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Dear Readers! I started this blog when my daughter was in the NICU. She had ventriculitis. Her CSF report grew E.coli. But, she was injected Teicoplanin directly into her brain. The doctors made two errors here:

Teicoplanin is for gram-positive bacteria only. It does not treat E.coli.
Teicoplanin is not for intraventricular use. The manufacturer strongly discourage injecting Teicoplanin into the brain.

My daughter bled into the brain. She lived for another two years and ultimately died.

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Chromium chloride injection for TPN

Chromium chloride injection is used as a supplement in total parenteral nutrition to maintain chromium levels, prevent subsequent deficiency, and restore the body stores. It is an essential element that maintains glucose homeostasis and maintain the normal functioning of neurons.

Chromium chloride Injection Dose in Adults

Chromium supplement for TPN:
- 10 - 15 mcg/day as an intravenous infusion.

Chromium chloride Injection Dose in Childrens

Chromium as a supplement for Total Pareneteral Nutrition:

Infants 3 - 10 kgs:
- 0.2 mcg/kg/day.
Children 10 - 40 kg:
- 0.14 - 0.2 mcg/kg/day.
Adolescents weighing more than 40 kgs:
- 5 - 15 mcg/day.
Manufacturer’s labeling:
- 0.14 - 0.2 mcg/kg/day.

Pregnancy Risk Factor C

It has not yet been tested in pregnancy.

Chromium injection use during breastfeeding

You should be cautious when nursing females, as the excretion into breastmilk can be unknown.

Chromium chloride Injection Dose in Renal Disease:

Patients with advanced kidney disease including those on hemodilysis should avoid the drug.

Chromium chloride Injection Dose in Liver Disease:

Dose adjustment has not been recommended by the manufacturer in patients with liver disease.

Side effects of the injection may include:

Skin irritation at the injection site
Headaches
Dizziness
Nausea and vomiting
Mood changes
Impaired thinking capability and judgment
Loss of coordination.

Contraindication to Chromium chloride Injection

Warnings & Precautions

Aluminum toxicity
- The injection contains aluminium. The body may accumulate toxic amounts of aluminum if the drug is administered for prolonged periods of time and in high doses.
- High doses of aluminum (more than 4 to 5 mg/kg/day) can cause bone and central nervous system damage.

Renal impairment
- Patients with kidney disease should be cautious when taking the drug. Adjusting the dose may be necessary.

Monitoring Parameters:

Monitor administration site thrombosis, evidence of catheter related blood stream infections, Renal functions, and serum electroyltes including serum phosphate levels.

How to administer Chromium chloride Injection?

It is intended for intravenous use only. It must be diluted prior to use in at least 100 mL of fluid and should never be injected in the concentrated form into a peripheral line.

The solution is acidic and direct intramuscular or intravenous administration is contraindicated.

Mechanism of action of Chromium chloride:

The essential element of Chromium helps maintain normal glucose homeostasis as well as peripheral nerve function.
It helps prevent impaired glucose tolerance, confusion, peripheral neuropathy, ataxia, and impairment of mental status. It is excreted in the urine and bile.

International Brands of Chromium chloride Injection: