milk butter liver eggs fatty fish Animal Products osteoid tissue of the bone broccoli cantaloupe sweet potatoes carrots tomatoes connective tissue diarrhea renal calculi nausea abdominal cramps rashes headache insomnia fatigue needed for dark green, orange fruits, vegetables Plant Products Phosphorus Absorption cereal Food Sources Teeth Formation margarine Other Sources Bone Formation Calcium Absorption Bone Growth Functions elgocalciferol fortified milk breakfast cereals yogurt fatty fish (salmon) butter egg yolk liver cholecalciferol carbohydrate metabolis protein & lipids synthesis readily absorbed Vitamin C aids iron absorption GI tract distributed throughout Reproduction Vision tissue repair collagen synthesis FREE RADICAL-a molecule with one or more unpaired electrons, which makes it unstable and highly reactive Immune System Functions capillary endothelium for Toxicity the body fluids excreted by the kidney, mostly unchanged Pharmacodynamics Food Sources Two (2) compounds Smoking decreases serum vitamin levels antioxidants defend against free radicals Pharmacokinetics Length of Exposure to UV Radiation Atmospheric Condition Skin Pigmentation eggs fatty fish Rickets Retarded bone growth Bone malformations (bowed legs) Enlargement of ends of long bones (knock knees) Delayed closing of the fontanel → rapid enlargement of the head Decreased serum calcium and/or phosphorus Malformed teeth; decayed teeth Protrusion of the abdomen related to relaxation of the abdominal muscles Increased secretion of parathyroid hormone Deformities of the ribs (bowed, with beads or knobs) Megadoses. Vitamin C + aspirin/sulfonamides → crystal formation in the urine Synthesis of Neurotransmitters & thyroid hormones Fe Absorption Important Note Factors Affecting Vit. D ABSORPTION Collagen formation Functions Immune System Functioning Metabolism of Amino Acids Keratomalacia→ dry eyes w/ a very dry cornea in infants and children Protection of Vita A, E, OUFAs, and Fe Vitamin C Nyctalopia→ night blindness Antioxidant Xerophthalmia→ dry eyes due to inability to produce tears adults Vitamin A Poor growth Deficiency Hyperkeratosis→ dry skin Vitamin D excessive thirst calcification of soft tissue (BV, kidneys, kidney stones irreversible kidney damage muscle and bone weakness excessive bleeding loss of appetite headache Food Sources Defective teeth and gums , lungs) Loss of smell and appetite Sx anorexia Abdominal pain lethargy peeling skin hair loss vomiting Toxicity Hypervitaminosis A Hypervitaminosis A Sx anorexia nausea vomiting irritability dehydration irritability bile kidney Portion nosebleeds pinpoint hemorrhages scurvy Deficiency poor wound & fracture healing small intestine Excreted Vitamins liver and other tissue urine Portion feces Excretion Bone Building Functions Vitamin K Blood Clotting; Fibrin Synthesis Fat-Soluble Vitamins Vit K1-PHYTONADIONE is synthesized by intestinal flora; not commercially available Vit K2-MENAQUINONE stored Vit K4- MENADIOL dairy products egg yolk liver cheese cereals fruits meats anemia phenytoin drugs that cause inadequate absorption weakness & muscle degeneration IMPORTANT NOTE!! methotrexate folic acid antagonist Folic Acid triamterene chronic alcoholism poor nutritional intake malabsorption syndromes pregnancy drugs that cause inadequate absorption folic acid antagonist Causes different tissues trimethoprim liver muscle Deficiency anorexia stomatitis fatigue nausea diarrhea alopecia blood dyscrasias Symptoms bile (75%) Four (4) forms excreted Body growth Functions DNA Synthesis Vitamin K use Vit K3-MENADIONE have been produced synthetically barbiturates fatty tissue Portion of Vitamin E is the most active form: called mephyton and aquaMEPHYTON pinpoint hemorrhages corkscrew hair Water- Soluble Vitamins feces Stored Pharmacokinetics Antioxidant Food Sources Cell membrane protection Functions blood and body tissue Synergistic effect with Vitamin C Bleeding stored excreted RBC destruction Deficiency liver blood formation Cell damage Detoxification Nerve destruction Toxicity Dark, green, leafy vegetables Neurologic/muscular symptoms physical performance vitality Energy Metabolism cell membrane Functions protection of the nerves Lipid Metabolism brain NOTE!! Vitamin K is used for two (2) reasons Wheat germ Nuts Vitamins K3 and K4 do not need bile salts for absorption Vitamins K1 and K2 are absorbed in the presence of bile salts. energy production DNA Synthesis loss of coordination reflexes fatigue impaired vision and speech Dry skin Sx jaundice anemia 1. as an antidote for oral coagulant overdose mucous membranes 80% → bile Lack of sexual activity rebound effect massive destruction of RBCs cell formation 20% → urine Loss of reproductive powers Deficiency 2. to prevent and treat hypoprothrombinemia of vitamin K deficiency capillary weakness liver Portion of Vitamin A Stored cabbage cauliflower spinach easy bruising Stored Excretion 400 to 800 mcg (0.4 to 0.8 mg) of folic acid per day can decrease the incidence of coronary artery disease (CAD) folic acid decreases the amino acid homocysteine in the blood, which may contribute to heart disease also offer some protection from colorectal cancer Patients taking phenytoin (Dilantin) to control seizures should be cautious about taking folic acid. This vitamin can lower the serum phenytoin level, which could increase the risk of seizures. loose teeth ↑ susceptibility to infections Toxicity Folic acid deficiency during the 1st trimester of pregnancy can affect the development of the CNS . This could lead to neural tube defects (NTDs) guava broccoli brussels sprouts "green" citrus fruits potatoes tomatoes cantaloupe cabbage Deficiency Osteomalacia Softening of the bones → deformities, pain, and easy fracture Decreased serum calcium and/or phosphorus, increased alkaline phosphatase Involuntary muscle twitching and spasms anencephaly→lack of brain mass formation spina bifida→defective closure of the bony structure of the spinal cord Food Sources almonds walnuts peanuts pistachios hazelnut Vitamin E Vegetable oil Grains & legumes fatigue nausea weakness GI upset headache breast tenderness Toxicity corn canola peanut rice bran palm oil soy sunflower sesame cottonseed Vitamin B12 Food Sources hormones neurotransmitters is a significant central nervous system disorder If not treated, it may cause irreversible brain damage DO NOT TAKE iron and vitamin E at the same time subcutaneous injection can be given orally To correct vitamin B12 deficiency, cyanocobalamin in crystalline form can be given intramuscularly for severe deficiency Large doses may also potentiate the effects of blood-thinning drugs, increasing the risk of hemorrhage. corn lentils wheat rice northern beans chickpeas grass oats barley grass Sx confusion nystagmus diplopia ataxia loss of recent memory beriberi/Wernicke's encephalopathy Deficiency DO NOT TAKE iron and vitamin E at the same time polyneuritis & cardiac pathology THIAMINE (Vitamin B1) NOTE!! may be given to manage dermatologic problems scaly dermatitis cracked corners of mouth inflammation of the skin and tongue RIBOFLAVIN (Vitamin B2) liver NOTE!! Messenger Substances meat poultry eggs fish milk products stored Large amounts of vitamin E are relatively nontoxic but can interfere with vitamin K action (blood clotting) by decreasing platelet aggregation Large doses may also potentiate the effects of blood-thinning drugs, increasing the risk of hemorrhage. Vitamin B Complex Four (4) vitamin B-complex members pellagra hyperlipidemia is given to alleviate NIACIN (Vitamin B3) GI irritation vasodilation large doses may cause caused by isoniazid (INH) therapy for tuberculosis alleviate the symptoms of neuritis correct vitamin B6 deficiency treat neonates with seizures refractive given to PYRIDOXINE (Vitamin B6) in the jejunum pharmacokinetics absorbed stored muscle liver brain liver metabolized urine excreted B6 deficiency cause by: lack of adequate diet inborn errors of metabolism penicillamine cyclosporine (or hydralazine) therapy drug-induced deficiencies secondary to INH
