Vitamins Flashcards
(40 cards)
Most likely not to eat balanced diet
Elderly
No money
Malabsorption syndrome
Alcoholics
Thiamine requirement increase in
1) pregnancy
2) Lactation
3) Chronic Alcoholism.
S/S of thiamine deficiency ( Mild)
Beriberi
Loss of appetite Skeletal muscle weakness Tendency of peripheral edema Decreased systemic BP Low body Temp
Korsakoff Syndrome ( Severe Thiamine deficiency S/S)
Common in Alcoholics
1- Peripheral polyneuritis ( weakness, numbness pain from nerve damage )plus Hyperesthesia( Increased sensitivity in any of your senses ) and Anesthesia of legs.
2- High output HF with extensive Peripheral edema
3- Flat or inverted T-Wave .
First signs of B2 deficiency
Pharyngitis and Angular stomatitis.
Later S/S of B2 Deficiency
Glossitis
Red denuded lips
Sebhorric Dermatitis of the face
Dermatitis of trunk and extremities
What is Oral-Ocular-Genital Syndrome ?
Classic sign of B2 deficiency: Angular Cheilitis , Photophobia, Scrotal Dermatitis
What signs can be prominent in B2 deficiency ?
Anemia and Peripheral Neuropathy
S/S of Niacin deficiency
Nausea Skin/Mouth lesions Anemia Headache Tiredness
Chronic Niacin Deficiency =
Pellagra
Skin: Erythematous skin especially Sun, friction pressure exposed. Very red and swollen tongue
Main GI : Enteritis, Stomatitis , Diarrhea
Other GI: N/V and excessive salivary secretions
Motor and sensory Peripheral neuropathy like Thiamine def , and Dementia
Tryptophan- deficient corn diet causes
Pellagra
Who else has Pellagra other than Niacin deficient
Alcoholics and chronic GI disease ppl.
What medication can lead to Pellagra
Isoniazied by stopping nicotinic acid to be in NAD
Treatment for Pellagra severe vs less severe
IV niacin= severe
PO niacin= less severe
Tx response in 24 hrs !
Toxic Effect of Niacin
Pruritus Headache Flushing Hepatotoxicity Hyperglycemia Hyperurecemia Activation of PUD
What is the function of B6 ( Pyridoxine)
Conversion of 1) Tryptophan to Serotonin 2) Methionine to Cysteine
1) Amnio acid Metabolism
2) Neuronal Excitability
3) Heme synthesis
4) Decrease blood Homocysteine level
* *Homocysteine is :( amino acid found in blood /when high level can cause heart disease/found in meat/high homocysteine is a risk factor for Heart disease,.high when you are deficient in B6, B12, folate and renal disease )
B6 deficiency ..Who?
Rare. May accompany other B vit. Deficiency
Elderly, alcoholic, malnourished
Renal disease and on HD/ Hepatic disease/Type 1 DM/ HIV/RA/
B6 deficiency effects are
Seizures bc lowers seizure threshold
Peripheral neuritis - Carpal Tunnel Syndrome
Decreased Synthesis of GABA ( so not enough inhibitory =seizures )
B6 and B3 deficiency goes to together
B6 Drug interactions
Isoniazied and Hydralazine = no pyridoxal kinase = no synthesis of B6= no GABA = seizures!! So give pyridoxine (b6) to decrease the chance for having seizures
B6 increased decarboxylation of levodopa at periphery = levodopa becomes dopamine at periphery = can’t cross BBB = now levodopa not effective for the Parkinsons patients
Oral contraceptive = less of pyridoxal phosphate level in blood= GABA can’t be synthesized = not enough inhibition = maybe seizures ???
Corticosteroids and anticonvulsants= interfere with metabolism of B6
B12 is what kind of compound? And other names please ..
Cobalt containing compound
Names: Cyanocobalamine , Cobalamine , B12
Storage depot of VitB12
Liver
B12 MOA
1- when **hydrogen ion ** is in stomach = release of B12 released from protein then binds to glycoprotein intrinsic factor . The combine and Form a complex
2- that complex travels to the ileum , goes a specific receptor then enters endothelium
THATS ABSORPTION
3 after absorption B12 binds to B globulin, transcobalamine II for transport to tissue ( especially Liver ).
Likely cause of VitB12 deficiency?
1-Have too little or no Hydrochloric acid in gastric secretion ( Acchlorydia ) and not having enough secretion of intrinsic factor ( remember b12 only released when hydrogen ions present plus that it binds to intrinsic factor to for a complex in order to enter ileum )
***not likely bc you eat to little VitB12, unless you are vegan :-)
2- Bacterial overgrowth = B12 can’t reach the ileum
3- cutting the ileum = B12 cannot be absorbed
4_ Nitrous Oxide = oxides the cobalt atom of B12= 2 enzymes now can’t be synthesized: a)methionine b) thymidalate.
Lab value of B12 deficiency
Less than 200pg/ml
**PG/ml **
