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Pharm Block 4
Vitamin B1 (Thiamine)
Mechanism
Branched-chain Ketoacid Dehydrogenase
Pyruvate Dehydrogenase
Alpha-ketoglutarate Dehydrogenase
Transketolase
DEFICIENCY EFFECTS
Wernicke-Korsakoff Syndrome
Beriberi
ATP Depletion
Aerobic Tissues Like Brain and Heart Affected First
Considerations
Deficiency Can Worsen with Glucose Infusion
2 mins
Beriberi (Thiamine Deficiency)
Thiamine Deficiency
Dry Beriberi
Polyneuritis
Muscle Wasting
Wet Beriberi
Dilated Cardiomyopathy
Edema
51 secs
Wernicke-Korsakoff Syndrome
Thiamine deficiency
Confusion
Ophthalmoplegia
Ataxia
Korsakoff
Confabulation
Personality Changes
Memory loss
Alcoholics
Damage to medial dorsal nucleus
Damage to mammillary bodies
2 mins
Vitamin B12 (Cobalamin) Mechanism and Deficiency
Mechanism
Cobalamin
Large reserve pool in the liver
Homocysteine to methionine
Methylmalonyl CoA to succinyl CoA
Deficiency Signs and Symptoms
Macrocytic Megaloblastic Anemia
Hypersegmented Neutrophils
Neurologic defects
Posterior column
Lateral corticospinal tract
Spinocerebellar tract
5 mins
Vitamin B12 (Cobalamin) Deficiency Causes
Causes
Vegans
Pernicious Anemia
Gastric Bypass Surgery
Malabsorption
Sprue
Enteritis
Crohn's Disease
Diphyllobothrium latum
4 mins
Folate Deficiency
Clinical Features
Macrocytic Anemia
Megaloblastic Anemia
Etiologies
Malabsorption
Dietary
Tea and Toast
Alcoholics
Medication-induced
Methotrexate
Trimethoprim
Increased Requirement
Hemolytic Anemia
Pregnancy
2 mins
Vitamin B6 (Pyridoxine)
Pyridoxal Phosphate
Mechanism
Transamination
Decarboxylation
Glycogen Phosphorylase
Cystathionine Synthase
Functions
Heme Synthesis
Niacin Synthesis
Neurotransmitter Synthesis
2 mins
Vitamin B6 (Pyridoxine) Deficiency
Deficiency From Isoniazid
Deficiency From Oral Contraceptives
Seizures
Hyperirritability
Peripheral Neuropathy
Sideroblastic Anemia
3 mins
Vitamin B3 (Niacin)
Derived from Tryptophan
Synthesis Requires Vitamin B6
Constituent of NAD+
Deficiency Causes
Hartnup Disease
Carcinoid Syndrome
Deficiency Symptoms
Pellagra
Diarrhea
Dermatitis
Dementia
Glossitis
Excess Symptoms
Flushing
2 mins
Riboflavin (Vitamin B2)
Classification
Vitamin B2
Biochemistry
FAD
FAD Makes 1.5 ATP
Succinate to Fumarate
DEFICIENCY
Glossitis
Cheilosis
Corneal Vascularization
2 mins
Vitamin C Mechanism and Deficiency
Mechanism
Ascorbic acid
Antioxidant
Protects Against Free Radicals
Keeps Iron in Reduced State
Hydroxylation of Proline and Lysine
Necessary for Dopamine B Hydroxylase
Deficiency Signs and Symptoms
Scurvy
Swollen Gums
Bruising
Poor Wound Healing
Hemarthrosis
Perifollicular Hemorrhages
Anemia
4 mins
Vitamin K
Sources
Dark Green Leafy Vegetables
Synthesized by Intestinal Flora
Mechanism
Activated by Epoxide Reductase
Gamma Carboxylation of Glutamate
Activation of Clotting Factors II, VII, IX, X, Protein C and S
Considerations
Deficiency with Broad Spectrum Antibiotics
Neonatal Hemorrhage with Increased PT and aPTT
Warfarin is a Vitamin K Antagonist
4 mins
Vitamin A (Retinol) Function and Deficiency
Mechanism
Retinol
Constituent of Visual Pigments
Differentiation of Epithelial Cells into Specialized Tissue
Signs and Symptoms
Night Blindness
Dry Skin
Considerations
Used to Treat Measles
Antioxidant
2 mins
Vitamin A (Retinol) Toxicity
Signs and Symptoms
Alopecia
Vision Changes
Headache
Skin Changes
Hyperlipidemia
Hepatotoxicity
Arthralgias
Teratogen
Cleft palate
Cardiac Abnormalities
3 mins
Vitamin D Mechanism
25 OH in the liver
1,25 OH in the kidney
Absorbs Calcium and Phosphorus
42 secs
Vitamin D Deficiency
Signs & Symptoms
Rickets in children
Bending bones
Rachitic rosary
Breast milk has decreased vitamin D
Osteomalacia in adults
Tetany from Hypocalcemia
2 mins
Vitamin D Toxicity
Kidney Stones
Metastatic Calcification of the Kidney
Loss of Appetite
Abdominal Pain
Sarcoidosis
1 min
Vitamin E (Alpha-tocopherol)
Mechanism
Antioxidant
Indications
Fat Malabsorption Syndrome
Alpha-TTP Deficiency
Side Effects
Bleeding
Considerations
Increased Risk Hemorrhagic Stroke
Limit Doses < 200 IU per Day
Nuts and Whole Grains
Vegetable Oils
2 mins
Cyclophosphamide
Mechanism
Requires Bioactivation by Liver
Cross-links DNA
Guanine N7 Position
Indications
Autoimmune Disorders
Leukemia
Lymphoma
Solid Tumors
Side Effects
Myelosuppression
Hemorrhagic Cystitis
Prevent with Mesna
3 mins
Busulfan
Indications
CML
Bone Marrow Ablation
Mechanism
Cross-Links DNA
Side Effects
Myelosuppression
Pulmonary Fibrosis
Hyperpigmentation
55 secs
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