Micronutrientes Flashcards
Defina ADECUADO
Enough in QUANTITY, or good enough in QUALITY for a particular purpose or need.
ABSENCE of any clinical signs or symptoms related to micronutrients. Status may be adequate despite a low plasma value in a patient with inflammation.
Defina DEPLETION (insuficiencia)
The reduction of something by a large amount so that there is not enough left.
Presence of an objective loss of a MN in body fluids, or intake below the standard recommendation with blood/plasma concentrations below reference range.
Clinical signs or symptoms ARE NOT PRESENT at this stage.
Defina OVERDOSE (sobredosis)
To take too much of a drug at one time, so that it is dangerous.
Detection of higher than upper reference values, associated with the administration or intake (accidental or intentional) of amounts greater than recommendations.
Generally ASYMPTOMATIC. May occur in context of repeated MN administration, particularly at risk in patients with diseases reducing elimination (LIVER AND RENAL DISEASE).
Defina DEFICIENCIA
The state of NOT having, or not having enough of, something that is essential.
PRESENCE of clinical signs and symptoms, compatible with a micronutrient deficiency.
Intake is NOT meeting losses, depending on the body stores clinical signs of deficiency generally may require any weeks to become visible.
B1 deficiency can occur in a very SHORT period.
B12 deficiency can take MONTHS or YEARS to appear.
Defina REFERENCE RANGE OR VALUES
None Oxford definition.
Set of values that includes upper and lower limits of a laboratory test based on a group of otherwise healthy people.
Ranges for normal values vary depending on patient populations and test assays used. Lab-to-lab variability can occur due to differences in testing equipment, chemical reagents used and analysis techniques.
There is no universally applicable reference value.
Defina TOXICIDAD.
The fact of being poisonous.
Presence of clinical signs or symptoms compatible with toxicity.
Toxicity diagnosis is most frequently based on blood levels.
High risk with IV administration.
Defina EAR: Estimated average requirement.
The average daily nutrient intake level estimated t meet the requirement of half the healthy individuals in a particular life stage and gender group.
Es lo mismo que AR: Average Requirement.
Is used to calculate the RDA.
Defina AI: Adequate Intake
The recommended average daily intake level is based on observed, or experimentally determined approximations or estimates of nutrient intake by a group of apparently healthy people that are assumed to be adequate. This is used when RDA CANNOT be determined.
Defina RDA: Recommended dietary allowance.
The average daily dietary nutrient intake level sufficient to meet the nutrient requirement of nearly all healthy individuals (97-98%) in a particular life stage and gender group.
Es lo mismo que PRI: Population Reference intake.
Applies to the general population.
Defina UL: Tolerable Upper Intake Levels
Daily MN doses that you can safely take without risk of an overdose or serious side effects.
The highest average daily nutrient intake level likely to pose no risk of adverse health effects to almost all individuals in the general population.
Integrated in DRI. The potential risk of adverse effects increases with intakes > UL.
Defina COMPLEMENT
The act of adding to something in a way that improves it or makes ir more attractive/complete. This is used to indicate the delivery of micronutrients to cover basal needs in case of progressive or insufficient EN.
Defina DRI: Dietary reference intake.
Set of reference values including: EAR, AI, RDA, UL, that, when adhered to, predict a low probability of nutrient inadequacy or excessive intake.
They are intended for the general population and will be used to indicate proportions of MNI´s used particularly in EN.
Define SUPPLEMENTATION.
The act of adding something to something else to improve or complete it.
Term used when the aim is to deliver HIGHER THAN STANDARD DOSES (higher that the basal requirement in an attempt to correct depletion or deficiency).
This term is often applied without differentiation of amount whenever a MN is prescribed, which leads to CONFUSION.
Defina REPLETION
The act to make something full again by replacing what has been used.
Doses aiming to restore a normal status and where the deficit is known.
This term is used when deficiency or losses are identified or presumed: the administration aims at restoring a normal status.
Defina PHARMACOLOGICAL DOSE
Connected with the scientific study mofa drugs and their use in medicine.
Treatment with a specific micronutrient to improve host defenses or any other biological endpoint associated with good clinical evolution and improve the outcome of critically ill patients.
Generally only one micronutrient is prescribed.
¿Qué son los MACROnutrientes?
-Nutrientes que suministran la mayor parte de la energÍa del organismo.
-Ejemplos: Proteinas, carbohidratos y grasas.
-Son VISIBLES la vista.
-Se consumen en GRAMOS.
Se trata de compuestos orgánicos. Son necesarias en pequeñas cantidades para procesos metabólicos. No se producen en forma endógena en cantidades adecuadas ó requieren de un precursor.
Vitaminas
¿Qué son los MICROnutrientes?
Se consumen en miligramos ó microgramos, son necesarios para no alterar el balance metabólico del organismo.
•Incluyen vitaminas, substancias parecidas a las vitaminas, minerales, fibra y subclases de micronutrientes esenciales para sobrevivir.
Características de TIAMINA (B1):
-Funciona como cofactor en la descarboxilación de cetoácidos.
-Tiene un rol en la VÍA DE LA PENTOSA FOSFATO.
-Genera energía de los macronutrientes ingeridos.
-RDA: 0.5 mg por 1000 kcal o 1 mg/día.
-Se encuentra en puerco, granos y semillas enteras.
-Deficiencia ocurre en alcohólicos y se manifiesta como SD DE WERNICKE-KORSAKOFF.
Otros pacientes en riesgo:
1.- desnutrición severa.
2.- Us crónico de diuréticos.
3.- cx bariátrica.
-Deficiencia por ingesta menor de 0.12 mg por cada 1000 kcal en adultos se manifiesta como BERIBERI.
1.-Húmedo: neuropatía sensitiva y motora y periféica + cardiopatía——– NIÑOS.
2.-Seca: neuropatía sensitiva y motora simétrica—– ADULTOS.
COSAS DE LA TABLA DIABOLICA:
-Mild deficiency—————– 10 mg/día por una semana y luego 3-5 mg/día por seis semanas.
-Chronic diuretic therapy— 50 mg/día VO.
-At risk for deficiency——— 100 mg, 3 veces al día, IV.
-High suspicion or proven deficiency—– 200 mg 3 veces al día, IV.
-Encephalopathy of uncertain etiology (including Wernicke encephalopathy)————- 500 mg 3 veces al día, IV.
Características de RIBOFLAVINA (B2)
Es requerida para las funciones de Piridoxina (B6) y Niacina (B3).
•Deficiencia ocurre en enfermedades gastrointestinales, desnutrición proteína-calórica, excreción aumentada por uso de antibióticos e infecciones sistémicas.
•Se manifiesta con lesiones de la piel y membranas mucosas particularmente estomatitis y glositis.
-RDA 0.6 mg por 1000 Kcal. (1.2 mg/día)
-No es tóxica a dosis altas.
-Se encuentra en carne, lácteos y granos fortificados.
-Características de la NIACINA (B3)
-¿Cómo se manifiesta la deficiencia de niacina?
-Su función es en la glicólisis, respiración celular y metabolismo de los ácidos grasos. Puede ser sintetizada del aminoácido
triptófano, aumentada por la acción de los
estrógenos. RDA es 16 mg para adultos hombres y 14 mg para mujeres.
-Pelagra 4 D´s (dermatitis, diarrea, demencia y death).
Características de ÁCIDO PANTOTÉNICO (B5):
•Vital para el metabolismo y liberación de energía de los carbohidratos, proteínas y grasas.
• Juega un papel en la síntesis de acetilcolina, biosíntesis de esteroides y producción de protoporfirina
-DEFICIENCIA: Solo en deficiencias experimentales. En prisioneros de guerra se presentaron parestesias que respondieron a la administración de acido pantoténico.
-RDA 5 mg/día
-Dosis altas son seguras pero pueden producir diarrea.
• Se encuentra en pescado, aves, vísceras, huevos, tomate, brócoli y granos enteros.
