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VITAMINS, MINERALS, AND
GENERAL NUTRITION CHAPTER
- 15
“YOU ARE WHAT YOU EAT”
Your body needs a balance of nutrients for
optimum health …
• Water, minerals, proteins, vitamins,
carbohydrates, fiber & essential
fatty acids
• Higher organisms cannot synthesize
many nutrients; we must get these
from the environment
FOOD & NUTRITION BOARD OF THE
NATIONAL ACADEMY OF SCIENCE
o Deficiency = Disease
o Dietary Reference Intake (DRI) published for
vitamins and minerals:
•EAR (ESTIMATED AVERAGE REQUIREMENT)
•RDA (RECOMMENDED DAILY ALLOWANCE)
•AI (ADEQUATE INTAKE)
•UL (UPPER INTAKE LEVEL)
o Vitamins- organic materials required in small amounts.
These help biochemical reactions in the body and so are
necessary for normal growth & function

Common vitamin-deficiency symptoms include …
aches/pains
 overall ‘poor’ feeling of tiredness/low energy

o Fat-soluble vitamins can accumulate and cause
hypervitaminosis
• Vitamin A deficiency affects vision
• Vitamin D deficiency causes rickets
• Vitamin E
• Vitamin K deficiency causes bleeding

Water soluble vitamins

thiamine (B1), riboflavin (B2), folic acid, cyanocobalamin (B12)
FOLIC ACID IN PREGNANCY
o extremely important supplement for women!
o Reduces the incidence of neural tube birth defects such
as …
* Spina Bifida
* anenchephaly
* encephalocele
o … essential for DNA formation
o Women of childbearing age should consume 0.4-mg/day
of Folic acid
o Also known as ‘Folate’
MINERALS
o non-organic material, found in the earth
o 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 ferritin
odeficiency leads to anemia especially in pregnant women
o Calcium: deficiency leads to osteoporosis
o Phosphorous: important in bone
o Potassium: important in cardiac rhythm
o Essential fatty acids- found in fats. Important for brain and
nervous system functioning.
o Saturated can be produced by humans
o Unsaturated cannot be produced by humans; found in
plants and fish
o Antioxidants - inhibit oxidation, reducing tissue
damage/aging:
• Vitamin C
• Vitamin E
• Lutien
o Fiber - (see table 15-1 for sources)
A food substance, found only in plants.
Not digested
May reduce colon cancer
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:
Ulcers
Gastroesophageal Reflux Disease (GERD)
Obesity
Vomiting
Diarrhea
GASTRIC CONDITIONS/ENVIRONMENT
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

10
ULCERS – GENERAL INFO
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

11
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 H2receptors 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:

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
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
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

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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

megestrol is an appetitite stimulant

orlistat (Xenical) blocks the absorption of fat in the GI tract
17
ANTI-EMETICS
 Emesis
(vomiting) caused by many factors
 dimenhydrinate,

meclizine are OTC
Good 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)
