Lecture Vitamins, Minerals, Obesity

Question 1

water soluble vitamins

Answer 1

Vit C, B-complex

Question 2

Vit C

Answer 2

Synthesis of collagen & adrenal steroids, antioxidant, iron absorption

Deficiency - scurvy

Toxic - nausea, abdominal cramps, diarrhea

Question 3

B-complex vitamins

Answer 3

Niacin (Nicotinic Acid)
Deficiency pellagra, GI upset, CNS

Riboflavin (Vitamin B2)
enzymatic reactions, migraine HA prevention

Thiamin (Vitamin B1)
carbohydrate metabolism (increased need in pregnancy & lactation)
Deficiency Beriberi, Wernicke-Korsakoff syndrome (due to alcoholism)

Pyridoxine (Vitamin B6)
metabolism of amino acids & protein
Deficiency seborrheic dermatitis, microcytic anemia, peripheral neuritis, convulsions, depression, confusion

Cyanocobalamin (Vitamin B12) & Folic Acid
synthesis of DNA
Deficiency megaloblastic anemia, neurologic damage

Pantothenic Acid
Component of coenzyme A & acyl carrier protein

Biotin
metabolism of carbohydrates and fat

Question 4

Fat Soluble vitamins

Answer 4

K, A, D, E

Stored in liver and fatty tissues - Can have too much of these (not excreted out)

Question 5

Vit K

Answer 5

Synthesis of prothrombin & clotting factors

Deficiency - bleeding

Toxic - teratogenesis, liver injury, bone-disorders

Question 6

Vit A (Retinol)

Answer 6

multiple functions in the eye

Deficiency

1. night blindness,
2. xeropthalmia (dryness of eye)
3. keratomalacia (cornea gets cloudy and soft)
4. blindness

Toxic - teratogenesis, liver injury, bone-disorders

Question 7

Vit D

Answer 7

Bone health

Deficiency - rickets, osteomalacia (softening of bones)

Question 8

Vit E (Alpha-Tocopherol)

Answer 8

Antioxidant

Deficiency (rare) – neurologic defects

Toxic - bleeding, risk of hemorrhagic stroke

Question 9

What is the most common nutritional deficiency in the world?

Answer 9

iron -> iron deficiency anemia!!

Question 10

orlistat [Alli, Xenical]

Answer 10

Mechanism of Action

1. Acts in GI tract to reduce absorption of fat
2. Decreased fat absorption lowers calories and promotes weight loss.

Adverse Effects:
oily rectal leakage, flatulence (with discharge), fecal urgency, fatty/oily stool, increased defecation, fecal incontinence
Possible liver damage, acute pancreatitis, kidney stones,
May decrease absorption of fat soluble vitamins - So need to take a multivitamin, Take it 2 hours apart

Drug interactions
Vitamin K levels may decrease in patients taking orlistat, which can affect anticoagulation produced by warfarin.
Levothyroxine - take 4 hours apart

Nursing 101

1. Administer drug during or up to 1 hour after a meal containing fat
2. Omit dose if eating a meal that does not contain fat or if a meal is skipped
3. Monitor weight and BMI
4. Monitor prothrombin time and INR if taking warfarin

Teaching

1. Take a daily multivitamin at least 2 hours before or after orlistat
2. Psyllium may help with GI effects
3. Avoid high-fat meals
4. Monitor weight several times weekly