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A dose is a measured quantity of a medicine, nutrient, or pathogen that is delivered as a unit. The greater the quantity delivered, the larger the dose. Doses are most commonly measured for compounds in medicine. The term is usually applied to the quantity of a drug or other agent administered for therapeutic purposes, but may be used to describe any case where a substance is introduced to the body. In nutrition, the term is usually applied to how much of a specific nutrient is in a person's diet or in a particular food, meal, or dietary supplement. For bacterial or viral agents, dose typically refers to the amount of the pathogen required to infect a host.
In clinical pharmacology, dose refers to the amount of drug administered to a person, and dosage is a fuller description that includes not only the dose (e.g., "500 mg") but also the frequency and duration of the treatment (e.g., "twice a day for one week"). Exposure means the time-dependent concentration (often in the circulatory blood or plasma) or concentration-derived parameters such as AUC (area under the concentration curve) and Cmax (peak level of the concentration curve) of the drug after its administration[ citation needed ]. This is in contrast to their interchangeable use in other fields.
A 'dose' of any chemical or biological agent (active ingredient) has several factors which are critical to its effectiveness. The first is concentration, that is, how much of the agent is being administered to the body at once. Under-dosing is a common problem in pharmacy, as predicting an average dose that is effective for all individuals is extremely challenging because body weight and size impacts how the dose acts within the body. [1]
Another factor is the duration of exposure. Some drugs or supplements have a slow-release feature in which portions of the medication are metabolized at different times, which changes the impacts the active ingredients have on the body. Some substances are meant to be taken in small doses over large periods of time to maintain a constant level in the body, while others are meant to have a large impact once and be expelled from the body after its work is done. It's entirely dependent on the function of the drug or supplement.
The route of administration is important as well. Whether a drug is ingested orally, injected into a muscle or vein, absorbed through a mucous membrane, or any of the other types of administration routes, affects how quickly the substance will be metabolized by the body and thus effects the concentration of the active ingredient(s). Dose-response curves may illustrate the relationship of these metabolic effects.
In over-the-counter medicines, both dose and dosage is usually based on age. Typically, different doses are recommended for children 6 years and under, for children aged 6 to 12 years, and for persons 12 years and older, but outside of those ranges the guidance is slim. [2] This can lead to serial under- or over-dosing, as smaller people take more than they should and larger people take less. Over-the-counter medications may be accompanied by a set of instructions directing the patient to take a certain small dose, followed by another small dose if their symptoms don't subside.
Prescription drug doses are often based on body weight. [3] Drugs come with a recommended dose in milligrams or micrograms per kilogram of body weight, and that is used in conjunction with the patient's age and body weight to determine a safe dose.
In single-dose scenarios, the patient's body weight and the drug's recommended dose per kilogram are used to determine a safe one-time dose. If multiple doses of treatment are needed in a day, the physician must take into account information regarding the total amount of the drug which is safe to use in one day, and how that should be broken up into intervals for the most effective treatment for the patient. [4] For example, if the desired total daily amount is 600 mg per day, they may decide a dosage plan that has one 200 mg dose taken three times a day, or one 300 mg dose taken twice a day, or a single 600 mg dose take once a day.
Medication underdosing occurs commonly when physicians write prescriptions that are correct for a certain time, but fails to increase the dose as the patient needs (i.e. weight-based dosing in children, or increasing dose of chemotherapy drugs if a patient's condition worsens). [5]
Medical cannabis is used to treat the symptoms of a wide variety of diseases and conditions. The dose of cannabis depends on the individual, the condition being treated, and the ratio of cannabidiol (CBD) to tetrahydrocannabinol (THC) in the cannabis. CBD is a chemical component of cannabis that is not intoxicating and used to treat conditions like epilepsy and other neuropsychiatric disorders. THC is a chemical component of cannabis that is psychoactive. It has been used to treat nausea and discomfort in cancer patients receiving chemotherapy treatment. For anxiety, depression, and other mental health ailments, a CBD to THC ratio of 10 to 1 is recommended. [6] For cancer and neurological conditions, a CBD to THC ratio of 1 to 1 is recommended. [6] The correct dose depends on each individual's reaction to both chemicals, and therefore the dosing must be continually adjusted once treatment is initiated to find the right balance.
There is limited consensus throughout the scientific community regarding the effectiveness of medicinal cannabis. [7] [8]
Calculating drug doses for treatment for more serious diseases like cancer is commonly done through measuring the patient's body surface area. There are approximately 25 different formulae for measuring a patient's body surface area, none of them exact. [9] Studies show that selecting the best method for an individual patient is a difficult task; consequently, people may receive somewhat too much or too little medication due to their particular physical anomalies. [9] Therefore, these formulas are typically adjusted by what is known as 'toxicity-adjusting dosing,' whereby physicians monitor immune suppression and adjust dosing accordingly. [10] Because this strategy of trial and error requires close monitoring, it is inefficient, risky, and cost ineffective. Research into the development of safer and more accurate dosing methods is ongoing.[ citation needed ]
This section needs to be updated.(September 2024) |
Another approach that's been investigated recently is dosing on a molecular level, either through conventional delivery systems, nanoparticle drug delivery, light-triggered delivery, or other methods. By combining these drugs with a system that detects the concentration of drug particles in the blood, proper dosing could be achieved for each individual patient. Research in this field was initiated with monitoring of small-molecule cocaine levels in undiluted blood serum with electrochemical aptamer-based sensing. DNA aptamers, which are peptides that have with specific target molecules that they search for, fold in response to the molecule when they find it, and this technology was used in a microfluidic detection system to create an electrochemical signal that physicians can read. Researchers tested it on cocaine detection and found that it successfully found trace amounts of cocaine in blood. [11]
This research was expanded upon and led to the creation of a product called MEDIC (microfluidic electrochemical detector for in vivo continuous monitoring) developed by faculty at the University of California at Santa Barbara. MEDIC is an instrument that can continuously determine the concentrations of different molecules in the blood. [12] The blood doesn't have to be mixed with anything prior to testing to create a 'serum' as the first device did. MEDIC can detect a wide variety of drug molecules and biomarkers. In trials, early models of the device failed after about half an hour because the proteins in whole blood clung to the sensors and clogged the components. This problem was solved via a second chamber that allowed a liquid buffer to flow over the sensors with the blood, without mixing or disturbing the blood, so the results remained unchanged. The device is still in clinical trials and actual implementation in medicine is likely years away, however in the interim, its creators estimate that it could also be used in the pharmaceutical industry to allow for better testing in Phase 3 clinical trials. [13]
Vaccinations are typically administered as liquids and dosed in milliliters. Each individual vaccine comes with constraints regarding at what age they should be administered, how many doses must be given, and over what period of time. There are 15 vaccines that the Centers for Disease Control and Prevention recommend every person (in the United States and Canada) receive between birth and 18 years of age to protect against various infectious agents that may affect long-term health. [14] Most vaccines require multiple doses for full immunity, given in recommended intervals depending on the vaccine. There are several typical routes of administration for vaccines: [15]
For healthy humans, experts recommend daily intake quantities of certain vitamins and minerals. The Food and Nutrition Board, Institute of Medicine, and National Academy of Sciences sets a recommended Dietary Reference Intake (DRI) in several forms: [16]
DRIs are established for elements, vitamins, and macronutrients. Common elemental [17] and vitamin [18] doses are measured in milligrams per day (mg/d) or micrograms per day (μg/d). Common macronutrient [19] doses are in grams per day (g/d). Recommended doses for all three are established by both gender and age.
Individuals take vitamin and mineral supplements to promote healthier lifestyles and prevent development of chronic diseases. There is no conclusive evidence linking continued vitamin and mineral supplement intake with longevity of life. [20]
The infectious dose of a pathogen is the number of cells required to infect the host. All pathogens have an infectious dose typically given in number of cells. The infectious dose varies by organism and can be dependent on the specific type of strain. [21] Some pathogens can infect a host with only a few cells, while others require millions or billions.
Examples of infectious doses, ranked loosely in increasing order: [22]
Typically, stomach acids can kill bacteria below the infectious dosing range for a given pathogen and keep the host from feeling symptoms or falling ill. Complexes constructed by fat can protect infectious agents from stomach acid, making fatty foods more likely to contain pathogens that successfully infect the host. For individuals with low or reduced stomach acid concentrations, in infectious dose for a pathogen will be lower than normal. [22]
Rather than being administered by a physician or individual, infectious doses are transmitted to a person from other persons or the environment, are generally unintentional, and usually result in symptoms or other adverse effects until the pathogen is defeated by the individual's immune system or flushed out of the individual's system by excretory processes.
Vitamin C is a water-soluble vitamin found in citrus and other fruits, berries and vegetables. It is also a generic prescription medication and in some countries is sold as a non-prescription dietary supplement. As a therapy, it is used to prevent and treat scurvy, a disease caused by vitamin C deficiency.
Vitamin K is a family of structurally similar, fat-soluble vitamers found in foods and marketed as dietary supplements. The human body requires vitamin K for post-synthesis modification of certain proteins that are required for blood coagulation or for controlling binding of calcium in bones and other tissues. The complete synthesis involves final modification of these so-called "Gla proteins" by the enzyme gamma-glutamyl carboxylase that uses vitamin K as a cofactor.
Pantothenic acid (vitamin B5) is a B vitamin and an essential nutrient. All animals need pantothenic acid in order to synthesize coenzyme A (CoA), which is essential for cellular energy production and for the synthesis and degradation of proteins, carbohydrates, and fats.
Retinol, also called vitamin A1, is a fat-soluble vitamin in the vitamin A family that is found in food and used as a dietary supplement. Retinol or other forms of vitamin A are needed for vision, cellular development, maintenance of skin and mucous membranes, immune function and reproductive development. Dietary sources include fish, dairy products, and meat. As a supplement it is used to treat and prevent vitamin A deficiency, especially that which results in xerophthalmia. It is taken by mouth or by injection into a muscle. As an ingredient in skin-care products, it is used to reduce wrinkles and other effects of skin aging.
A dietary supplement is a manufactured product intended to supplement a person's diet by taking a pill, capsule, tablet, powder, or liquid. A supplement can provide nutrients either extracted from food sources, or that are synthetic. The classes of nutrient compounds in supplements include vitamins, minerals, fiber, fatty acids, and amino acids. Dietary supplements can also contain substances that have not been confirmed as being essential to life, and so are not nutrients per se, but are marketed as having a beneficial biological effect, such as plant pigments or polyphenols. Animals can also be a source of supplement ingredients, such as collagen from chickens or fish for example. These are also sold individually and in combination, and may be combined with nutrient ingredients. The European Commission has also established harmonized rules to help insure that food supplements are safe and appropriately labeled.
In the context of nutrition, a mineral is a chemical element. Some "minerals" are essential for life, but most are not. Minerals are one of the four groups of essential nutrients; the others are vitamins, essential fatty acids, and essential amino acids. The five major minerals in the human body are calcium, phosphorus, potassium, sodium, and magnesium. The remaining elements are called "trace elements". The generally accepted trace elements are iron, chlorine, cobalt, copper, zinc, manganese, molybdenum, iodine, and selenium; there is some evidence that there may be more.
Calcium ions (Ca2+) contribute to the physiology and biochemistry of organisms' cells. They play an important role in signal transduction pathways, where they act as a second messenger, in neurotransmitter release from neurons, in contraction of all muscle cell types, and in fertilization. Many enzymes require calcium ions as a cofactor, including several of the coagulation factors. Extracellular calcium is also important for maintaining the potential difference across excitable cell membranes, as well as proper bone formation.
Cholecalciferol, also known as vitamin D3 or colecalciferol, is a type of vitamin D that is produced by the skin when exposed to UVB light; it is found in certain foods and can be taken as a dietary supplement.
Electrolyte imbalance, or water-electrolyte imbalance, is an abnormality in the concentration of electrolytes in the body. Electrolytes play a vital role in maintaining homeostasis in the body. They help to regulate heart and neurological function, fluid balance, oxygen delivery, acid–base balance and much more. Electrolyte imbalances can develop by consuming too little or too much electrolyte as well as excreting too little or too much electrolyte. Examples of electrolytes include calcium, chloride, magnesium, phosphate, potassium, and sodium.
Thiazide refers to both a class of sulfur-containing organic molecules and a class of diuretics based on the chemical structure of benzothiadiazine. The thiazide drug class was discovered and developed at Merck and Co. in the 1950s. The first approved drug of this class, chlorothiazide, was marketed under the trade name Diuril beginning in 1958. In most countries, thiazides are the least expensive antihypertensive drugs available.
Nutrition and pregnancy refers to the nutrient intake, and dietary planning that is undertaken before, during and after pregnancy. Nutrition of the fetus begins at conception. For this reason, the nutrition of the mother is important from before conception as well as throughout pregnancy and breastfeeding. An ever-increasing number of studies have shown that the nutrition of the mother will have an effect on the child, up to and including the risk for cancer, cardiovascular disease, hypertension and diabetes throughout life.
Hydroxocobalamin, also known as vitamin B12a and hydroxycobalamin, is a vitamin found in food and used as a dietary supplement. As a supplement it is used to treat vitamin B12 deficiency including pernicious anemia. Other uses include treatment for cyanide poisoning, Leber's optic atrophy, and toxic amblyopia. It is given by injection into a muscle or vein, by pill or sublingually.
Health is the state of complete physical, mental, and social well-being and a positive concept emphasizing social and personal resources, as well as physical capacities. This article lists major topics related to personal health.
Vitamin B12, also known as cobalamin, is a water-soluble vitamin involved in metabolism. It is one of eight B vitamins. It is required by animals, which use it as a cofactor in DNA synthesis, and in both fatty acid and amino acid metabolism. It is important in the normal functioning of the nervous system via its role in the synthesis of myelin, and in the circulatory system in the maturation of red blood cells in the bone marrow. Plants do not need cobalamin and carry out the reactions with enzymes that are not dependent on it.
Vitamin D deficiency or hypovitaminosis D is a vitamin D level that is below normal. It most commonly occurs in people when they have inadequate exposure to sunlight, particularly sunlight with adequate ultraviolet B rays (UVB). Vitamin D deficiency can also be caused by inadequate nutritional intake of vitamin D; disorders that limit vitamin D absorption; and disorders that impair the conversion of vitamin D to active metabolites, including certain liver, kidney, and hereditary disorders. Deficiency impairs bone mineralization, leading to bone-softening diseases, such as rickets in children. It can also worsen osteomalacia and osteoporosis in adults, increasing the risk of bone fractures. Muscle weakness is also a common symptom of vitamin D deficiency, further increasing the risk of fall and bone fractures in adults. Vitamin D deficiency is associated with the development of schizophrenia.
A health claim found on a food labels and in food marketing is a claim by a food manufacturer that their product will reduce the risk of developing a disease or condition.
Vitamin D is a group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, along with numerous other biological functions. In humans, the most significant compounds within this group are vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol).
Selenium is an essential micronutrient for animals, though it is toxic in large doses. In plants, it sometimes occurs in toxic amounts as forage, e.g. locoweed. Selenium is a component of the amino acids selenocysteine and selenomethionine. In humans, selenium is a trace element nutrient that functions as cofactor for glutathione peroxidases and certain forms of thioredoxin reductase. Selenium-containing proteins are produced from inorganic selenium via the intermediacy of selenophosphate (PSeO33−).
Calcium supplements are salts of calcium used in a number of conditions. Supplementation is generally only required when there is not enough calcium in the diet. By mouth they are used to treat and prevent low blood calcium, osteoporosis, and rickets. By injection into a vein they are used for low blood calcium that is resulting in muscle spasms and for high blood potassium or magnesium toxicity.
Megavitamin-B6 syndrome, also known as hypervitaminosis B6, vitamin B6 toxicity, and vitamin B6 excess, is a medical condition characterized by adverse effects resulting from excessive intake of vitamin B6. Primarily affecting the nervous system, this syndrome manifests through symptoms such as peripheral sensory neuropathy, characterized by numbness, tingling, and burning sensations in the limbs. The condition is usually triggered by chronic dietary supplementation of vitamin B6 but can also result from acute over-dosages, whether orally or parenterally.
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