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Ascorbic Acid (Vitamin C) Injection

Ascorbic acid is a water-soluble vitamin found in plants like citrus fruits and peppers. When isolated, it resembles a white or yellowish powder with an acidic taste. When exposed to air and light the color gradually darkens. In its dry state the product is relatively stable, but in solution it quickly oxidizes. Ascorbic acid is a free radical, or a scavenger of oxygen species, and it plays a role in oxidation-reduction reactions. The product is a cofactor for enzymes involved in the biosynthesis of collagen, carnitine, and neurotransmitters. Humans cannot synthesize ascorbic acid endogenously and must receive it through diet; a lack of intake leads to scurvy. Vitamin C is typically consumed as a nutritional supplement or an adjunct treatment of idiopathic methemoglobinemia and as a participant in the treatment of chronic iron toxicity. Ascorbic acid has been used to treat the common cold, gum infections, acne, depression, infertility, and cancer, though these claims have not been proven and vitamin C is not recommended for these purposes. Ascorbic acid received FDA approval in 1939.

Mechanism of Action

Ascorbic acid supports collagen formation and tissue repair, and when reverse oxidized, it becomes dehydroascorbic acid. Both forms are involved in oxidation-reduction reactions. Vitamin C also contributes to the metabolism of tyrosine, carbohydrates, norepinephrine, histamine, and phenylalanine. It contributes vitally to the biosynthesis of corticosteroids and aldosterone, proteins, neuropeptides, and carnitine, also the conversion of cholesterol to bile acids, blood vessel maintenance, and cellular respiration. Vitamin C may activate white blood cells and thereby promote resistance to infection. It also supports the production of interferon and the regulation of the inflammatory process. It reduces iron in the intestine to allow absorption, transfers iron from plasma transferrin to liver ferritin, and regulates iron distribution and storage by preventing oxidation. Ascorbic acid also contributes to the treatment of chronic iron toxicity, and may have a role in the regeneration of other biological antioxidants such as glutathione and α-tocopherol to their active state.

In the absence of vitamin C, collagen formation is impaired due to a deficiency in the hydroxylation of procollagen and collagen. Non-hydroxylated collagen is unstable, and the normal processes of tissue repair cannot occur. This results in the various features of scurvy including capillary fragility manifested as hemorrhagic processes, bony abnormalities and delayed wound healing.

 

Other than scurvy, the use of vitamin C in the prevention and treatment of diseases is unclear. Further study is needed to recommend vitamin C therapy for the following ailments, but recent data suggest a role for vitamin C in the address of: the prevention of coronary heart disease; diabetes mellitus management; reducing stroke risk; management of atherosclerosis; osteoporosis prevention; reducing Alzheimer disease risk in combination with vitamin E; and cataract prevention. An exogenous source of ascorbic acid is required by humans for collagen formation and tissue repair.

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