VITAMINS, MINERALS, AND GENERAL NUTRITION CHAPTER

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“YOU ARE WHAT YOU EAT”

FOOD & NUTRITION BOARD OF THE NATIONAL ACADEMY OF SCIENCE

FOLIC ACID IN PREGNANCYo extremely important supplement for women!o Reduces the incidence of neural tube birth defects such

as … * Spina Bifida * anenchephaly * encephaloceleo … essential for DNA formationo Women of childbearing age should consume 0.4-mg/day

of Folic acido Also known as ‘Folate’

MINERALSo non-organic material, found in the eartho required in small amounts

o *****See “lab values” in handout in Doc Sharing*****o help biochemical reactions, help nerve conduction, help

cardiac rhythm and some are incorporated into the body o Iron: component of hemoglobin & myoglobin

ostored bound to ferritinodeficiency leads to anemia especially in pregnant women

o Calcium: deficiency leads to osteoporosiso Phosphorous: important in boneo Potassium: important in cardiac rhythm

CHAPTER - 26

Drugs affecting the Gastrointestinal Tract and Digestive System

GI TRACT – A DEFINITION Long, hollow tube from the mouth to the anus primary purpose - to convert food into chemicals that can be

used by the body Food’s pathway through GI tract … … Mouth Esophagus Stomach Small Intestines

[gallbladder, liver, pancreas enzymes]Large Intestine Anus

Diseases and conditions:UlcersGastroesophageal Reflux Disease (GERD)ObesityVomitingDiarrhea

GASTRIC CONDITIONS/ENVIRONMENT

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Acidic environment is needed in the stomach for enzymes to digest food and inhibit or kill microorganisms found in food and other materials that are ingested

Sometimes acid level is toohigh or stomach protection is lost: this can erode the stomach wall/lining

Worry and Stress increase secretions in the stomach This can lead to ulcers

Gastric ulcer = Peptic ulcer = stomach ulcer ‘Duodenal ulcer’ is found at the junction of stomach and duodenum

ULCERS – GENERAL INFO

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Goal of treatment: to alleviate symptoms, promote healing prevent complications, and prevent recurrence.A bacteria called Helicobacter pylori has been found in

>75% of peptic ulcer disease! Drugs (ASA and NSAID’s) can cause ulcers too

MEDICATIONS TO TREAT ULCER All these work together to eradicate the microorganism

Helicobacter pylori and reestablish an intact lining of the stomach by neutralizing excess hydrochloric acid. Antisecretory Agents (decrease secretion of acid into stomach)

H2 receptor antagonists Proton pump inhibitors

Antacids (neutralize acid that is currently present) Mucosal protectants (forms a protective barrier on the surface of

ulcerated tissue) Antibiotics

H2-RECEPTOR ANTAGONISTS Histamine receptors in stomach lining activate the “proton

pump” that pumps gastric acid into stomach These drugs inhibits the interaction of histamine with the H2-

receptors in stomach so they inhibit acid secretions Very effective for GERD Available as OTC and RX Examples: cimetidine (Tagamet), nizatidine (Axid), ranitidine

(Zantac) Tagamet can cause drug interactions by reducing metabolism

of other drugs

PROTON PUMP INHIBITORS (PPIS) Inhibits the “proton pump” directly For SHORT TERM treatment of gastric ulcers and GERD Side effects are relatively rare (headache, abdominal pain,

diarrhea, nausea, constipation are possible) Examples:

esomeprazole (Nexium) lansoprazole (Prevacid) omeprazole (Prilosec) pantoprazole (Protonix)

* NOTE – see how the generic drug names within the same class tend to end with the same suffix? This is very helpful in learning drugs!

ANTACIDS Alkaline (basic) compounds used to neutralize HCl acid in the stomach Relieves symptoms of Gastroesophageal Reflux Disease (GERD) Poorly absorbed (this is good!), therefore they do not alter systemic pH

when used properly Can be dosed up to 7 times per day since they have a short duration of

action Classified by formulation (aluminum, magnesium, etc) Aluminum (side-effect = Constipation) Calcium (side-effect = Constipation) Magnesium (side-effect = Diarrhea) Aluminum & Magnesium combo is common because these cancel out each

other’s negative side-effects … very effective! careful when taking other medications, these can interfere with absorption

of other drugs Examples of Antacids …

Mylanta, Maalox Tums, Rolaids

ANTIBIOTICS for ulcers Commonly used to treat Helicobacter pylori Treatment with two antibiotics decreases resistance Used in combo with bismuth-salts to prevent bacteria from

attaching stomach wall. Antibiotics that are commonly used …

Amoxicillin Tetracycline Metronidazole (Flagyl) Clarithromycin (Biaxin)

antisecretory agents often used in combo (PrevPak)

DRUGS THAT CAUSE WEIGHT GAIN OR WEIGHT LOSS

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megestrol is an appetitite stimulant

orlistat (Xenical) blocks the absorption of fat in the GI tract

ANTI-EMETICS Emesis (vomiting) caused by many factors

dimenhydrinate, meclizine are OTCGood for motion sickness

prochlorperazine (Compazine) or trimethobenzamide (Tigan)Post-operatively

Granisetron (Kytril), ondansetron (Zofran)chemotherapy

ANTI-DIARRHEALS Need to slow down the GI tract

Lomotil Loperamide (Imodium)