Week 2 Flashcards
What drugs do to the body
Pharmacodynamics
What the body does to drugs
Pharmacokinetics
30% of elderly population use more than 5 prescription medications, this is called
Polypharmacy
Most drugs are physiological poisons, which impair normal functions and are adverse to health. This is called
Toximolecular
Drug absorption depends on
Physical form
Particle size
pH of GI that
Solubility in fats
Nutrient absorption depends on
Ease of digestibility by enzymes
GI secretions
Drugs effect nutrients by altering (4)
Food intake
Nutrient absorption
Nutrient metabolism
Nutrient excretion
Specific drug-nutrient interactions
…there are many of them…
An organic compound obtained via the diet, needed to maintain cellular metabolic integrity
Vitamin
A non-protein organic compound that is required for function of specific enzymes
Coenzyme
Most important B vitamin for pregnant women
Folate
Food sources of folate
Leafy green vegetables
Fruits
Beans
Peas
Deficiencies in vitamin b12 or folate may result in
Megaloblastic, macrocytic anemia
Adequate folate before and immediately during pregnancy protects against
Neural tube defects
The Neural tube is the embryo’s precursor to the
Central nervous system (brain + spinal cord)
High ____ levels are associated with higher risk of coronary heart disease, stroke, peripheral vascular disease
Homocysteine
3 vitamins regulate Homocysteine in the body
Folic acid
Vitamin b6
Vitamin b12
Vitamin involved in AA/protein metabolism
Vitamin b6
Three forms of vit b6
Pyridoxine
Pyridoxal
Pyridoxamine
Food sources of vit b6
Liver Legumes Whole grains Lentils Nuts Avocados Bananas Potatoes
Vitamin that requires intrinsic factor (IF) for absorption
Vitamin b12, cobalamin
IF is secreted in the stomach, so anyone who has had a gastrictomy is vulnerable to vit b12 deficiency
Vitamin b12 is also called
Cobalamin
Vitamin b12 food sources
Meat Meat products Poultry Fish Shellfish Eggs
Deficiency of this vitamin causes pellagra
Niacin or vitamin b3
vitamin b3 is also called
Niacin
Food sources of vitamin b3
Cereals Legumes Oilseeds Meat Chicken Fish Diary products Beverages: coffee and tea
Pellagra (3 Ds)
Dermatitis
Diarrhea
Dementia
What is the yellow b vitamin?
Vit b2 or riboflavin
Vitamin b2 is also called
riboflavin
riboflavin food sources
Meat Fish Poultry Dairy Eggs Legumes Green leafy vegetables Fruits Grains
riboflavin b2 deficiency
Impaired growth Dermatitis Soreness or burning of lips Glossitis Weakness Decreased visual function Anemia Neuropathy Burning/itching eyes
Deficiency of this b vitamin causes beriberi
Thiamin or vit b1
vit b1 is also called
Thiamin
Vit b1 or Thiamin food sources
Cereal
Nuts
Meat
Legumes
Beriberi
Mental confusion Anorexia Muscular weakness Edema Muscle wasting Tachycardia Enlarged heart
Means “I can’t, I can’t” in Singhalese
Raw eggs affect absorption of this b vitamin
Biotin or vit b7
Food sources of biotin, vit b7
Yeast Liver Organ meats Soybeans Rice bran Peanut and almond butter Egg yolk Cauliflower
Deficiency of vit b7, biotin has been observed in consumers of raw eggs because raw eggs contain avidin, avidin is a protein that binds biotin. Cooking eggs denatures avidin.
Sx of deficiency:
Dermatitis Increased skins dryness Mental depression Muscle pain Nausea Anorexia Hypercholesterolemia
Pathothenic acid is also
Vit b5
Sources of pathothenic acid, vit b5
Liver Egg yolk Broccoli Yeast Fish Shellfish Chicken Milk Yogurt Legumes Mushrooms Avocados Sweet potatoes Whole grains
pathothenic acid, vit b5 is lost with
Freezing, canning foods and the processing and refining of grains
pathothenic acid, vit b5 deficiency
Is rare
Deficiency of this vit causes scurvy
Vit c
What do these vitamins have in common?
Thiamin, b1 Riboflavin, b2 Niacin, b3 Pathothenic acid, b5 Vit b6, pyridoxine etc Biotin, b7 Folate, b9 Cobalamin, b12 Ascorbic acid, vit c
Water soluble vitamins
What do these vitamins hav in common?
Vit a
Vit d
Vit e
Vit k
Fat soluble vitamins
Deficiency in this vitamin leads to blindness
Vitamin a
Vitamin a forms include:
Retinoids
Carotenoids
Deficiency in vit A can cause
Night blindness because there is a delay in the regeneration of rhodopsin (because there isn’t enough retinal to join opsin)
This is a reversible symptom of vit A def
Adverse effects of vitamin A supplementation
Cancer? in smokers
Hepatotoxicity? in alcoholics
Osteoporosis? in animal models at least
Birth defects
Vitamin d2 is also called
Ergocalciferol
Vit d3 is called
Cholecalciferol
25(OH) vit d3; 25-hydroxyl-vitamin d3; 25-hydroxycholecalciferol is called
Calcidiol
1,25(OH)2 vit d3: 1,25-I’d hydro you-vit d3 is called
Calcitriol
Vitamin d food sources
Eggs Liver Butter Fatty fish Milk Margarine
From the sun, vit D is formed in this way:
7-dehydrocholesterol is exposed to UV light, becomes pre-vitamin D3.
Pre-vit d3 is converted to vit d3
Vit d3 diffuses from skin into blood where it binds to vit d binding protein
Active form of vit d
1,25(OH)2 vit d3
The active form of vit d (1,25(OH)2 vitamin D3) functions to maintain normal __ levels in the blood
Calcium
When Ca levels fall in the kidney, vitamin D3
stimulates reabsorption of Ca
When Ca levels fall in the intestine vitamin D3
stimulates absorption of Ca
When Ca levels fall in the bone, vitamin D3
stimulates the release of Ca into blood along with PTH (parathyroid hormone)
When Ca levels rise in the bone, vit d3
Stimulates deposition of Ca with aid of calcitonin
When Ca levels fall, PTH is produced and release by
Parathyroid gland
Kidney:
1. PTH stimulates synthesis of more 1,25(OH)2 vitamin D3
2. PTH stimulates reabsorption of Ca
Bone:
PTH stimulates release of Ca into blood with 1,25(OH)2 vitamin D3
Vitamin D deficiency (3)
Rickets (bowed bone)
Osteomalacia (soft bone)
Osteoporosis (porous bone)
How to assess vitamin D status
Measure 25(OH)vitamin d3 in the blood
Adverse effects of vit D:
Hypercalcemia?
Heart issues?
Kidney stones?
What vitamin is a free radical scavenger
Vitamin E
What form of vitamin E has the most activity
Tocopherols (alpha, beta, gamma, delta)
Vitamin E works with what other vitamin
Vit C
Antioxidant capacity of vit E can be restored/recycled by vit C
Increased polyunsaturated fatty acid [increases/decreases] need for vitamin E
Increases
Vit E deficiency is rare. Sx:
RBC rupture leading to anemia
Toxicity of vitamin E
Large doses can inhibit blood clotting by interfering with the action of vitamin K
Synthetic forms of vitamin E are labed
“dl”
Natural forms are labeled “d” e.g. d-alpha tocopherol
What vitamin is involved in coagulation?
Vitamin k
50% of vit k is derived from what organ?
colon
Functions of vitamin k
Blood clotting (prothrombin and fibrin) Bone mineralization
Tx for vitamin K toxicity is the administration of
Dicumarol or Warfarin, anticoagulants
