minerals

Minerals : 

Minerals Dr.Hariharan

INTRODUCTION : 

INTRODUCTION Minerals are required by the body for a variety of functions such as formation of blood, bones and teeth Essential constituents of body fluids and tissues Components of enzyme systems and nerve functions.

MINERALS : 

MINERALS Macronutrients : more than 100 mg/day calcium, phosphorous, magnesium, sodium potassium, chlorine. Micronutrients : less than 100 mg/day iron , zinc , iodine ,fluorine, selenium copper .

Dose-Effect Relationship : 

Dose-Effect Relationship 100% biological function def toxic intake

Sodium : 

Sodium Total body sodium-4000meq It’s the major cation of ECF Sodium pump- in all cells- pumps sodium out all time- ATP dependent Sodium bicarbonate- important for acid-base balance Normal plasma level = 136-145meq/l….ICF-35meq/l

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Diet contains 5-10gm of sodium as NaCl same amount excreted through urine 99% of Na is reabsorbed in proximal tubule. Along with that water is also absorbedsecondary absorption Aldosterone increases sodium absorption in distal tubules ADH increases water reabsorption

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Edema – diuretic drugs increases excretion of sodium along with it water is also excreted In congestive cardiac failure more water retained hemodilution of sodiumtriggers secretion of aldosterone more sodium retained inc water retention…this cycle broken by aldosterone antagonists

Hyponatremia – causes : 

Hyponatremia – causes Cushing’s disease Prolonged cortisol therapy- mineralocorticoid axn Pregnancy- steroid hormones Dehydration- if only water lost

Hyponatremia : 

Hyponatremia Vomiting Diarrhea Burns Addison’s disease- adrenal insufficiency Renal tubular acidosis Severe sweating- muscle cramps

Pottasium : 

Pottasium Major intracellular cation Depolarisation  pottasium efflux- in heart muscles Requirement: 3-4 gm per day - banana, apple, orange, pineapple dates, potato, tender coconut water Normal level-plasma-3.5- meq/l….ICF-160 Aldosterone and steroids increases k excretion through urine

Hypokalemia : 

Hypokalemia <3.5 meq/l Cardiac arrhythmias, muscular weakness, cardiac arrest T wave of ECG inverted In diabetic coma insulin is given pottasium moves to ICF hypokalemmia Alkalosis K+ taken inside in exchange for H+ Acute tubular necrosis, renal tubular acidosis, metabolic alkalosis pottasium lost in urine Diuretics for CCF inc excretion of K+

Hyperkalemia : 

Hyperkalemia >5.5 mmol/l Even minor increase- fatal Increased membrane excitability ventricular fibrillation cardiac arrest Flaccid paralysis ECG- elevated T wave Treatment glucose and insulin glycogen storage traps K+ in ICF Addison’s disease, K+ sparing diuretics dec excretion of K+ K+ channel mutations long QT syndrome- arrhythmia

COPPER : 

COPPER liver, kidney, nuts,meat, whole grain cereals ingestion increased by Cu containing fertilizers, cooking in Cu utensils, RDA: 1.5-3mg Total body Cu-100mg Excretion: through bile Blood level- 100mcg/dl 90% is in cerulo plasmin, other 10%-90% in RBC, 10% bound to albumin

Absorption, transport, metabolism, excretion: : 

Absorption, transport, metabolism, excretion: Cu + albumin Cu + cuproenzymes & proteins Cu + albumin Cu+ histidine Organs & muscles Cu in ceruloplasmin (90%) liver SI

Functions : 

Functions 15 copper Connective tissue Lysyl oxidase Extra cellular matrix Cytochrome c oxidase Ferro oxidase Energy prodn Anti oxidant Ferrous to ferric Dopamine monooxygenase CNS Skin (melanin) Myelin sheath MAO (serotonin)

Abnormalities of Cu metabolism : 

Abnormalities of Cu metabolism Wilson’s Disease: copper binding ATPase is defective Cu not excreted from cells accumulation of Cu inside cells Cu deposits in liver and brain…. ceruloplasmin level also decreased Cu defeciency anemia: ceruloplasmin helps in iron transport Cu is a part of ALA synthase synthesis of heme Cu helps uptake of iron by Normoblasts In Cu deficiency  RBC count reduced

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3. Cardiovascular diseases: Lysyl oxidase contains copper Lysyl oxidase necessary for cross linking of elastin Cu deficiency abnormal elastin blood vessel walls weaken aneurysyms in aorta leads to aortic rupture 4. Menke’s kinky hair syndrome Deficiency of intracellular copper binding ATPase Copper not taken inside cells Defective cross linking of connective tissue

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5. Melanin Cu present in tyrosinase Tyrosinase needed for melanin production In Cu deficiency decreased melanin grey hair if deficiency is intermittent flag pattern of hair 6. Toxicity Diarrhea, blue-green saliva, hemolysis, hemoglaobinuria

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