Citicoline Indication and Nursing Management

Generic Name: Citicoline

Brand Name: Nicholin, Somazine, 5′-Cytidine diphosphate choline, CDPC, CDP Choline, CDP-Choline, Citicholine, Citicolina, Cytidine 5-Diphosphocholine, Cytidine 5′-diphosphocholine, Cytidine (5′) diphosphocholine

Classification: Neurotonics, Nootropics

Mechanism of Action

Citicoline seems to increase a brain chemical called phosphatidylcholine. This brain chemical is important for brain function. Citicoline might also decrease brain tissue damage when the brain is injured.It is usually known that phospholipid, especially lecithin, decreases following decline in brain activity with cerebral trauma. Citicoline, which is a co-enzyme, accelerates the biosynthesis of lecithin in the body.

This medication enhances the action of the brain stem ciliary body especially the ascending ciliary body activating system, which is closely related to consciousness, but does not exert effort on the extrapyramidal system. Citicoline increases cerebral blood flow and oxygen consumption of the brain and improves cerebral circulation and metabolism.

Scientific research demonstrates that Citicoline consumption promotes brain metabolism by enhancing the synthesis of acetyl-choline, restoring phospholipid content in the brain and affecting neuron membrane excitability and osmosis (by its effect on the ATP-dependent sodium and potassium pump).  When taken orally, its two main components, Cytidine and Choline are absorbed into the bloodstream.

Citicoline is also believed to protect nerve cells when in low oxygen conditions. Citicoline may be used for nutritional support in cerebral vascular disease, head trauma, stroke, and cognitive disorders. It also is used by those who have age related mental decline, such as Alzheimer’s and Parkinsons.

Indication

  • Parkinson’s disease
  • Head injury
  • Cerebral vascular disease
  • Alzheimer’s disease
  • Cerebral surgery or acute cerebral disturbance
  • Disturbance of consciousness following brain surgery

Special Precautions

  • Patients with acute, severe & progressive disturbance of consciousness
  • Administration with hemostatics
  • Intracranial pressure relieving drugs or use measures to keep body temp low.

Side Effects

Citicoline seems to be safe when taken short-term (up to 90 days). The safety of long-term use is not known. Most people who take citicoline don’t experience problematic side effects. However, these are the common side effects reported by some patients:

  • Body temperature elevation
  • Restlessness
  • Headaches
  • Nausea and vomiting
  • Diarrhea
  • Low or high blood pressure
  • Tachycardia
  • Sleeping troubles or insomnia
  • Blurred vision
  • Chest pains

Nursing Management

  • Citicoline may be taken with or without food. Take it with or between meals.
  • The supplement should not be taken in the late afternoon or at night because it can cause difficulty sleeping.
  • Women who are pregnant or trying to become pregnant should consult with their doctor before taking the supplements. Not enough is known about the use of Citicoline during pregnancy and breast-feeding. Stay on the safe side and avoid use.
  • Special attention should be paid for administration in the neonate, premature and children.
  • Contact the physician immediately if allergic reaction such as hives, rash, or itching, swelling in your face or hands, mouth or throat, chest tightness or trouble breathing are experienced.
  • Citicoline therapy should be started within 24 hours of a stroke. The physician will prescribe the correct dosage and the length of time it should be taken for a medical condition.

image courtesy of myhealthmyworld.com

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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