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Vitamins and deficiency diseases by keerthi

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Vitamins and deficiency diseases by keerthi

  1. 1. VITAMINS AND DEFICIENCY DISEASES AISWARYA THOMAS 2nd year Pharm D 1
  2. 2. INTRODUCTION  Vitamins are organic compounds required in the diet in small quantities to perform biological functions.  We obtain them from : foods we eat or via vitamin supplements. 2
  3. 3. HISTORY OF VITAMINS  In 1749 the prevention of scurvy by citrus foods was first discovered by Scottish surgeon James Lind.  In Orient: Beriberi was common due to polished white rice.  In 1913 Funk coined the term “VITAMINE”. 3
  4. 4. VITAMINS  According to solubility vitamins are of: Fat-soluble & Water-soluble  Thirteen vitamins are known of which: Four are fat-soluble : Vitamins A , D , E ,K Nine are water- soluble. 4
  5. 5. Distinction between fat-soluble and water-soluble vitamins.  Fat soluble vitamins are readily stored in the body.  Not readily excreted in urine.  Excess consumption can lead to their accumulation and toxic effects. 5
  6. 6. VITAMIN SUPPLEMENTS  Synthetic or natural substances which can be purchased as pills, capsules, powders or liquids.  Best when accompanied by a well balanced diet.  Do not replace a healthy diet.  Do not provide calories or energy. 6
  7. 7. RECOMMENDED DIETARY ALLOWANCES (RDA)  These are suggested levels of essential nutrients considered adequate to meet nutritional needs of healthy individuals.  Requirements are influenced by physical characteristics , dietary habits, sex, pregnancy, lactation and age. 7
  8. 8. MULTIVITAMIN SUPPLEMENT  A multivitamin should contain fat-soluble vitamins A,D,E ; water-soluble vitamins B1,B2,B6,B12 , niacin, biotin , folic acid , pantothenic acid and vitamin C. Contains minerals :zinc, magnesium, copper, and calcium. 8
  9. 9. VITAMINS Fat-soluble Water-soluble Vitamin A Non B- Complex B-Complex Vitamin D Vitamin C Thiamine (B1) Vitamin E Riboflavin(B2) Vitamin K Niacin (B3) Pantothenic acid(B5) Pyridoxine(B6) Biotin(B7) Folic acid (B9) Vitamin B12 9
  10. 10. FAT-SOLUBLE VITAMINS 10
  11. 11. VITAMIN- A  It is the name given to a group of related compounds : Retinol (vitamin A alcohol) Retinal ( vitamin A aldehyde) Retinoic acid ( vitamin A acid)  Its provitamin carotenes are found in plants. 11
  12. 12. SOURCES:  Fish oil , liver, egg yolk, milk, cheese , butter.  Vegetable sources contains provitamin A carotenes.  Yellow and dark vegetables and fruits are sources of carotenes. Carrots mango papaya spinach. 12
  13. 13. FUNCTIONS OF VITAMIN A  Maintenance of normal vision.  Maintenance of normal cartilaginous and bone growth.  Increased immunity against infections in children.  Anti-proliferative effect. 13
  14. 14. VITAMIN- A DEFICIENCY  May be due to : inadequate dietary intake impaired intestinal absorption Chronic alcoholism.  Impaired vision – Night blindness.  Extremely dry skin ,hair or nails.  Epithelial metaplasia and keratinization.  Xerophthalmia ( dry eye ). 14
  15. 15. WHO IS AT RISK ?  Young children's.  Children with inadequate health care.  Adults with diseases of : pancreas liver intestine 15
  16. 16. Too Much Can Be Toxic !!  Hypervitaminous A leads to toxic symptoms: Dry , itchy skin Hair loss Liver damage Skin coloration Loss of appetite Head ache and fatigue Blurred vision. 16
  17. 17. SIDE EFFECTS OF VITAMIN A  Severe birth defects. women of child bearing age should not consume more than 8000 IU per day.  Skin can take on yellow or orange glow. 17
  18. 18. VITAMIN D SUNSHINE VITAMIN.  CALCITRIOL.  Exists in two activated sterol forms: Vitamin D2 - CALCIFEROL Vitamin D3 - CHOLECALIFEROL. 18
  19. 19. SOURCES:  Sunlight.  Milk.  Fish.  Orange juice .  Fortified cereals. 19
  20. 20. FUNCTIONS OF VITAMIN D  Maintenance of adequate plasma levels of calcium and phosphorous.  Metabolic functions.  Bone mineralization.  Neuromuscular transmission. 20
  21. 21. VITAMIN -D DEFICIENCY  May be due to: Limited exposure to sunlight Diet deficiency. Renal disorders.  Rickets.  Osteomalacia ( in adults).  Hypocalcaemictetanydue to neuromuscular dysfunction. 21
  22. 22. 22
  23. 23. CAUSES  Increased risk of: Cancers Autoimmune diseases Hypertension WHO IS AT RISK ? Covered and protected skin Elderly breast – fed infants 23
  24. 24. Too Much Vitamin D !!!  High dose can cause accumulation in the liver.  Produces symptoms of poisoning.  Signs of toxicity include: excess calcium in the blood. nausea vomiting decreased appetite. 24
  25. 25. VITAMIN E  Vitamin E describes a family of eight antioxidants: four tocopherols four tocotrienols.  It is an antioxidant in cells. 25
  26. 26. SOURCES  Vegetables: spinach carrot  Egg Bread Almonds Peanuts.  vegetable oils 26
  27. 27. FUNCTIONS OF VITAMIN- E  Antioxidant.  Inhibits platelets aggregation.  Enhances vasodilation.  Scavenger of free radicals. 27
  28. 28. VITAMIN -E DEFICIENCY  Increased risk of cardiovascular diseases.  Hemolytic anaemia in children.  Neurological symptoms (impaired coordination and muscle relaxation).  RISK FACTOR : fat malabsorption syndrome. 28
  29. 29. THERAPEUTIC USES  DIABETES MELLITUS.  CANCER PREVENTION.  PREVENTION OF CARDIOVASCULAR DISEASES. 29
  30. 30. TOXICITY  Excess vitamin E causes : Impaired blood clotting leading to risk of bleeding in some persons.  Recommended that vitamin E supplements to be stopped one month before surgery. 30
  31. 31. VITAMIN K  K derived from the German word KOAGULATION  Two naturally occuring forms : Plants synthesize phylloquinone –Vitamin K1 Bacteria synthesize menaquinone-3 –Vitamin K2 31
  32. 32. SOURCES  Vegetable oils  Almonds  Peanuts  Spinach  Body can produce its own(from bacteria in intestine). 32
  33. 33. FUNCTIONS OF VITAMIN -K  Helps in clotting .  Assist in bone mineralization. 33
  34. 34. VITAMIN K DEFICIENCY  It is common in adults.  Biliary obstruction .  Due to antibiotic therapy.  Due to malabsorption syndrome.  Hemmorhage.  Deficiency may appear in infants or in people.  Who take anticoagulants such as Warfarin. 34
  35. 35. WATER-SOLUBLE VITAMINS 35
  36. 36. VITAMIN C  Exist as L- ascorbic acid.  Smokers and lactating mother needs higher range. 36
  37. 37. SOURCES  Fruits  Vegetables  Tomato juice  Sweet potato  Citrus fruit  Orange juice. 37
  38. 38. FUNCTIONS OF VITAMIN C  Collagen synthesis.  Body to fight against infections.  Keep gum’s healthy.  Aids in the prevention of heart disease and cancer. 38
  39. 39. VITAMIN C DEFICIENCY  Leads to scurvy.  Weight loss.  Slow healing of wound and fractured bone.  Fatigue and joint pain.  Skin rash .  Anaemia. 39
  40. 40. THERAPEUTIC USES  Cardiovascular diseases.  Cataracts.  Diabetes mellitus.  Cancer prevention.  Common cold.  Lead toxicity. 40
  41. 41. VITAMIN B  Group of seven water-soluble vitamins : Thiamine Riboflavin Niacin Pyridoxine Cobalamin Biotin Pantothenic acid Folic acid 41
  42. 42.  Biotin and pantothenic acid deficiencies are rare.  As it is found in numerous foods.  Biotin deficiency may occur with prolonged antibiotic therapy. 42
  43. 43. VITAMIN B1-THIAMINE SOURCES 43  Yeasts  Cereals  liver
  44. 44. FUNCTIONS OF THIAMINE  ATP production.  Stabilizing the appetite.  Proper nerve function. 44
  45. 45. VITAMIN -B1 DEFICIENCY  BERI-BERI.  WERNICKE –KORSAKOFF SYNDROME. RISK OFTHIAMIN DEFICIENCY  Excessive loss: hemodialysis and diuretics.  Low intake and alcoholism. 45
  46. 46. THERAPEUTIC USE  CONGESTIVE HEART FAILURE.  CANCER PREVENTION.  ALZHEIMER’S DISEASE. 46
  47. 47. VITAMIN B2-RIBOFLAVIN  Also calledYELLOW RESPIRATORY ENZYME.  Cytochrome oxidase enzyme.  Rapidly absorbed from the bowel and stored in tissues. 47
  48. 48. SOURCES  Eggs.  Meat.  Leafy green vegetables.  Milk 48
  49. 49. FUNCTIONS OF RIBOFLAVIN  Energy production.  Cell respiration.  Maintenance of good vision ,skin ,nails.  Carbohydrate ,fat and protein metabolism. 49
  50. 50. RIBOFLAVIN DEFICIENCY  Itching and burning eyes.  Oily skin.  Dermatitis.  Digestive disturbances.  Cracks and sores in mouth and lips. 50
  51. 51. WHO’S AT RISK ?  Alcoholics  People with cataracts.  People with sickle-cell anemia. 51
  52. 52. VITAMIN B3 - NIACIN  Includes biologically active derivative: NICOTINAMIDE  Essential for the formation of two oxidative coenzymes ( dehydrogenases ). NAD ( Nicotinamide adenine dinucleotide ) NADP. 52
  53. 53. SOURCES  Liver  Kidney  Meat  Green vegetables  Grain cereals. 53
  54. 54. FUNCTIONS OF NIACIN  Energy production.  Improves circulation.  Maintenance of skin and tongue.  Maintenance of nervous system. 54
  55. 55. VITAMIN B3 DEFICIENCY  Pellagra – rare in Western societies.  Nervousness .  irritability  Fatigue .  Head ache.  Insomnia.  Mental depression. 55
  56. 56. VITAMIN B5-PANTOTHENIC ACID FUNCTIONS  Produces energy. SOURCES Fruits ,meats, poultry ,legumes . 56
  57. 57. VITAMIN B6-PYRIDOXINE Related to two naturally occuring substance: pyridoxine , pyridoxal , pyridoxamine. SOURCES Meat Eggs Green vegetables 57
  58. 58. FUNCTIONS OF VITAMIN B6  Production of red blood cells.  Nervous system function.  Immunity.  Reducing muscle spasm , cramps and numbness.  Maintaining proper balance of sodium and phosphorous. 58
  59. 59. DEFICIENCY OF VITAMIN B6  Nervousness , Insomnia  Skin lesions  Loss of muscle control, muscle weakness.  Arm and leg cramps. 59
  60. 60. VITAMIN B7 - BIOTIN SOURCES  Meat  Egg yolk  Soya beans 60
  61. 61. FUNCTIONS OF VITAMIN B7  Produce energy.  Helps produce body chemicals (insulin).  In gene expression. 61
  62. 62. VITAMIN-B7 DEFICIENCY  Nausea.  Anorexia.  Mental and neurological symptoms : Hallucination Depression 62
  63. 63. VITAMIN B9-FOLIC ACID SOURCES  Yeasts  leafy vegetables FUNCTION Synthesis of nucleic acids 63
  64. 64. FOLIC ACID DEFICIENCY  Neural tube defects.  Anaemia. THERAPEUTIC USE: Chronic hemolytic anaemia. 64
  65. 65. VITAMIN B12- COBALAMIN FUNCTIONS  Proper nerve function.  Production of red blood cells.  DNA reproduction.  Prevention of anaemia.  Metabolizing fats and proteins. 65
  66. 66. VITAMIN- B12 DEFICIENCY  Anemia nerve damage hypersensitive skin. 66
  67. 67. WHO’S AT RISK ?  Pernicious anemia. B12 injection often taken regularly.  HIV  Chronic fatigue syndrome. 67
  68. 68. ROLE OF PHARMACIST IN VITAMIN DEFICIENCY DISORDES 68
  69. 69.  Pharmacist by counselling patients provides safe consumption of vitamins.  Counselling on vitamin supplements is a part of their role in pharmaceutical care.  Provides responses to specific knowledge questions such as: Interaction of vitamins with drugs or the recommended dietary allowance of vitamins for infants , children , pregnant women. 69
  70. 70.  Provides consequences of vitamin consumption.  Informs the patients that: beat ways to meet nutrient needs is by consuming appropriate foods .  Vitamins supplementation is only suggested for: individuals with chronic diarrhoea. Pregnant and breast-feeding women. 70
  71. 71.  Food allergies.  Food intolerance.  Surgical removal  Too much calcium leads to kidney stones.  Excess vitamin D can damage heart. 71
  72. 72. REFERENCE TEXTBOOK OF PATHOPHYSIOLOGY - HARSH MOHAN. TEXTBOOK OF BIOCHEMISTRY - U. SATYANARAYANA. aggie-horiculture.tamu.edu 72
  73. 73. THANK YOU 73

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