Vitamin

• A vitamin is an organic compound required

as a nutrient in tiny amounts by an organism.
• The term 'vitamin' first became popular in
the early 1800's as a contraction of the words
'vital' and 'mineral', though the actual meaning
of the word has developed somewhat since
that time.
• A compound is called a vitamin when it
cannot be synthesized in sufficient quantities
by an organism, and must be obtained from
the diet. Thus, the term is conditional both on
the circumstances and the particular organism.
Vitaminoides are biochemical factors whithout enzymece
functions, included in the past in vitamins.

vit B4 - cholin
vit B8 - inozitol
vit B13 - orotic acid
vit B15 - calcium pangamat
vit N – thiocthic acid
vit U - methilmetioninsulfoniu
vit H1 - paraaminobenzoic acid
 Clasification the vitamines according to
solubility

water-soluble fat soluble.

• B1 (thiamine) A (rethinol)
• B2 (riboflavin) D (ergocalciferol)
• B3 (PP, nicotinic acid) E (tocoferol)
• B5 (pantothenic acid) K (menadion)
• B6 (pyridoxine)
• B12 (ciancobalamin)
• Bc (folic acid)
• H (biotin)
• P (cverserutin, rutozid)
• C (ascorbic acid)
 VITAMINS CLASSIFICATION
(according to the prophilactic and treatment effects)
1. Vitamins with influence on body reactivity – states of the SNC,
metabolism and tissu trophic:
B1, B2, PP, B6, B12, B15, A, C.
2. Vitamins which protect the moucosa and skin, contributs to his
regeneration, amplifyes the protective properties:
B2, B3, PP, B6, A, E, biotin (H).
3. Vitamins with antitoxic and antiinfection effects – stimulating the
synthessis of the antibody, decrease hypoxia.
group B, A, C.
3. Vitamins with influence on hematopoesis and blood coagulability:
B6, B12, Bc, C, P, K, A, PP.
3. Vitamins that regulate vision:
A, C, E, B2.
6. Vitamins with influence the bones tisu metabolism and storage Ca
in bones:
C, D, E, B1, B5.
 Principles of uzing vitamins drugs
With propfilactic aim
• in alimentary defficiency;
• excesiv use;
• sindrom malabsorbtion.

With specific tratament aim

- in vitamin defficiency determined throuth: clinical
examenation, alimentary anamnesis, biochemical analyses
of the blood, urine, tisu.
 CAUSES HIPO - and AVITAMINOZES

Causes

I. Decreese intake of the - Reduced level of population's life (A, B1);

vitamin - New-born and children under 1 y with artificial food (C, B6,
B12, , folic ac.);
- children with deficit or surplus of the protein, diet with
predominate of carbohydrates;
- diets, nausea, vomiting and pain due to eating.
II. Increase necessity of - pregnancy and lactation period;
the vitamins (relative - colitis, spru;
insufficiency) - fever long time;
- pathology with increasing the cathabolism of proteins;
- cancer.
III. Lack synthesis the - disbacteriozis, (antibiotherapy);
vitamins endogenous - premature new-born (insufficiency synthesis Vit.K);
- superinfection (B12).
Vitamin A

Vitamin B1, B2, B3, B5, B6, B7, B9, B12

Vitamin D
Vitamin E
Vitamin K
Strucura şi functia
 IV. Disturbances of vitamines
pharmacokinetics
Decreases absorbtion:
- gastrectomy (B12);
- Removal of gut, pathology of pancreas, bile duct, that manifest with
steatorhoee şi and diminish absorbtion of fat- soluble vitamines A,
E, D, K;
- enteropathy, chronic diarrhoe with insufficiency preponderently a
water- soluble vitamines (B, C);
- Treatment with drugs that disturb absorbtion of vitamines ( ex:
vazeline oil (A, D), contraceptives, anticonvulsants (folat);
B. Distribution disregulation :
- Disturbances of vitamines transport or în case hypoproteinemie (A)
in liver disease;
 C. Disturbances or metabolism insuficiency

- genetic phactors– enzimopathy (Vit B12- megaloblastic

anemia in children);
- insuficiency enzyme systeme ce transformă vitaminele în
metaboliţi activi in premature new-born. B12, K, E, D, C,
Bc în ficat;
- insuficiency enzyme systeme in hard kidney failure,
chyrozis biliară primară (Vit.D), alcoholic chirozis (B);
- Deficiincy of proteines synthezis in liver (K);
- Interactions with some drugs that disturb the vitamines
metabolism (contraceptive - B6;
- metotrexat, alcohol, trimetoprim –folats;
anticonvulsivantele – a Vit.D).
 D. Increase eliminnation of vitamines

• - în diabetus (water-soluble vitamine);

• In insuficiency entering of vitamines body
use reserve.
• After their emaciation can be biochimical
and functional disturbances.
• After that can develop morfological
disturbances with clinical manifestations.
 Vitamins
 Vitamins are classified as either water-soluble or
fat soluble.
 In humans there are 13 vitamins: 4 fat-soluble
(A, D, E and K) and 9 water-soluble (8 B
vitamins and vitamin C).
 Water-soluble vitamins dissolve easily in water,
and in general, are readily excreted from the
body, to the degree that urinary output is a
strong predictor of vitamin consumption.
 Because they are not readily stored, consistent
daily intake is important.
 Many types of water-soluble vitamins are
synthesized by bacteria.
 Vitamins
 Fat-soluble vitamins are absorbed through
the intestinal tract with the help of lipids
(fats).
 Because they are more likely to
accumulate in the body, they are more
likely to lead to hypervitaminosis than are
water-soluble vitamins.
 Fat-soluble vitamin regulation is of
particular significance in cystic fibrosis.
 Fat Soluble Vitamins (A.D.E.K)
 Absorbed with fats in intestinal tract.
 Small amounts of vitamins A, D, E and K are
needed to maintain good health.
 Foods that contain these vitamins will not lose
them when cooked.
 The body does not need these every day and
stores them in the liver when not used.
 Most people do not need vitamin supplements.
 Mega-doses of vitamins A, D, E or K can be
toxic and lead to health problems.
 Vitamin A “Retinol”
Properties Sources
 Also called retinol
 Maintenance of healthy  Butter 815mcg/100g
skin, hair, eyes, etc.  Margarine
 Increases infection 780mcg/100g
resistance  Yolk 535mcg/100g
 Essential for night  Milk 52mcg/100g
vision  Liver 30mcg/100g
 Promotes bones and
 Fish 45mcg/100g
tooth development.
 Vitamin A Deficiency
 Low resistance to infection.
 Diarrhea.
 Intestinal infections.
 Psoriasis.
 inflammation of eyes.
 keratinization of skin and eyes.
 Night blindness.
 Properties
Vitamin D
Sources
Needed for calcium and
phosphorous absorption.  Fish (code) liver oils
 Play a role in inhibition 210mcg/100g
of calcitonin release  Sardines, salmon,
from the thyroid gland. tuna 8-11mcg/100g
 Play role in  Egg 1.75mcg/100g
pathogenesis and
prevention of diabetes
mellitus.
 Vitamin D Deficiency
 Rickets
 Bone softening
 Bad teeth
 Type 1 DM
 Vitamin E
Properties
Sources
 Formation of muscle, and
other tissues  Whole grain cereals
 Prevents abnormal  Vegetable oils
breakdown of fat.  Nuts
 Protects vitamins A and  Leafy vegetables
C and fatty acids  Avocado
 Prevents damage to cell
membranes.
 Antioxidant.
 Vitamin E Deficiency
 Poor circulation
 Loss of body and sexual vigor
 Muscle/heart problems
 Nose bleeds
 Skin infections
 Intermittent Claudication.
 Possible anemia in low birth-weight
infants.
 Vitamin K
Properties Sources

 Part of clotting  Broccoli

process  Cabbage
 Yogurt
 Yolk
 Soya bean
 Code liver oil
 Vitamin K Deficiency
 Rare, generalized bleeding.
 Excessive bleeding.
 Water Soluble Vitamins
 Absorbed in intestinal tract.
 Not as readily stored as fat soluble
vitamins.
 The water-soluble vitamins, excluding
vitamin C, popularly are termed the B-
complex vitamins.
 There are eight of them, namely; B1
(thiamine),B2 (riboflavin), B6 (pyridoxine),
niacin (nicotinic acid), B12, folic acid,
pantothenic acid, and biotin.
 Thiamine (B1)
Properties
Sources

 Oxidation of  Yeast 4.25mg/100g

carbohydrates  Peas 0.89mg/100g
 Glucose production.  Orang 0.70mg/100g
 Depression reduction.  Corn 0.65mg/100g
 Yolk 0.30mg/100g
 Thiamine (B1) Deficiency
 Loss of energy  Beriberi:
 Depression  Disease from lack of
 Poor appetite thiamine
 Bell parleys.  Stiffness/Weakness
 Pain
 Muscle Damage
 Death
 Most common today in
addicts.
 Riboflavin (B2)
Properties Sources

 Needed for energy  Yeast

metabolism in cells  Liver sheep
 Fat synthesis  Cheddar cheese
 Benefit in anemia.  Egg
 Beef meat
 Yogurt
 Chicken (legs)
 Milk
 Riboflavin (B2) Deficiency
•  Tissue damage.
•  Eye strain.
•  Fatigue.
•  Itching.
•  Sensitivity to light.
 VITAMIN B3 (PP)
Properties
Sources
 Involved in energy
reactions in cells  Poultry. 12.8mg/100g
 Increase HDL  Meat.
 Reduce the request  Whole wheat and
of narcotics. enriched grains.
 Egg 3.8mg/100g
 Niacin (B3) Deficiency
 Pellagra
 Lack of concentration
 Aggression
/ poor memory
 Light sensitivity
 Headaches
 Dermatitis
 Insomnia
 Skin lesions
 Backache
 Dementia
 Vitamin ciancobalamine (B12)
Sources
 Genetic molecule
synthesis.  Liver 81mcg/100g
 Nervous system  Beef meat 2mcg/100g
function.  Fish 1mcg/100g
 Benefit for mood.
 Benefit for diabetics.
 Vitamin B12 Deficiency
 Anemia / fatigue
 Bowel disorders
 Poor appetite
 Poor growth
 Vitamin ascorbic acid (C)
Sources
 Normal development
of bones, teeth, gums,  Guava 230mg/100g
 Black berry 200mg/100g
and cartilage
 Green Pepper
 Antioxidant (protects 120mg/100g
vit. A & E)  Broccoli 87mg/100g
 Immune response  Papaya 60mg/100g
(antihistamine)  Strawberry 77mg/100g
 Kiwi 59mg/100g
 Orange 54mg/100g
Vitamin C Deficiency
 Scurvy
 Bleeding gums
 Bruising
 Low infection
resistance
 Osteoporosis
• Osteoporosis is defined as a generalized
decrease in bone mass (osteomalacia) that
affects bone matrix and mineral content equally,
giving rise to fractures of vertebral bodies with
bone pain, kyphosis and shortening of the torso.
• Fractures of the hip and the distal radius are
also common. The underlying process is a
disequilibrium between bone formation by
osteoblasts and bone resorption by osteoclasts.
 Classification:
• Idiopathic osteoporosis type I, occurring in
postmenopausal females; type II, occurring in
senescent males and females (>70 y).
• Secondary osteoporosis: associated with
primary disorders such as Cushing’s disease, or
induced by drugs, e.g., chronic therapy with
glucocorticoids or heparin. In these forms, the
cause can be eliminated.
• Postmenopausal osteoporosis
 Treatment of osteoporoses
• I. Hormons and its analogues
1. sexual hormons – oestrogens, androgens;
2. calcitonines (human, pork, fish)
• II. Vitaminei D3 active metabolites -
alfacalcidiol, calcitriol, calcifediol
• III. Animal horigin drugs - oseina
• IV. Syntetics drugs -
1. Bisphosphonates - clodronat, atidronat,
alendronat, pamidronat, risedronat
2. Fluorides - fluorura de sodiu,
monofluorfosfat
3. Calcium saults - Calcium citrate,
calcium carbonate
4. Steroidal anabolics -
- Nandrolone fenylpropionate
- Nandrolone decanoate.
 Mechanism of action
• 1. Remedies inhibiting resorption of bones
tissue:
estrogens, calcitonin, bisphosphonates
• 2. Drugs that contributes to the synthesis
and mineralization of bones:
fluorides, steroidal anabolics
• 3. both mechanism of action:
oseina-hydroxiapatite, calcium drugs, vit.
D3.
• Risk factors are: premature menopause,
physical inactivity, cigarette smoking,
alcohol abuse, low body weight, and
calcium-poor diet.
 Therapy.
• Formation of new bone matrix is induced by fluoride.
• Administered as sodium fluoride, it stimulates osteoblasts.
• Fluoride is substituted for hydroxyl residues in hydroxyapatite
to form fluorapatite, the latter being more resistant to resorption
by osteoclasts.
• o safeguard adequate mineralization of new bone, calcium
must be supplied in sufficient amounts.
• However, simultaneous administration would result in
precipitation of non- absorbable calcium fluoride in the
intestines.
• With sodium monofluorophosphate this problem is
circumvented. The new bone formed may have increased
resistance to compressive, but not torsional, strain and
paradoxically bone fragility may increase.
• Because the conditions under which bone fragility is decreased
remain unclear, fluoride therapy is not in routine use.
 Calcitonin
• inhibits osteoclast activity, hence bone
resorption.
• As a peptide it needs to be given by
injection (or, alternatively, as a nasal
spray).
• Foreign is more potent than human
calcitonin because of its slower
elimination.
 Indications:

- boala Paget;
- osteoporosis postmenopauzal;
- osteoporosis in old people;
- osteoporosis dupăafter corticosteroids;
- osteoporosis with pain;
- situations de hipocalciemie (hiperparatiroidism,
hipercalciemia în carcinomul mamar, pulmonar,
rinichi, mielom);
- acută pancreatitis (adjuvant);
- osteoporoza posttraumatics, afecţiuni neurotrofe
provocate by drugs);
 Bisphosphonates
• structurally mimic endogenous pyrophosphate, which
inhibits precipitation and dissolution of bone minerals.
• They retard bone resorption by osteoclasts and, in part,
also decrease bone mineralization.
Indications include: tumor osteolysis,
hypercalcemia, and Paget’s disease.
• Clinical trials with etidronate, administered as an
intermittent regimen, have yielded favorable results in
osteoporosis.
• With the newer drugs clodronate, pamidronate, and
alendronate, inhibition of osteoclasts predominates; a
continuous regimen would thus appear to be feasible.
• .
• Bisphosphonates irritate esophageal and
gastric mucuosa membranes; tablets
should be swallowed with a reasonable
amount of water (250 mL) and the patient
should keep in an upright position
• for 30 min following drug intake
 Farmacocinetica Bifosfonaţilor:

- absorbption şi Bd reduse (1-3%) internaly administration;

- food, mineral water, juice, coffe) diminish absorption;
- is recomanded administration with 30 min before eating;
- circa 60% are distributed in bone;
- nu se metabolizează;
- aproximativ 40 % are eliminated unchainted withaut
metabolism;
- T1/2 in plasmă - 4-6 h;
- T1/2 in bone from some mounth til years.