function of insulin

Pharmacokinetics

Half-life: 11 days following cessation of therapy (inhibition of copper uptake)

Absorption: pH dependent (enhanced at pH<3); impaired by food

Excretion: Feces (primarily)

IV Info

Do NOT give undiluted as a bolus injection- acidic, may cause phlebitis & tissue damage

Dilute in at least 100 mL