17 POWERPOINT Folate • Critical to the production and maintenance of new cells • Found in foods such as green leafy vegetables, citrus fruits, and dried legumes • Folic acid is the synthetic form of folate. • Folate deficiency occurs during pregnancy and with increased losses. • Folic acid supplementation is recommended for Childbearing age teens and women: 400 mcg/day Pregnant women: 600 mcg/day Lactating women: 500 mcg/day Antacid therapy or potassium therapy can reduce absorption of folic acid, iron, and vitamin B 12 .Phenytoin reduces the level of folic acid. 25.THIAMINE Vitamin B 1 ( thiamine) is a water-soluble vitamin critical for many body functions and is widely available in fortified breads and cereals. Deficiency of thiamine can lead to beriberi or Wernicke’s encephalopathy. Alcoholic patients develop thiamine deficiency at 8 to 10 times the rate of the nonalcoholic population . Wernicke’s encephalopathy is a serious neurological illness in alcoholic patients and requires immediate high-dose levels of thiamine (500 mg IV TID for 2 days, then 500 mg/d IV or IM for 5 days). Patients should be given a daily 100 mg dose of oral thiamine until no longer considered at risk. Treatment for beriberi in children is IV thiamine 10 to 25 mg or 10 to 50 mg daily for 2 weeks, and in adults 50 mg IM/IV for several days or 5 to 30 mg/day for a month . POWERPOINT Vitamin B 1 (thiamine) Deficiency can lead to beriberi or Wernicke’s encephalopathy Alcoholics at high risk
18 26. Symptoms of Folate and Vitamin B12 Deficiency. vitamin B 12 deficiency will lead to megaloblastic anemia, fatigue, loss of appetite, and neurological changes (numbness and tingling in hands and feet). Deficiency will lead to megaloblastic anemia Folate is necessary for the normal maturation and functioning of red blood cells. Folate deficiency produces a macrocytic-normochromic anemia . Patients with folic acid –deficiency anemia commonly complain of glossitis, stomatitis, nausea and anorexia, and diarrhea, and a systolic ejection murmur may be heard. Oral folic acid is well absorbed, and doses of 1 to 2 mg/day result in correction of the deficiency in 4 to 5 weeks. Hemoglobin (Hgb) levels begin to rise within the first week, and anemia is completely corrected in 1 to 2 months. 27.Characterstics of each Anemia and treatment ANEMIA: Decreased iron-carrying capacity of the blood ▪ Iron deficiency anemia ▪ Caused by poor intake or blood loss (acute or chronic) ▪ Treated with iron replacement ▪ Folic acid deficiency anemia ▪ Seen in alcoholics, chronic malnutrition, fad diets, and diets low in vegetables ▪ Drugs: dilantin, sulfamethoxazole/trimethoprim, oral contraceptives, methotrexate ▪ Pernicious anemia ▪ Vitamin B12 deficiency leads to macrocytic-normochromic anemia. ▪ Vegetarians, vegans, genetic predisposition, autoimmune disease ▪ GOAL:Restore hemoglobin (Hgb) and red blood count to normal levels to maintain oxygen-carrying capacity of blood.
19 ▪ 1.IRON DEFICIENCY ANEMIA ▪ Prevention ▪ Adequate intake via iron-rich diet ▪ Monitor in periods of rapid growth (infancy, adolescence, pregnancy).
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- The American, Vitamin, Folic acid, vitamin B12 deficiency, Vitamin B12