Sie sind auf Seite 1von 7


- Chemical elements required as an essential nutrients by organisms

Sodium Chloride a. Potassium Calcium Phosphorus Magnesium

Function 1. Maintenance 1. Regulates 1. Muscle contraction 1. Structure of bones 1. Structure of 1. Activates

of fluid osmotic 2. Intracellular and teeth bones and cellular
volume in pressure osmolarity 2. Nerve irritability teeth enzymati
vessels & 2. Constituent 3. Cardiac activity 3. Muscle contractility 2. Impt. c activity
tissues of HCI of 4. Permeability of cell
cellular 2. Inhibits
2. Muscles and gastric juice membrane
constituent muscle
nerve 5. Blood coagulation
irritability 6. Milk production (phospholipi contractio
3. Controlled by ds, nucleic n
adrenal acid &
mineralocortic nucleoprotei
oid ns)
3. Buffer subs.
for acid-
RDA: 1g or 2mEq/kg 0.5g/d 1-2g or 1.5mEq/kg 6-12mo. – 0.6g/d equal to Ca 150-300mg/d
1-9y – 0.5g/d
>10y – 0.7g/d
Deficiency 1. Muscle 1. alkalosis 1. Muscle weakness 1. Osteomalacia 1. Assoc. with 1. Assoc.
cramps 2. Abdominal 2. Osteoporosis Ca vit.D def. with Ca
2. Seizure distention 3. Tetany 2. Muscle def.
3. Irritability 4. Growth impairment weakness
4. Drowsiness
3. Anorexia
5. Tachycardia
4. Malaise
5. Growth
Excess 1. Edema 1. edema 1. S-T waves changes 1. Hypercalcemia 1. Tetany 1. None
2. Seizure associated 2. Heart block – 2. Ca deposits in from
with sodium Cardiac arrest kidneys dietary
3. Thirst and polyuria intake
4. Loss of weight,
2. Sedation
muscle weakness
and fever

1|Vitamins and miner als by KTRC and t riple med 2019

=constituent =goiter Iodism
a.IRON hormones thyroid func.
=Structure of = hypochromic Hemosiderosis =impt. in =cretinism
heme in microcytic regulation of
relation to Hb anemia cellular
= constituent of = malabsorption oxidation &
oxidative = anorexia growth
enzymes = lethargy RDA:
=inc. 34-45mcg/day
resistance to
Infant – =essential in certain Impaired Severe
1mg/kg/d enzymes involved in growth skeletal psychiatric &
Children – CHON & energy abnormalities neurologic
10-18mg/d metabolism =lowered disorder (in
b.ZINC =formation of reproductive extremely high
= constituent of
= prod. By = GI upset mucopolysaccharid func. exposure of
carbonic binding with (from cooking e =neonatal contamination
anhydrase drugs (ASA, utensils) RDA: 0.05- ataxia )
= hydrolysis ofINH) = lethargy 1.5mg/day
CHON = dwarfism
= coenzyme of = iron def. f.CHROMIUM
dehydrogenase = delayed Maintenance of Disturbed
wound healing normal glucose glucose
immunobooster = hair loss metabolism metabolism
RDA: = sexual =cofactor for insulin
3-5mg/kg/d immaturity RDA:
= diarrhea 0.02-0.10mg/day
=acrodermatitis g.SELENIUM
enteropathica As part of enzyme cardiomyopath In animals –
(triad of glutathione y blindness,
dermatitis, peroxidase which = sec. to lack of vitality
alopecia, protects cellular oxidative
diarrhea ) components from damage
c. COPPER oxidative damage
=Necessary for =develop during =excess RDA:
func. Of tx. and recovery accumulates 0.02-0.10mg/day
enzymes such from in the liver, h.MOLYBDENUM
as cytochrome kwashiorkor kidney, hair,
oxidase =anemia cornea
=concerned w/ =neutropenia
prod. Of RBC =bone changes
and Fe =found in
metabolism exclusive milk
RDA: feedings

2|Vitamins and miner als by KTRC and t riple med 2019

Essential for the Very rare Acts as  Nerve cells use lots of energy, sx.
func.flavin antagonist to  Peripheral neuropathy
dependent enzymes the essential  Depression
involved in the prod. element of Cu
Of uric acid and in =Gout-like 1. THIAMINE (Vit.B1) Def.
the oxidation of syndrome Pathology
aldehyde and =assoc. o Biohemically, there is accumulation of
sulfides w/elevated pyruvic & lactic acid in body fluids
RDA: 0.15- levels of this causing: cardiac dysfunc.
0.15mg/d trace, uric o Degeneration of myelin & of axon
acid, xanthine cylinders resulting in peripheral
oxidase neuropathy
i.FLOURIDE o In chronic def. states, vascular,
Tooth and bone Risk for dental fluorosis dilatation & brain hemorrhages – ataxia
structure caries of gait, mental disturbance, nystagmus –
=makes enamel = poor dentition WERNICKE’S ENCEPHALOPATHY
more resistance to =osteoporosis 3 forms
dental caries  Wet beri-beri: generalized edema, acute
RDA: 0.5-1mg/day cardiac s/s
or 1ppm  Dry beri-beri: no edema, peripheral
j. COBALT neuritis w/ neurological disorders
Constituent of Unknown Unknown  Infantile beriberi divided into:
cobalamin (medically) (medically) = acute cardiac – ages 2-4 mos; sudden
RDA: 1-2mcg/d or =goitrogenic onset of such as cyanosis, dyspnea,
1ppm cardiomyopath systolic murmur & pulmonary edema
y =aphonic – ages 5-7 mos; insidious
onset of hoarseness, dysphonia or
VITAMINS aphonia
- Organic compounds =pseudomeningeal – ages 8-10mos;
- Vital nutrient that an organism requires in signs of meningeal irritation w/ apathy,
limited amts. drowsiness & even unconsciousness
- Compounds needed by an organism cannot Diagnosis
synthesize in sufficient quantities and so must o Clinical s/s non-specific
be obtained thru diet o Therapeutic test w/parenteral
thiamine=dramatic improvement
The Energy-Releasing Vitamins o Blood lactic & pyruvic acid levels
elevated after oral load of
Functions glucose
1. Collagen synthesis RDA
2. Antioxidant  Infants 0.4mg
3. Aids iron absorption  Older children 0.6-1.2mg
4. Enhances the utilization of folic acid  Nursing mothers 1.5mg
Source: pork, liver, fish, beans

a. WATER-SOLUBLE (B complexes) Prevention

- Cofactors to enzyme in energy metabolism o Richest sources are pork, whole
 Typical Sx. grain, enriched cereal grains,
 Dermatitis and legumes
 Glossitis o Improved milling of rice conserve
 Cheilitis thiamine
 Diarrhea
3|Vitamins and miner als by KTRC and t riple med 2019
o Breast-fed infants: maternal diet o Hx. & manifestations of diet poor in
impt. factor niacin
Treatment o Def, urinary levels of N-methyl-
 Children 10mg p.o daily for nicotinamide low or absent
several weeks
2. RIBOFLAVIN (Vit.B2) Def.  Infant & Children <10yrs 6-10mg
Function  Older indv. 10-20mg
o Coenzyme of flavoCHON impt. in a.a, Sources meat, poultry, legumes, vegetables
f.a & CHO metabolism & cellular Prevention
respiration o Avoid too large a proportion of corn-
o Needed by retinal eye pigments for light based diet
Clinical Manifestation 4. PYRIDOXINE (Vit.B6) Def.
 Angular stomatitis & cheilosis Function
 Nasolabial seborrhea & Angular o Synthesis & catabolism of amino acids
palpebritis (tryptophan)
 Ocular s/s such as photophobia, o Synthesis of neurotransmitters,
blurred vision, itching, of the porphyrins, & niacin
eyes, lacrimation & corneal Etiology
vascularization  Direct antagonism might occur in
Diagnosis between INH & pyridoxal phosphate
o Urinary riboflavin determination Clinical Manifestation
o RBC riboflavin load test o Neuropathic
RDA o Pellagrous
 Infant & Children 10yrs 0.6- o Anemic
 Children >10yrs 1.4-2mg Diagnosis
depending on food intake  As screening test, tryptophan load test
Prevention done – 100mg/kg BW tryptophan will
o Best sources: eggs, liver, meat, give large amount of xanthurenic acid in
fish, milk, cereals, legumes, urine
green leafy vegetables RDA
Treatment o Infant 0.1-0.5mg
 Riboflavin 2-5mg p.o daily w/ inc. o Child 0.5-1.5mg
Bcomplex Sources yeast, whole wheat, corn, egg yolk,
liver, and
3. NIACIN (Vit.B3) Def. Lean meat
Etiology =Children receiving INH therapy: observed for
o Diets low in niacin &/or Neurologic s/s
tryptophan Treatment
o Amino acid imbalance or as a  Pyridoxine 100mg IM for seizures due to
result of malabsorption def.
Clinical Manifestation  Children w/pyridoxine dependency
 Pellagra should be given 2-10mg IM or 10-
Clinical triad Dermatitis (pellagrous glove, 100gm oral Vit. B6
casal’s necklace, pellagrous boot) Diarrhea,
Dementia b. The Hematopoietic Vitamins

4|Vitamins and miner als by KTRC and t riple med 2019

5. FOLIC ACID (Vit.B9) Def. Sources seafoods, egg yolk, meat fortified
Function milk
o RBC & DNA formation cell multiplication
esp. GI cells Treatment
o Prevents neural tube defects o Pernicious anemia: monthly Vit.b12
o Prevents colon cancer 1mg IM
 Impaired metabolism w/ ascorbic 7. PANTHOTHENIC ACID (Vit.B5)
acid def. drugs like trimetophrim & Function >required for coenzyme-A (CoA),
alcoholism synthesize & metabolize CHON, sugar &
 Goat’s milk; canned milk fats
Clinical Manifestation Deficiency
o Megaloblastic anemia  Extremely rare, malnourished
o Thrombocytopenic hemorrhages  S/S irritability, fatigue, numbness,
o Scurvy may be present muscle cramps
Laboratory Findings Toxicity >diarrhea, abdominal pain
 Anemia – macrocytic
 Serum folic acid ,3ng/ml 8. BIOTIN (Vit.B7)
(Normal 5-20ng/ml) Function >synthesis of fatty acids,
 RBC folate levels indicator of Isoleucine, valine
chronic def. (Normal 150- Deficiency
600ng/ml)  > related consuming raw egg whites
 Hypercellular BM aspirate over mos.
 S/S hair thinning, facial rashes
6. COBALAMINE (Vit.B12) Def. Toxicity
Function Dermatitis
o Co-factor for CHO & Lipid metabolism
o ‘impt. for folic acid metabolism 9. Ascorbic acid (Vit.C)
Etiology Etiology
 lack of secretion of intrinsic factor by o More common 6-24 mos.
stomach manifest o May develop in breastfed infant if
 Inadequate intake or dietary deficiency mothers diet deficient
 Strict vegetarian diet o Improper cooking practices produce
Clinical Manifestation significant nutrient losses & faulty
o Megaloblastic (Macrocytic) anemia dietary habits
o Neurological s/s ataxia,,paresthesias,
hyporeflexia, Babinski responses, Clinical Manifestation
clonus & coma, tongue smooth, red &  Ecchymoses or petechiae
painful  Severe def: poor wound healing,
Laboratory Findings osteoporosis, bleedin gums
 Macrocytic anemia (pernicious anemia)  Pseudoparalysis, edematous in “frog
 Serum Vit.B12 <100pg/ml position”
 Inc. serum LDH  “rosary of scorbutic beads” – sternum
 Urinary Methylmalonic acid: reliable & depression
sensitive index Diagnosis
 Schilling test: assess absorption of o Vit.C def. diet
Vit.B12 o Clinical s/s
RDA o Xray: “ground glass appearance ” of
Infant 0.5mcg/day shaft trabeculae
o “pencil-point thinness” of cortex

5|Vitamins and miner als by KTRC and t riple med 2019

Prevention metabolism & disturbance
 Daily intake of 30mg RBC wall stability
 Supplement starting 2nd week of life RDA 4-5 IU/day
 Lactating mothers: 50mg Vit.C daily
 Eating Vit.C rich foods Necessary for Bleeding Jaundice
Treatment blood clotting tendencies =hemolytic
o Ascorbic acid 200-500mg daily or 100- (II,VII,IX,X) =common in anemia
150ml of fruit juice RDA 1-2mg/day non- =nerve
institutional palsy
NB;not given
a.Vit.A injection
ds) TREATMENT (Fat-Soluble Vitamins)
Retinal pigment Eye s/s Most toxic a. Vit.A
formation & (nyctalopia, vit.  110mg retinol palmitate or 66mg
maturation of the photophobia, Overdose: retinol acetate (200,000 IU) or orally
epithelium xerophthalmi s/s  Or 55mg retinol palmitate (100,000
=devt. of bones & a, anorexia,
teeth keratomalaci slow
 2nd day 110mg retinol palmitate or
=regulation of a) growth,
membrane func. & =Bitot’s spot dryness &
66mg retinol acetate (200,000 IU)
structure cracking of orally
RDA 1800 IU/day the skin,  Another dose pior to discharge if
swelling & critical, or 2-4 weeks later
pain of the  Prophylaxis: measles <12mos
long bones, 50,000 IU O.D x 2days; <12mos.
hepato 100,000 IU O.D. x 2days
splenomeg  HyperVitaminosis A
 Excessively large single intake of
300,000IU with serum Vit.A of
200 to 1000 IU/dl (Normal:50-
Regulates Rickets Hyper
absorption of Ca =infantile calcemia 100 IU)
&P tetany  Pseudotumor cerebri
RDA 400 IU/day =craniotabes  Chronic state: anorexia, pruritus
=cranial irritability, tender swelling of
bossing bones, alopecia, seborrheic
=enlargemen dermatitis, craniotabes,
tof the hyperostosis of the long bone,
costochondr hepatomegaly, hypercalcemia
a junction
b. Vit.D
 Infantile Tetany
=harrison’s  Latent tetany – symptoms are
groove not evident but can be elicited:
=rachitic  Chvostek – stimulation of the facial
dwarfism nerve by tapping anterior to the external
c.Vit.E auditory meatus
(Tocopherol) - contraction of the orbicularis
Related to Hemolytic unknown oris muscle
reproduction anemia
muscle =growth

6|Vitamins and miner als by KTRC and t riple med 2019

 Trousseau sign – induction of
carpopedal spasm by production of
ischemia of the motor nerves
o Exposure to UV light (296-310nm)
o Oral Vit.D – 10ug (400 IU)

o Vitamin D 50-150ug daily
o 1,25-dihydrocholecalciferol 0.5-2ug
o Large single dose of 15,000uf of Vit.D
o When healed give a daily dose of
 Hypervitaminosis D
 Hypotonia, anorexia, irritability,
constipation, polydipsia, polyuria,
 Hypecalcemia, and
 Evidence of dehydration
 Aortic valvular stenosis,
vomiting, hypertension, clouding
of the cornea and conjunctiva

7|Vitamins and miner als by KTRC and t riple med 2019