Drug Guide

Generic Name

Vitamin A Palmitate

Brand Names Aquasol A, Vitamin A, Del-vi-a, Alphalin, Vitamin A Solubilized, Vi-dom-a, Afaxin

Classification

Therapeutic: Nutritional supplement, Vitamin A deficiency treatment

Pharmacological: Fat-soluble vitamin, retinoid

FDA Approved Indications

  • Treatment of vitamin A deficiency
  • Adjunct in the management of conditions requiring vitamin A supplementation

Mechanism of Action

Vitamin A palmitate, once ingested, is converted into active retinol, which is essential for normal vision, immune function, and cellular growth and differentiation.

Dosage and Administration

Adult: Dosing varies based on deficiency severity; typically 5,000 to 25,000 IU daily under medical supervision.

Pediatric: Dosing depends on age and deficiency severity; generally 1500 to 10,000 IU daily.

Geriatric: Similar to adult dosing; monitor for toxicity.

Renal Impairment: Adjust dose based on clinical response and toxicity risk.

Hepatic Impairment: Use with caution; monitor liver function.

Pharmacokinetics

Absorption: Absorbed via intestinal lymphatics, especially when taken with dietary fats.

Distribution: Bound extensively to retinol-binding protein in plasma; stored mainly in the liver.

Metabolism: Metabolized in the liver to various derivatives, including active retinoic acid.

Excretion: Excreted primarily in the bile and feces, minor urinary excretion.

Half Life: Approximately 20 hours.

Contraindications

  • Known hypersensitivity to vitamin A or its components.
  • Pre-existing hypervitaminosis A.

Precautions

  • Use cautiously in pregnancy (category A or X warnings), as excessive intake can cause teratogenic effects.
  • Monitor serum retinol levels in long-term therapy.

Adverse Reactions - Common

  • Nausea (Common)
  • Vomiting (Common)
  • Headache (Less common)

Adverse Reactions - Serious

  • Hypervitaminosis A with symptoms such as blurred vision, dizziness, nausea, vomiting, increased intracranial pressure (Rare)
  • Teratogenicity in pregnancy (Serious if excessive use during pregnancy)

Drug-Drug Interactions

  • Retinoid medications (e.g., isotretinoin) - increase risk of toxicity.

Drug-Food Interactions

  • High-fat diets may enhance absorption.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of deficiency or toxicity; check liver function and serum retinol levels if long-term therapy.

Diagnoses:

  • Risk for toxicity related to excessive vitamin A intake.
  • Deficient knowledge related to safe dosing and potential adverse effects.

Implementation: Administer with food containing fat to enhance absorption; educate about toxicity and proper storage.

Evaluation: Assess for resolution of deficiency symptoms and absence of toxicity signs.

Patient/Family Teaching

  • Take medication with meals containing fat to improve absorption.
  • Do not exceed prescribed dose to avoid toxicity.
  • Report symptoms of toxicity such as headache, nausea, or visual changes.
  • Pregnant women should consult healthcare provider before use.

Special Considerations

Black Box Warnings:

  • Caution in pregnant women due to teratogenic potential.

Genetic Factors: None specific beyond general considerations for vitamin A metabolism.

Lab Test Interference: Serum retinol levels may be affected by recent dosing or health status.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, increased intracranial pressure, blurred vision, skin peeling, hepatotoxicity.

Treatment: Discontinue vitamin A, provide supportive care, treat symptoms; in severe cases, hospitalization and specific interventions may be necessary.

Storage and Handling

Storage: Store in a cool, dark place, tightly closed.

Stability: Stable under recommended storage conditions for shelf life duration.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.