Vitamins are a class of organic compounds necessary to maintain normal metabolism in the human body, for which little is needed, but they can perform important physiological functions. The role of vitamin drugs, the dangers of abuse and rational application are reported below.
1, the role of vitamins, the use and abuse of the hazards
1.1 vitamin AVitA is one of the components of the composition of the retinal mass, involved in the formation of dark vision, so VitA deficiency can cause night blindness. vitA maintain the integrity of epithelial cells, lack of epithelial tissue keratinization, hyperplasia and dryness, prone to infection. vitA promote growth and development, lack of bone growth and development is hindered, reproductive function decline, it also promotes thymic hyperplasia, enhance immune function, commonly used in Night blindness, dry eye disease, corneal softening disease, etc. However, fatigue, general malaise, fever, increased cranial pressure, increased nocturia, dry hair or hair loss, dry and itchy skin, loss of appetite, pain in the limbs, anemia, protruding eyes, severe headache, nausea, vomiting and other toxic phenomena can occur when taken in large quantities for a long time.
1.2 Vitamin B1VitB1 is involved in sugar metabolism, and affects the body’s energy supply when deficient. Patients initially appear forgetful, restless, irritable and other symptoms, followed by multiple peripheral neuritis, manifesting abnormal sensation, decreased muscle strength, muscle aches and pains. VitB1 inhibits cholinesterase, and when it is deficient, gastrointestinal peristalsis is slow, digestive juice secretion is reduced, appetite is poor, indigestion, etc. VitB1 is used for VitB1 deficiency, and also for the auxiliary treatment of various diseases, such as neuritis, myocarditis, indigestion, hyperthermia, hyperthyroidism, etc. However, excessive dosage can cause headache, blurred vision, irritability, arrhythmia, etc. irritability, arrhythmia, edema and neurasthenia.
1.3 Vitamin B6VitB6 is involved in a variety of biochemical metabolic processes in the body, and atherosclerotic lesions occur in the absence of VitB6. VitB6 is used to prevent peripheral neuritis caused by isoniazid, insomnia, restlessness, etc. It can also be used for pregnancy vomiting, but excessive dosage can cause VitB6-dependent syndrome in newborns.
1.4 Vitamin CVitC is involved in redox reactions in the body, promoting the absorption of iron and intercellular matrix formation, the lack of wound ulcers do not easily heal, bones and teeth easily fold or fall off, subcutaneous or mucosal bleeding, which is clinically known as scurvy. vitC also has a detoxification function, can be used to prevent scurvy, but also for acute and chronic infectious diseases, to supplement its excessive consumption, to enhance the body’s ability to resist disease. However, large amounts of oral or injected VitC (daily dose > 1g) can cause diarrhea, red and bright skin, headache, frequent urination, nausea, vomiting, stomach cramps, etc.
1.5 Vitamin DVitD has an important role in calcium and phosphorus metabolism and pediatric bone growth, promoting the absorption of calcium and phosphorus, increasing the supply of calcium and phosphorus to bone, and promoting normal bone calcification. It is mainly used for the prevention and treatment of rickets, osteochondrosis and hand-foot convulsions, but long-term use in large quantities can cause hypothermia, irritable crying, convulsions, anorexia, weight loss, liver enlargement, kidney damage, sclerosis of bones and other diseases, which is more harmful than rickets.
1.6 Vitamin EVitE can increase the secretion of anterior pituitary gonadotropic cells, promote sperm production and activity, and increase ovarian function. Clinically used in the treatment of pre-eclampsia and infertility, VitE has antioxidant effect, used to prevent atherosclerosis, anti-aging, but long-term use of large amounts of VitE (daily dose 400 ~ 800mg), can cause blurred vision, breast enlargement, diarrhea, dizziness, flu-like syndrome, headache, nausea, stomach cramps, weakness. Long-term use of overdose (daily dose > 800mg) for VitE deficient patients can cause bleeding tendency, change endocrine metabolism, change the immune mechanism, affect sexual function, and the risk of thrombophlebitis or embolism.
2, the rational use of vitamins
2.1 Distinguish between therapeutic use and prophylactic use to supplement inadequate intake In the case of therapeutic use, the indications for the use of vitamins should be clear. For the prevention of vitamin D deficiency, the adult oral daily dose of 0.01-0.02mg (400-800u); for the therapeutic use of vitamin D deficiency, the adult oral daily dose of 0.0235-0.05mg (1000-2000u); for vitamin D-dependent rickets, the adult oral daily dose of 0.25-1.5mg (10,000-60,000u), with a maximum daily dose of 12.5mg (500,000u). When used to treat hypocalcemia, it is necessary to review blood calcium and other relevant indicators regularly and avoid the simultaneous application of calcium, phosphorus and vitamin D preparations. For the treatment of vitamin D overdose, in addition to discontinuing its use, a low-calcium diet with plenty of water should be given to keep the urine acidic, along with symptomatic and supportive treatment.
Identify the causative factors of vitamin deficiency.
(1) Inadequate intake: such as unreasonable recipes, partial diet, long-term lack of appetite, dental disease, swallowing difficulties in the elderly, etc. ;
(2) Impaired absorption: hepatobiliary diseases, inadequate secretion of gastric juice, lack of gastric acid, intestinal fistula, post-gastrectomy, gastrointestinal dysfunction, chronic diarrhea, etc.;
(3) Increased need: children, pregnant and lactating women, special workers, patients with chronic wasting diseases;
(4) Long-term use of broad-spectrum antibiotics: can make the intestinal bacteria inhibited and can not synthesize vitamins;
(5) improper cooking methods: such as excessive rice panning, cooking porridge with alkali, deep-fried food, etc;
(6) Drug interactions: for example, long-time use of liquid paraffin can cause a deficiency of fat-soluble vitamins; long-term use of isoniazid patients, prone to vitamin B6 deficiency;
(7) Deficiency caused by certain diseases: pregnant women, lactating women, malaria patients with folic acid deficiency; liver and kidney insufficiency is prone to vitamin C deficiency; severe liver disease is prone to vitamin K synthesis disorders.
In addition, vitamins are also used in the adjuvant treatment of certain diseases: for example, allergic diseases, cardiovascular diseases and iron deficiency anemia are often supplemented with vitamin C, and vitamin B1 is used in the treatment of neurological and psychiatric diseases.
2.2 Strictly control the dose and course of treatment Some people think that vitamin drugs are safer and have enhanced human resistance, so they can be used arbitrarily, which is not desirable. Acute poisoning can occur 6h after ingesting a large amount of vitamin A (more than 1.5 million u in adults and more than 7.5 to 300,000 u in children). Patients develop abnormal agitation, dizziness, drowsiness, diplopia, headache, vomiting, diarrhea, desquamation, and raised lumps may be found on the head of infants, with agitation, convulsions, vomiting and other manifestations of increased intracranial pressure, hydrocephalus, and pseudotumor cerebri. Those who take 250,000 to 500,000 u of vitamin A daily for several weeks or even years can also cause chronic poisoning, and overdose of vitamin A for pregnant women can also lead to fetal malformation.
2.3 Active treatment for the cause of most vitamin deficiencies are caused by certain diseases, so the cause should be identified and treated at the root, rather than relying solely on vitamin supplements.
2.4 Master the timing of medication such as water-soluble vitamins B1, B2, C, etc. should be taken after meals, so the vitamins will pass through the gastrointestinal tract faster, if taken on an empty stomach, they are likely to be excreted before they are fully absorbed and utilized by human tissues. In addition, fat-soluble vitamins A, D, E, etc. should also be taken after meals, because the gastrointestinal tract has more than enough fat after meals, which is conducive to their dissolution and promotes the easier absorption of such vitamins.
2.5 Pay attention to the interaction between vitamins and other drugs liquid paraffin can reduce the absorption of fat-soluble vitamins A, D, K and E and promote their excretion. Vitamin B6, 10-25 mg orally, can rapidly eliminate the therapeutic effects of levodopa. Broad-spectrum antibiotics reduce vitamin K synthesis by inhibiting intestinal bacteria. Drugs with enzymatic effects, such as phenobarbital, phenytoin sodium, and aspirin, can promote the excretion of folic acid. Vitamin C can destroy vitamin B12. iron with vitamin C can increase the amount of iron ion absorption. Vitamin C and B1 should not be combined with aminophylline, and should not be taken with oral contraceptives to avoid reducing the effectiveness of the drug.