The use of vitamins in medicine. Vitamins: types, indications for use, natural sources. Brief characteristics of individual vitamins
Vitamin and antivitamin preparations.
Coenzyme preparations.
Vitamin preparations are medicines containing natural vitamins or their synthetic analogues or their isomers (vitamers).
Vitamin-like compounds are a group of conditionally essential nutritional factors that resemble vitamins in their physiological action, but if they are deficient, vitamin deficiency does not develop. Medicines made from such compounds are called vitamin-like drugs.
Coenzyme preparations are medicines containing synthetic analogues of coenzymes and used to correct various metabolic processes in the body. Coenzyme preparations are divided into 2 groups:
vitamin origin
non-vitamin origin
Antivitamins are derivatives of vitamins with substituted functional groups that have the opposite effect of the vitamin and partially or completely exclude vitamins from the body's metabolic reactions.
Classification of vitamin and coenzyme preparations:
Drugs fat-soluble vitamins.
Vitamin A preparations (retinol):
roaccutane
retinol acetate, palmitate;
Vitamin D preparations (calciferol):
ergocalciferon
oxidevit
Vitamin E (tocopherol) preparations:
tocopherol acetate
Vitamin K preparations (cartoquinones):
vitamin K 1
conachion
Preparations of water-soluble vitamins and their coenzymes
Vitamin B1 (thiamine) preparations:
Thiamine bromide (chloride)
Coenzyme preparation:
cocarboxylase
Thiamine derivatives:
phosphothiamine
benfotiamine
Vitamin B2 (riboflavin) preparations:
riboflavin
Coenzyme preparations:
flavin mononucleotides
flavinate
Vitamin B 3 preparations (pantothenic acid):
calcium pantothenate
Vitamin B 5 preparations (niacin PP):
a nicotinic acid
Coenzyme preparations:
nicotinamide
Vitamin B 6 (pyrodoxine) preparations:
pyridoxine hydrochloride
Coenzyme preparations:
pyridoxal phosphate
Vitamin B 9 (B c) preparations (folic acid):
calcium folinate
Vitamin B 12 preparations (cyanocobalamins):
cyanocobalamin
oxycobalamin
Vitamin C (ascorbic acid) preparations:
ascorbic acid
Coenzyme preparations of non-vitamin origin
Phosphaden
carnitane chloride
lipoic acid
Multivitamin preparations
dekamevit
gendevit
macrovit
Complex preparations of multivitamins with macro- and microelements
Unicap T, M
glutamevit
complivit
Typical mechanisms of action vitamin preparations:
Most vitamins are converted into coenzymes in the body and are part of enzymes. Thus, they participate in carbohydrate, fat, protein and other types of metabolism. For example, vitamin B 1 (thiamine) in the form of an active form is part of cocarboxinase. Cocarboxinase is a coenzyme of: pyruvic and ketoglutaric acid dehydrogenases.
Thanks to this, thiamine preparations participate in carbohydrate metabolism, in the formation fatty acids, in the synthesis of a/choline nucleic acids; NAD, NADP.
Another typical mechanism of action of vitamin preparations is that vitamins can be donors or acceptors of various chemical groups and thus participate in biochemical reactions.
For example, ascorbic acid is a donor of hydrogen protons and is involved in redox processes in the body.
Some vitamins have hormone-like effects. So active form Vitamin D, together with the parathyroid hormone, regulates the metabolism of Ca and P.
The following can be distinguished basickindsvitamin therapy.
Preventive – prescribing vitamin preparations if there is a risk of developing hypovitaminosis. For example, in the winter-spring period. In these cases, the dose of the drug corresponds daily requirement body. I prescribe drugs enterally.
IN Lately started to allocate adaptive vitamin therapy is the prescription of vitamin preparations to facilitate adaptation to unfavorable and difficult conditions. In such situations, the need for vitamins increases sharply, therefore, if they are supplied in normal quantities, hypovitaminosis may develop. In these cases, doses are used that are 2-3 times higher than the daily requirement.
Substitute vitamin therapy (etiotropic) – the prescription of vitamin preparations for the elimination and development of hypo- and avitaminosis. Doses exceed the daily requirement. Method of administration: enteral.
The next type of vitamin therapy is the use of vitamins for eliminating or reducing the negative effects of others medicines. For example, pyridoxine hydrochloride eliminates the side neurotoxic effect of the drug ftivazide.
Nonspecific (pharmacodynamic)– this is the use of vitamins in high doses in order to influence the metabolism and other processes of the patient’s body. In this case, the vitamin preparation is not prescribed to compensate for the deficiency (such patients do not have it). Vitamin preparations are prescribed as medicines that have certain pharmacodynamics and vitamin therapy is in the nature of conventional pharmacotherapy.
Let us dwell in more detail on some types of vitamin therapy. Unfortunately, we have to admit that the problem of prevention and treatment of hypo- and even vitamin deficiency has again become relevant these days.
Hypovitaminosis in recent years is characterized by 2 features:
1 they affect all age groups
2 hypovitaminosis persists in the summer-autumn period.
The main cause of hypovitaminosis in our country is known - it is the low quality of nutrition and insufficient consumption of fresh vegetables and fruits.
For the prevention and treatment of hypovitaminosis, multivitamin preparations “Undevit”, “Dekamevit”, “Makrovit”, etc. are used. When preventing vitaminosis, the dose is close to the daily requirement. Multivitamins are usually taken in winter and spring for a course of 3-8 weeks to several months. With vitamin replacement therapy, the dose usually exceeds the daily requirement. The course depends on the disappearance of clinical signs; if hidden hypovitaminosis is possible, the course is also from 1 to several months.
Adaptive vitamin therapy. There are many situations in which the need for vitamins, especially water-soluble ones, increases several times, first of all:
periods of adaptation to new or complicated living conditions
increased physical and mental stress.
Under such conditions, all enzyme systems begin to function with increased intensity. As a result, the utilization of vitamins increases and the need for them becomes higher than usual. Insufficient intake of vitamins leads to serious changes in metabolism. Persistent fatigue develops, immunity decreases, and various pathological conditions appear. To prevent this from happening, so-called vitamin therapy is carried out. In this case, doses are used that are 2-3 times higher than the daily requirement of a healthy person. Therapy is carried out in courses of 3 to 8 weeks. But perhaps longer. If necessary, courses are repeated after 3-5 months.
The need for vitamins also increases during pregnancy (2 times). A special vitamin complex has been developed for pregnant women, which contains vitamin D and folic acid, for example, “Gendevit”.
An increased need for vitamins is observed in old age. In this case, vitamins are used to stimulate the enzyme systems of an aging body. Multivitamin preparations such as “Undevit”, “Aerovit”, “Dekameviit” are also shown.
Pharmacodynamic vitamin therapy– this is the use of vitamins as medicines for diseases that do not relate to hypo- or vitamin deficiency. This is the first difference between pharmacodynamic vitamin therapy and replacement and adaptation therapy. Second significant difference– in dosing. With replacement and adaptation therapy, the dose of vitamins generally corresponds to the daily requirement and exceeds it no more than 2-3 times, i.e. remains within the physiological norm for the supply of vitamins to the body. In order to obtain a certain pharmacological effect, vitamins are taken in doses tens and sometimes hundreds of times higher than the daily norm. The pharmacodynamic properties of vitamins appear precisely when high, non-physiological doses are prescribed.
Finally, the third feature of pharmacological vitamin therapy is the prescription of one particular vitamin that has the desired pharmacological effect.
Using pharmacological properties vitamin preparations can act on both metabolic processes, and on executive systems and organs.
It has been established that nicotinic acid has a vasodilating effect, in addition, in doses of 3 g and higher per day, it has a hypolipidemic effect (with a daily requirement of 15-20 mg).
Nicotinic acid preparations are used for hypertension, IHD, peripheral circulatory disorders. Abroad, nicotinic acid in large doses (3 g per day) is used to treat atherosclerosis.
THIAMIN (B 1 )
IN medical practice Vitamin B1 is used in the form of thiamine bromide and thiamine chloride. A coenzyme drug is used - cocarboxylase and thiamine derivatives - benfotiamine and phosphotiamine. Thiamine introduced into the body in the form of a drug undergoes phosphorylation. As a result, mono-, di-, and triphosphates are formed. Of primary importance is thiamine diphosphate, which is often called cocarboxylase. Benfotiamine and phosphotiamine are also converted into cocarboxylase in the body.
Pharmacodynamics: Cocarboxinlase is part of such enzymes as -PVK dehydrogenase and -ketoglutaric acid; - trinsketolases.
Thanks to this, thiamine preparations participate in various types metabolism:
First of all, thiamine in the form of cocarboxylase is involved in carbohydrate metabolism: it promotes the utilization of glucose and is an insulin synergist; promotes the combustion of PVC, and therefore lactic acid and ketone bodies; helps eliminate metabolic acidosis.
Transketolase is necessary for the use of glucose in the pentose cycle and the formation of NADPH 2. NADPH 2 then participates in the synthesis of fatty acids, nucleic acids, acetylcholine proteins and other substances.
Thiamine diphosphate in brain tissue is necessary for the activity of GABA, acetylcholine and serotonin.
Application.
Thiamine is used when absorption is impaired, when the need for it increases, and for the treatment of certain diseases.
One of the indications is metabolic acidosis, including diabetes mellitus. It is better to use cocarboxylase, although thiamine is acceptable. These drugs eliminate excess PVC and normalize the composition of blood plasma and tissues.
IN complex treatment In diabetes mellitus, cocarboxylase promotes the utilization of glucose.
Heart failure (usually as an adjunct to cardiac glycosides).
Violation heart rate(cocarboxylase).
IHD (cocarboxylase).
What is the basis of the action of thiamine preparations?
Cocarboxylase affects carbohydrate metabolism, improves redox processes and energy production in the myocardium. This leads to an increase in the content of potassium and calcium ions in the heart muscle cells. As a result, the force of contraction of the heart increases and its increased excitability decreases. Arrhythmias disappear and, as a consequence, a cardiotonic effect.
Peripheral neuritis. Thiamine has a neurotropic effect. Its effect on the peripheral nervous system is especially pronounced. It promotes the synthesis of acetylcholine.
Side effect:
The main thing is allergic reactions. The most serious is anaphylactic shock. It develops more often with intravenous administration of thiamine. Therefore, thiamine should not be administered parenterally, much less intravenously, unless absolutely necessary.
THIAMIN PREPARATIONS
Cocarboxylase. This is a coenzyme formatiamine. Its pharmacological activity is somewhat different from thiamine - it is not used for the prevention and treatment of hypovitaminosis B1. Less toxic, it can be administered intramuscularly and intravenously.
Pyridoxine (B 6 ). In medicine, pyridoxine hydrochloride and the coenzyme drug pyridoxal phosphate are used. Features of pharmacokinetics: pyridoxine, administered in the form of pyridoxine hydrochloride, is converted in the body into pyridoxal phosphate. Pyridoxal phosphate plays an important role in many biochemical reactions:
participates in amino acid metabolism
necessary for the synthesis of glutamic acid
necessary for the formation of neurotransmitters, GABA, glycerol, serotonin
participates in carbohydrate metabolism
participates in the metabolism of vitamin B 12, folic acid, and the synthesis of HB.
All these functions of pyridoxine in the body determine its medical use.
Indications:
Heart failure, myocardial dystrophy. Usually together with cardiac glycosides. Pyridoxal phosphate is more effective. It activates metabolic processes and myocardial contractility. Thus, pyridoxal phosphate has a cardiotoxic effect.
Hepatitis, liver cirrhosis. Pyridoxine has a hepatotropic effect, it improves liver functions: exocrine, protein-forming, detoxification.
Some hereditary hypochromic anemias.
Epilepsy – in complex treatment. It has been established that in such patients the conversion of glutamic acid to GABA is impaired.
Radiation damage – stimulates leukopoiesis.
Adverse reactions when using antitumor drugs.
Skin diseases: psoriasis, eczema, neurodermatitis.
Toxicoses of the 1st half of pregnancy.
Side effect:
Allergic reactions
Increased gastric acidity
PYRIDOXINE PREPARATIONS
Pyridoxine
Pyridoxal phosphate- a coenzyme form of vitamin B 6 - causes almost the same effects as pyridoxine. The difference is a faster and more pronounced effect. Pyridoxal phosphate may have an effect in cases where there is resistance to the vitamin itself.
ASCORBIC ACID (VITAMIN C)
Ascorbic acid and the product of its oxidation in the body - dehydroascorbic acid - together constitute a redox system that plays an important role in tissue respiration. Participates in the synthesis of steroid hormones, in the regulation of blood clotting, and ensures collagen synthesis.
The participation of ascorbic acid in the formation of cellular and humoral immunity has been shown.
An important property of ascorbic acid is the elimination free radicals and stabilization of biological membranes. This is due to the conversion of ascorbic acid into the monodehydroascorbic acid radical. Therefore, with a lack of ascorbic acid, lipid peroxidation is activated.
The average daily requirement is 70-100 mg. The need for ascorbic acid significantly depends on the physiological state of the body and on external conditions: it increases with increased physical and mental work, pregnancy and lactation, etc.
Indications:
State of hypoxia, metabolic and respiratory acidosis.
Severe infectious diseases
Inflammatory joint diseases, especially rheumatoid arthritis, because it stimulates collagen synthesis.
Hypochromic anemia
Side effects: They usually occur when taking high doses. Hypervitaminosis does not occur, because the excess amount is quickly eliminated from the body in the urine. But with long-term use:
vitamin C daily dose 1-1.5 years, a feeling of heat may appear, headache, insomnia, anxiety, increased blood pressure
at long-term use Vitamin C accumulates dehydroascorbic acid, which suppresses the function of the pancreatic islets, this leads to hyperglycemia.
Excessive doses of vitamin C have immunosuppressive effects
Dehydroascorbic acid is converted in the body to oxalic acid, oxalic acid can concentrate in the urinary tract and form stones - oxalates
High doses – increase the tendency to thrombosis
High doses during pregnancy lead to miscarriages.
Vitamin preparations have a very wide application:
· during pregnancy;
· for older people;
· for immunity;
· for vision;
· for children;
· in dentistry;
· for allergies;
· for depression.
Use during pregnancy.
Expectant mothers experience an increased need for vitamins, primarily vitamins A, C, B1, B6, and folic acid. It is necessary that a woman’s body is provided with all these micronutrients even before conceiving a child and throughout the entire period of pregnancy and lactation. This will save the mother and her child from many troubles and complications.
It should be remembered that during planning and management of pregnancy one must be very careful when taking vitamin A or retinol. IN high dosages this vitamin can have a teratogenic effect and provoke the development of various abnormalities in the fetus. Therefore, it is very important during pregnancy management and planning to be careful about the doses of this vitamin. The permissible dosage of vitamin A for pregnant women is 6600 IU or 2 mg per day.
Insufficient supply of vitamins to a woman during the period of conceiving a child and pregnancy may be the cause congenital anomalies development, malnutrition, prematurity, physical and mental development children. That's why, when planning a pregnancy, you need to think about taking poly vitamin complexes.
Use for the elderly.
With age, changes occur in the human body that require a restructuring of nutrition. In older people, the absorption capacity of food ingredients is reduced, and energy metabolism is also reduced. In addition, chronic diseases and taking medications lead to the fact that a person regularly does not receive the substances he needs, primarily vitamins, minerals and trace elements. It has been shown that 20-30% of older people have intakes of, for example, vitamin B6 below the recommended level. And the blood levels of vitamins B1 and B2 are much lower than normal in a significant number of elderly people. Vitamins are especially important for patients undergoing treatment in hospitals. Almost a third of all patients in US clinics suffer from hypo- and vitamin deficiencies. Vitamin E deficiency was found in 80% of elderly patients, vitamin C in 60%, and vitamin A in up to 40%. On the other hand, older people who regularly take vitamin supplements are more likely to active image life, as evidenced by numerous medical and social studies.
Use to strengthen the immune system.
The immune system protects us from the effects of external adverse factors; it is a kind of “line of defense” against the aggressive action of bacteria, fungi, viruses, etc. Without a healthy and effectively functioning immune system, the body becomes weaker and is much more likely to suffer from viral and bacterial infections.
The immune system protects the body from own cells whose organization has been disrupted and who have lost their normal characteristics and functions. It finds and destroys such cells that are potential sources of cancer.
It has long been known that vitamins are necessary for the formation immune cells, antibodies and signaling substances involved in the immune response. The daily need for vitamins may be small, but it depends on the supply of vitamins normal operation immune system and energy metabolism. This is why vitamin deficiency accelerates the aging of the body and increases the incidence of infectious diseases and malignant tumors, which significantly reduces the duration and quality of life.
Vitamin E deficiency reduces antibody formation and lymphocyte activity. A decrease in antibody production is also possible with a deficiency of vitamins A, B5 (pantothenic acid), B9 (folic acid) and H (biotin). Folic acid deficiency reduces the speed of the immune system's response to foreign factors. Vitamin A deficiency weakens immune system body when foreign proteins enter the body. Vitamin B12 deficiency reduces reaction power immune defense and reduces its ability to kill foreign cells. Vitamin B6 deficiency reduces the ability of neutrophils to digest and destroy bacteria.
And vice versa:
· B vitamins help stimulate the immune system during times of stress, surgery or injury.
· Taking multivitamins containing vitamins A, C, D, E, B6 helps strengthen the immune system and prevent colds and viral diseases.
· Vitamin B6 stimulates the synthesis of nucleic acids, which are necessary for cell growth and the production of antibodies to fight infection.
· Vitamin C or ascorbic acid increases the activity of macrophages in the fight against infectious agents.
Taking vitamin E increases resistance to diseases in all age groups, and it is especially useful for elderly patients.
· It has been proven that children whose parents regularly give vitamins are less likely to get sick from common diseases. infectious diseases, acute respiratory infections, otitis media, sinusitis.
An important part of the prevention of acute respiratory infections and flu during the season of increased incidence is taking multivitamins. This will help avoid illness, support your body, and improve immunity.
You should pay close attention to choosing a suitable and effective drug.
Experts recommend taking medications that contain the entire spectrum of vital important vitamins, and, no less important, the complex must be of high quality and well balanced in dosage. This will guarantee the effectiveness and safety of the drug. High quality And optimal dosages vitamins can significantly reduce the risk allergic reactions, which, unfortunately, are often encountered recently, and this, in turn, will provide the opportunity to carry out a complete preventive course.
Application for children.
Today, as always, at appointments with pediatricians, parents very often ask the question about the need to take vitamins or, conversely, the lack thereof, about the effectiveness and safety of using certain vitamin complexes in their children, as well as about what kind of vitamins they should use. should be preferred and why.
The content of vitamins in the diet may vary and depends on various reasons: depending on the variety and type of products, methods and periods of their storage, the nature of the technological processing of the food. Eating canned food also creates big problem in this plan. Drying, freezing, mechanical restoration, storage in metal containers, pasteurization and many other achievements of civilization reduce the content of vitamins in products. After three days of storing food, the percentage of vitamins decreases significantly. But on average, for 9 months or more a year, residents of our country eat vegetables and fruits that are frozen, stored for a long time, or grown in greenhouses. Storing cabbage at room temperature for 1 day entails a loss of vitamin C by 25%, 2 days - 40%, 3 days - 70%. When frying pork, the loss of vitamin B is 35%, stewing - 60%, boiling - 80%.
Insufficient intake of vitamins from food leads to the development of hypovitaminosis, which does not have a clearly defined clinical picture. Their signs may be: nonspecific symptoms, How fast fatiguability, general weakness, decreased concentration, decreased performance, poor resistance to infections, increased irritability, changes in the condition of the skin and mucous membranes.
Use for allergies.
The relevance of the allergy problem is increasing every day. Allergic diseases are in first place in terms of prevalence among all non-communicable diseases. And the number of patients suffering from allergies is only last decade tripled.
Patients with allergic diseases are one of the risk groups for the development of hypovitaminosis. Particularly significant vitamin deficiencies are experienced by patients with food allergies And atopic dermatitis, which is caused by several reasons:
First of all, hypovitaminosis is provoked by elimination measures (as one of the main methods of therapy) aimed at eliminating the effect of allergens, including, among other things, nonspecific and/or specific hypoallergenic diet consisting of a limited list food products. This naturally leads to the fact that the child’s daily need for vitamins is not met.
In addition, most people with allergic diseases, especially with atopic dermatitis, suffer from dysbiosis, which disrupts the absorption of vitamins from food, as well as the endogenous synthesis of B vitamins, which aggravates the manifestations of hypovitaminosis.
All of the above leads to an increased need for vitamins in children and adults with various allergopathologies.
Despite the obvious need for vitamin therapy, numerous dosage forms vitamins and multivitamins, the choice of these drugs in patients with allergic diseases is usually difficult. The reason is the risk of allergic reactions to auxiliary components multivitamin complexes certain manufacturers and the vitamins themselves, mainly group B. This often leads to an unreasonable refusal to prescribe multivitamins to this group of patients by both allergists and pediatricians, and, as a consequence, aggravation of hypovitaminosis.
Application in dentistry.
Vitamins and related drugs are widely used for prevention and as part of complex therapy diseases maxillofacial area. Showing high biological activity in very small doses, they are necessary for normal cellular metabolism and tissue trophism, plastic metabolism, energy transformation, normal functioning of all organs and tissues, maintaining such vital important functions such as tissue growth and regeneration, reproduction, immunological reactivity of the body.
The main source of vitamins in the human body is food. Some vitamins (groups B and K) are synthesized by the microflora of the large intestine or can be formed in the human body in the process of exchange from close chemical composition organic substances (vitamin A - from carotene, vitamin D - from sterols in the skin under the influence ultraviolet rays, vitamin PP - from tryptophan). However, the synthesis of vitamins in the body is insignificant and does not cover the total need for them. Fat-soluble vitamins can be retained in body tissues, and most water-soluble vitamins (with the exception of vitamin B12) are not stored, so their deficiency leads to deficiency more quickly and they must be supplied to the body systematically.
So, we can conclude that it is necessary to use vitamins to prevent many diseases.
IN last years on pharmaceutical market arrives a large number of vitamin-containing preparations. They are actively used both in complex therapy of various pathological conditions, and in the process rehabilitation activities as prophylactic drugs. According to official data government agencies for control over the quality, safety and production of medicines in Ukraine, vitamin preparations are currently the most in demand in all branches of medicine, especially in the clinic of infectious diseases, pediatrics, neurology, gerontology, etc. Vitamin preparations have become so firmly established in everyday life medical practice that the doctor sometimes does not think about the fact that vitamins, like others medications, have their own mechanisms of action and points of application, knowledge of which is absolutely necessary.
When there is insufficient intake or synthesis of any vitamin in the body, a condition called hypovitaminosis occurs, or its more severe form - vitamin deficiency. The reasons for the development of hypovitaminosis can be:
- * increased body need for vitamins;
- * lack of vitamins in food;
- * failure to digestive tract to the absorption of vitamins;
- * accelerated removal of vitamins from the body; disruption of the synthesis of vitamins (D and K) in the body.
In this case, the use of certain groups vitamins to compensate for hypovitaminosis. Vitamins are delivered to the body through a specially selected (balanced) diet, which includes foods rich in vitamins, as well as as part of single preparations and vitamin complexes. The introduction of vitamins into the body along with food is possible if it is satisfactory. functional state, difficult to dose. It is impossible to deliver vitamins with food without passing through the gastrointestinal tract, i.e. parenterally. The simplest and most convenient way of introducing a vitamin preparation into the body is considered enteral (oral). An exception is made for hypovitaminosis, manifested by disruption of the functioning of the digestive tract in the form of diarrhea syndrome. When prescribing a specific vitamin preparation, the dosage is calculated based on the body's daily need for the vitamin. This optimal amount increases by 4-5 times.
Now there are potentized preparations containing, in addition to vitamins and ME, all kinds of adaptogen herbs (ginseng, Rhodiola, Echinacea, etc.), bee royal jelly and even mental stimulants (dimethylaminoethanol bitartrate). The use of IUDs containing deanol (dimethylaminoethanol bitartrate) is prohibited for epilepsy and seizures, arterial hypertension. These complexes are not prescribed in the second half of the day, because they can disrupt the process of falling asleep and lead to overexcitation. Manufacturers warn about this in the drug inserts. Such IUDs help manage patients with asthenia, but when prescribing them, monitoring the patient’s condition is necessary. Thus, in both therapeutic and preventive vitamin and mineral therapy, the problem of choosing a specific drug and its dosage is very acute. Treatment is the prerogative of the doctor.
Improving the quality of life, health culture, dietary education, knowledge of general issues regarding the effects of vitamins and minerals is part of everyone's civic responsibility for their health and the health of their children. However, proper correction of vitamins and minerals with for preventive purposes largely falls on the shoulders of pharmacists, pharmacists and front desk workers. Pharmacists and pharmacists will first have to delve into this (seemingly simple) problem and pass on their knowledge to people. It is from their preparedness, active position, constant desire Indeed, helping a patient largely depends on the health of Russians and the future of the country.
The use of vitamins in preventive and medicinal purposes can be systematized as follows.
For preventive purposes:
1. Prevention of primary hypovitaminosis caused by:
- insufficient intake of vitamins from food;
- increased consumption and increased need in vitamins (stress, physical and mental stress, exposure to harmful environmental and extreme factors, pregnancy, childbirth).
2. Increasing the body's defenses, reducing the risk of colds, cardiovascular, cancer and other diseases.
For medicinal purposes:
1. Treatment of primary vitamin deficiencies.
2. Prevention and (or) treatment of secondary disorders of the metabolism and function of vitamins caused by:
- pathological processes;
- surgical interventions;
- medicinal and physical therapy;
- dietary restrictions.
3. Correction of congenital disorders of vitamin metabolism and functions.
4. Use of high doses of vitamins in therapy various diseases.
Insufficient intake of vitamins weakens protective forces the body, reduces its resistance to various diseases, adverse effects external environment, contributes to the development of chronic diseases, accelerates the aging of the body.
Insufficient supply of the body with vitamins is aggravated by illnesses gastrointestinal tract, liver and kidneys, in which the absorption and utilization of vitamins is impaired. Drug therapy(antibiotics, etc.), diets, surgical interventions, stress aggravates vitamin deficiency. Vitamin deficiency in turn, disrupts metabolism and prevents successful treatment any disease. Therefore, it is justified to include multivitamin preparations and therapeutic and preventive nutrition products enriched with vitamins in the complex therapy of various diseases.
Use of vitamins in doses exceeding physiological need, in the treatment of various diseases:
1. Vitamin A – prevention of infertility, enhancement of tissue regeneration, to stimulate the growth and development of children.
2. Vitamin D – treatment of rickets and skin diseases.
3. Vitamin K - for bleeding associated with decreased blood clotting.
4. Vitamin E – prevention of pregnancy and threats of miscarriage, liver disease, muscle atrophy, congenital disorders of red blood cell membranes in newborns.
5. Vitamin B1 – for diabetes (to improve the absorption of carbohydrates), for inflammation peripheral nerves and defeats nervous systems s, with dystrophies of the heart and skeletal muscles.
6. Vitamin B2 – for dermatitis, poorly healing wounds and ulcers, keratitis, conjunctivitis, liver damage.
7. Pantothenic acid– for diseases of the skin and hair, liver damage, dystrophy of the heart muscle.
8. Vitamin PP - for dermatitis, damage to peripheral nerves, dystrophy of the heart muscle.
9. Vitamin B6 – for polyneuritis, dermatitis, pregnancy toxicosis, liver dysfunction.
Vitamin preparations - medical supplies containing natural vitamins and their synthetic analogues. Used as a means replacement therapy with vitamin deficiency and hypovitaminosis. Considering the active influence of vitamins on metabolic processes in the body, vitamin preparations are prescribed for hypovitaminosis, various pathological conditions as a means of pathogenetic and symptomatic therapy.
Types of vitamin preparations
Vitamin preparations divided into 2 groups. The first includes preparations of fat-soluble vitamins: vitamin A (retinol) - retinol acetate, retinol palmitate, fish fat and etc.; vitamins D - ergocalciferol (vitamin D2), cholecalciferol (vitamin D3) - ergocalciferol, in the form of chol, fish oil; vitamin E (tocopherol) - tocopherol acetate; vitamin K - synthetic analogue vikasol. The second group consists of preparations of water-soluble vitamins: vitamin Bi (thiamine) - thiamine bromide and thiamine chloride, cocarboxylase; vitamin B2 (riboflavin) - riboflavin, riboflavin mononucleotide; vitamin B - nicotinic acid, nicotinamide; vitamin B5 (pantothenic acid) - calcium pantothenate; vitamin B6 (pyridoxine) - pyridoxine hydrochloride; vitamin B (cyanocobalamin); vitamin BC - folic acid; vitamin C - ascorbic acid; vitamins P (routine) - quercetin.
Use of vitamin preparations
Vitamin preparations are widely used in obstetrics, gynecology and pediatric practice. The effect of retinol (vitamin A) is due to its participation in many parts of metabolism, in particular in the synthesis of nucleic acids and proteins, lipid metabolism, as well as its influence on the activity of tissue respiration enzymes, on the processes of oxidative phosphorylation, metabolism minerals, such as calcium.
Vitamin preparations group A is used in the complex treatment of late toxicosis of pregnant women, postpartum sepsis, inflammatory diseases of the genitals (vulvo-ginitis, colpitis), cervical erosions. For children, these drugs are prescribed for exudative diathesis, diseases of the skin and mucous membranes (diaper rash in newborns, thrush, stomatitis), eye diseases (conjunctivitis, keratitis), infectious diseases(pneumonia, diphtheria, etc.) to increase the body’s resistance, chronic diseases hepatobiliary system, hypervitaminosis D, etc.
Vitamin preparations groups D regulate mineral metabolism, in particular the absorption of calcium in the intestine, the reabsorption of phosphorus, promote bone mineralization. Prescribed to pregnant and lactating women to prevent rickets in newborns and infants; used to treat rickets and dermatoses in children. Tocopherols (vitamin E) normalize redox processes and have antioxidant properties. Necessary for the normal functioning of the reproductive system, contribute to normal pregnancy. Tocopherol acetate is used for routine abortions, premature birth, menstrual cycle disorders.
Vitamin preparations group B. Thiamine (vitamin B1) plays a significant role in carbohydrate metabolism, transamination of keto acids, promotes the synthesis of nucleic and fatty acids, and enhances the synthesis of steroids. Riboflavin (vitamin B2) provides normal course redox processes, increases metabolism in the body of a pregnant woman, fetus, child, promotes its growth. A nicotinic acid, nicotinamide (vitamin B3) regulates redox reactions, carbohydrate metabolism And lipid metabolism, normalizes cholesterol metabolism. Strengthens the secretion and motor function of the stomach, the exocrine function of the pancreas, liver function, and increases the protective properties of the body. Pantothenic acid (vitamin B5) regulates fat, protein and carbohydrate metabolism, enhances the synthesis of corticosteroids, hemoglobin, cholesterol, and has a detoxifying effect. Pyridoxine (vitamin B6) regulates protein, fat and lipid metabolism, is involved in the synthesis and transamination of amino acids, and improves the absorption of unsaturated fatty acids. Stimulates hematopoiesis, promotes the development of immunity in case of infection of the body. Pangamic acid (vitamin B15) has antihypoxic properties, increases the body’s resistance to oxygen starvation. The presence of lipotropic properties and increased cellular metabolism cause an increase in the antitoxic function of the liver and regeneration of liver tissue. Cyanocobalamin (vitamin Bi2) and folic acid (vitamin Bc) regulate the functions of the hematopoietic organs. Promote protein accumulation and amino acid synthesis. Cyanocobalamin also stimulates the body's protective properties.
Ascorbic acid (vitamin C) stimulates the growth and development of the fetus and child, normalizes redox processes, stimulates hematopoiesis, participates in the processes of steroidogenesis, regulates collagen synthesis, and ensures normal permeability vascular walls. Rutin (vitamin P) regulates the permeability of vascular walls, prevents capillary fragility, and has antioxidant and antihypoxic properties.
Vitamin preparations complex B, ascorbic acid, rutin is used for early and late toxicosis of pregnant women, weakness labor activity, diseases of the cardiovascular and hepatobiliary systems, anemia. In pediatric practice, vitamin preparations are used for diseases of the digestive and respiratory organs, infectious diseases, sepsis, intoxications, in complex therapy of diseases of the cardiovascular and nervous systems, to accelerate the healing of fractures, wounds, burns, prevention and treatment of hemorrhagic disorders in newborns, hemorrhagic diathesis, capillaropathies. At long-term use vitamins A and D accumulate in the body, hypervitaminosis may occur, manifested by irritability, weakness, sleep disturbance, loss of appetite, and physical retardation. development. With hypervitaminosis A, polyuria, low-grade fever, and anemia are also observed. With hypervitaminosis D - symptoms of kidney damage (hematuria, phosphaturia, etc.), hypercalcemia, excessive ossification. In case of hypervitaminosis, it is necessary first of all to stop taking the vitamin preparations that caused it. In case of hypervitaminosis A, thyroxine and ascorbic acid are used; for hypervitaminosis D, a calcium-free diet is prescribed, the drug parathyroid glands- calcitonin, thiamine bromide or chloride, ascorbic acid, glucocorticoids.
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