PHARMACOLOGY Lec 17 Dr.

Labeeb
Vitamins
‫اﻟﻔﯿﺘﺎﻣﯿﻨﺎت ﻣﻄﻠﻮﺑﺔ ﻟﻌﻤﻠﯿﺔ‬
‫اﻟﺘﻤﺜﯿﻞ اﻟﻐﺬاﺋﻲ اﻟﻄﺒﯿﻌﻲ‬
.‫ﻟﻠﺠﺴﻢ واﻟﻨﻤﻮ واﻟﺘﻄﻮر‬ Vitamins are required for normal body metabolism, growth,
‫إﻧﮭﺎ ﻣﻜﻮﻧﺎت أﻧﻈﻤﺔ اﻹﻧﺰﯾﻢ‬
‫اﻟﺘﻲ ﺗﻄﻠﻖ اﻟﻄﺎﻗﺔ ﻣﻦ‬
‫اﻟﺒﺮوﺗﯿﻨﺎت واﻟﺪھﻮن‬ development. They are components of enzyme systems that release
‫ ﻛﻤﺎ أﻧﮭﺎ‬.‫واﻟﻜﺮﺑﻮھﯿﺪرات‬
‫ﺿﺮورﯾﺔ ﻟﺘﻜﻮﯾﻦ ﺧﻼﯾﺎ اﻟﺪم‬
‫اﻟﺤﻤﺮاء واﻟﺨﻼﯾﺎ اﻟﻌﺼﺒﯿﺔ‬
‫واﻟﮭﺮﻣﻮﻧﺎت واﻟﻤﻮاد‬
energy from proteins, fats, and carbohydrates. They also required for
‫اﻟﻮراﺛﯿﺔ واﻟﻌﻈﺎم واﻷﻧﺴﺠﺔ‬
‫ وھﻲ ﻓﻌﺎﻟﺔ ﺑﻜﻤﯿﺎت‬.‫اﻷﺧﺮى‬
‫ﺻﻐﯿﺮة وﯾﺘﻢ اﻟﺤﺼﻮل ﻋﻠﯿﮭﺎ‬
formation of red blood cells, nerve cells, hormones, genetic materials,
‫ﺑﺸﻜﻞ أﺳﺎﺳﻲ ﻣﻦ اﻷطﻌﻤﺔ‬
.‫أو اﻟﻤﻜﻤﻼت اﻟﻐﺬاﺋﯿﺔ‬
bones, and other tissues. They are effective in small amounts and are
mainly obtained from foods or supplements.

Vitamins are usually classified as ‫ﻋﺎدة ﻣﺎ ﯾﺘﻢ ﺗﺼﻨﯿﻒ اﻟﻔﯿﺘﺎﻣﯿﻨﺎت ﻋﻠﻰ أﻧﮭﺎ‬
.(B complex ، C) ‫( وﻗﺎﺑﻞ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء‬A ، D ، E ، K) ‫ﻗﺎﺑﻞ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﺪھﻮن‬

fat soluble (A, D, E, K) and water soluble (B complex, C).

‫ﯾﺘﻢ اﻣﺘﺼﺎص اﻟﻔﯿﺘﺎﻣﯿﻨﺎت‬ Fat-soluble vitamins are absorbed

‫اﻟﺘﻲ ﺗﺬوب ﻓﻲ اﻟﺪھﻮن‬
‫ﻣﻦ اﻷﻣﻌﺎء ﻣﻊ اﻟﺪھﻮن‬
‫ واﻻﻣﺘﺼﺎص‬، ‫اﻟﻐﺬاﺋﯿﺔ‬ from the intestine with dietary fat, and absorption requires the presence
‫ﯾﺘﻄﻠﺐ وﺟﻮد أﻣﻼح‬
‫اﻟﺼﻔﺮاء واﻟﻠﯿﺒﺎز‬
‫ ھﺬه‬.‫اﻟﺒﻨﻜﺮﯾﺎس‬
‫اﻟﻔﯿﺘﺎﻣﯿﻨﺎت ﻣﺴﺘﻘﺮة ﻧﺴﺒﯿًﺎ‬
of bile salts and pancreatic lipase. These vitamins are relatively stable
‫ﻓﻲ اﻟﻄﮭﻲ‬
in cooking.

‫ﯾﺘﻢ اﻣﺘﺼﺎص اﻟﻔﯿﺘﺎﻣﯿﻨﺎت‬

‫اﻟﻘﺎﺑﻠﺔ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء‬ Water-soluble vitamins are readily absorbed but are also readily lost
‫ﻀﺎ‬
ً ‫ﺑﺴﮭﻮﻟﺔ وﻟﻜﻨﮭﺎ ﺗُﻔﻘﺪ أﯾ‬
‫ﺑﺴﮭﻮﻟﺔ ﻋﻦ طﺮﯾﻖ اﻟﻄﮭﻲ‬
‫واﻟﺘﺨﺰﯾﻦ‬ by cooking and storage.

‫ﯾﺠﺐ اﻟﺘﻌﺮف ﻋﻠﻰ‬

‫اﺿﻄﺮاﺑﺎت اﻟﻔﯿﺘﺎﻣﯿﻨﺎت ﻓﻲ‬
Vitamin disorders should be recognized as early as possible
‫أﻗﺮب وﻗﺖ ﻣﻤﻜﻦ‬
.‫وﺑﺪأ اﻟﻌﻼج اﻟﻤﻨﺎﺳﺐ‬
‫ﯾﻤﻜﻦ أن ﯾﻤﻨﻊ ﻋﻼج‬
and appropriate treatment initiated. Early recognition treatment can
‫اﻟﺘﻌﺮف اﻟﻤﺒﻜﺮ اﻟﻨﻘﺺ‬
‫اﻟﺨﻔﯿﻒ أو اﻟﺰاﺋﺪ ﻣﻦ أن‬
‫ﯾﺼﺒﺢ ﺷﺪﯾﺪًا‬ prevent a mild deficiency or excess from becoming severe.

I
 PHARMACOLOGY Lec 17 ‫ﺗﺘﻀﻤﻦ اﻹرﺷﺎدات اﻟﻌﺎﻣﺔ ﻟﻠﻌﻼج ﺑﺎﻟﻔﯿﺘﺎﻣﯿﻨﺎت ﻣﺎ ﯾﻠﻲ‬ Dr.Labeeb
General guidelines of vitamin therapy include
the following
‫ﻟﺤﺎﻻت اﻟﻨﻘﺺ ﯾﻔﻀﻞ‬-1
1-For deficiency states, oral vitamin preparations are preferred
‫ﻣﺴﺘﺤﻀﺮات اﻟﻔﯿﺘﺎﻣﯿﻨﺎت‬
‫ﻋﻦ طﺮﯾﻖ اﻟﻔﻢ‬
.‫ﻋﻨﺪﻣﺎ ﯾﻜﻮن ذﻟﻚ ﻣﻤﻜﻨﺎ‬ when possible. They are usually effective (exception alabsorption
‫ﻋﺎدة ﻣﺎ ﺗﻜﻮن ﻓﻌﺎﻟﺔ‬
‫)ﺑﺎﺳﺘﺜﻨﺎء ﻣﺘﻼزﻣﺎت‬
‫اﻻﺑﺘﺰاز( وآﻣﻨﺔ وﻣﺮﯾﺤﺔ‬ syndromes), safe, convenient to administer, and relatively inexpensive.
‫ﻟﻺﻋﻄﺎء وﻏﯿﺮ ﻣﻜﻠﻔﺔ‬
‫ اﻟﻨﻘﺺ اﻟﻤﺘﻌﺪد‬.‫ﻧﺴﺒﯿًﺎ‬
‫ وﻋﺎدة ﻣﺎ ﯾﺤﺘﻮي‬، ‫ﺷﺎﺋﻊ‬
‫اﻟﻤﺴﺘﺤﻀﺮ ﻣﺘﻌﺪد‬
Multiple deficiencies are common, and multivitamin preparation used
‫اﻟﻔﯿﺘﺎﻣﯿﻨﺎت اﻟﻤﺴﺘﺨﺪم ﻋﻠﻰ‬
‫أﻛﺜﺮ ﻣﻦ اﻟﻜﻤﯿﺔ اﻟﯿﻮﻣﯿﺔ‬
.‫اﻟﻤﻮﺻﻰ ﺑﮭﺎ‬
usually contains more than the recommended daily amount.
‫ ﻟﻠﺤﺎﻻت اﻟﺰاﺋﺪة‬-2
‫اﻟﻌﻼج اﻟﻤﻌﺘﺎد ھﻮ اﻟﺘﻮﻗﻒ‬
‫ﻋﻦ ﺗﻨﺎول اﻟﺪواء‬ 2- For excess states, the usual treatment is to stop administration
.‫ﻣﻦ إﻋﺪاد ﻓﯿﺘﺎﻣﯿﻦ‬

of the vitamin preparation.

‫اﺿﻄﺮاﺑﺎت ﻓﯿﺘﺎﻣﯿﻦ أ اﻟﻘﺎﺑﻞ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﺪھﻮن‬

Disorders of Fat-Soluble Vitamin A

With vitamin A deficiency, increase intake of foods containing
، ‫ﻣﻊ ﻧﻘﺺ ﻓﯿﺘﺎﻣﯿﻦ أ‬
‫ﯾﺠﺐ زﯾﺎدة ﺗﻨﺎول اﻷطﻌﻤﺔ اﻟﺘﻲ‬
‫ﺗﺤﺘﻮي ﻋﻠﻰ ﻓﯿﺘﺎﻣﯿﻦ أ أو ﺑﯿﺘﺎ‬ vitamin A or beta carotene. Use a single, pure form of vitamin A rather
‫ﺷﻜﻼ واﺣﺪًا‬ً ‫ اﺳﺘﺨﺪم‬.‫ﻛﺎروﺗﯿﻦ‬
‫ﻧﻘﯿًﺎ ﻣﻦ ﻓﯿﺘﺎﻣﯿﻦ أ ﺑﺪﻻً ﻣﻦ‬
‫ ﻣﺎ ﻟﻢ‬، ‫اﻟﻔﯿﺘﺎﻣﯿﻨﺎت اﻟﻤﺘﻌﺪدة‬
.‫ﺗﻜﻦ ھﻨﺎك أوﺟﮫ ﻧﻘﺺ ﻣﺘﻌﺪدة‬
than a multivitamin, unless multiple deficiencies are present. Give
‫اﻋﻄﺎء ﺟﺮﻋﺎت ﻻ ﺗﺰﯾﺪ ﻋﻦ‬
‫ وﺣﺪة ﯾﻮﻣﯿﺎ ﻣﺎ ﻟﻢ‬25000
‫ ﺗﻌﻄﻲ‬.‫ﯾﻜﻦ ھﻨﺎك ﻧﻘﺺ ﺷﺪﯾﺪ‬
doses no larger than 25,000 U daily unless a severe deficiency is
‫ﺷﻔﻮﯾﺎ إذا ﻟﻢ ﯾﻜﻦ ﺑﻄﻼن ؛‬
‫ﯾﻌﻄﻰ ﻋﻦ طﺮﯾﻖ اﻟﺤﻘﻦ‬
‫اﻟﻌﻀﻠﻲ إذا ﻛﺎن اﻣﺘﺼﺎص‬ present. Give orally if not contraindicated; give intramuscularly if
‫( اﻟﺠﮭﺎز اﻟﮭﻀﻤﻲ‬GI) ‫ﺿﻌﯿﻔًﺎ‬
‫ﺑﺸﺪة أو ﻛﺎﻧﺖ اﻷﻋﺮاض‬
‫ ﻣﻊ زﯾﺎدة‬.‫اﻟﻌﯿﻨﯿﺔ ﺷﺪﯾﺪة‬ gastrointestinal (GI) absorption is severely impaired or ocular
‫ ﺗﻮﻗﻒ ﻓﻮ ًرا ﻋﻦ‬، ‫ﻓﯿﺘﺎﻣﯿﻦ أ‬
‫اﻟﻤﺼﺎدر اﻟﻤﻌﺮوﻓﺔ ﻟﻠﻔﯿﺘﺎﻣﯿﻦ‬
symptoms are severe. With vitamin A excess, immediately stop known
sources of the vitamin.
‫اﺿﻄﺮاﺑﺎت ﻓﯿﺘﺎﻣﯿﻦ أ اﻟﻘﺎﺑﻞ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﺪھﻮن‬

Disorders of Fat-Soluble Vitamin K

‫ ﻗﺪ‬، ‫ﻣﻊ ﻧﻘﺺ ﻓﯿﺘﺎﻣﯿﻦ ك‬ With vitamin K deficiency, bleeding may occur spontaneously
‫ﯾﺤﺪث ﻧﺰﯾﻒ ﺑﺸﻜﻞ ﻋﻔﻮي‬
.‫أو ردا ﻋﻠﻰ اﻟﺼﺪﻣﺔ‬
‫ ﯾﺸﺎر إﻟﻰ إﻋﻄﺎء‬، ‫وﺑﺎﻟﺘﺎﻟﻲ‬ or in response to trauma. Thus, administration of vitamin K and
‫ﻓﯿﺘﺎﻣﯿﻦ ك واﺗﺨﺎذ ﺗﺪاﺑﯿﺮ ﻟﻤﻨﻊ‬
‫ إذا ﻟﻢ ﯾﻜﻦ اﻟﻨﻘﺺ‬.‫اﻟﻨﺰﯾﻒ‬
‫ ﯾﻤﻜﻦ إﻋﻄﺎء ﻓﯿﺘﺎﻣﯿﻦ‬، ‫ﺷﺪﯾﺪًا‬
‫ك ﻋﻦ طﺮﯾﻖ اﻟﻔﻢ ﻟﺒﻀﻌﺔ أﯾﺎم‬
measures to prevent bleeding are indicated. If the deficiency is not
‫ﺣﺘﻰ ﯾﻌﻮد ﻧﺸﺎط اﻟﺒﺮوﺛﺮوﻣﺒﯿﻦ‬
.‫ﻓﻲ اﻟﺪم إﻟﻰ اﻟﻤﻌﺪل اﻟﻄﺒﯿﻌﻲ‬
‫ ﯾﻤﻜﻦ‬، ‫ﻓﻲ ﺣﺎﻟﺔ اﻟﻨﺰﯾﻒ اﻟﺤﺎد‬
severe, oral vitamin K may be given for a few days until serum
‫إﻋﻄﺎء ﻓﯿﺘﺎﻣﯿﻦ ك ﻋﻦ طﺮﯾﻖ‬
‫اﻟﻮرﯾﺪ‬
prothrombin activity returns to a normal range.. In severe bleeding
may be given intravenously

II
 PHARMACOLOGY Lec 17 ‫اﺿﻄﺮاﺑﺎت ﻓﯿﺘﺎﻣﯿﻨﺎت ب اﻟﻤﻌﻘﺪة‬ Dr.Labeeb
Disorders of B-Complex Vitamins
Most deficiencies of B-complex vitamins are multiple
‫ﻣﻌﻈﻢ أوﺟﮫ اﻟﻘﺼﻮر ﻓﻲ‬ rather than single If a single deficiency seems predominant, that
‫ﻓﯿﺘﺎﻣﯿﻨﺎت ب اﻟﻤﺮﻛﺐ ﻣﺘﻌﺪدة‬
‫ﺑﺪﻻً ﻣﻦ واﺣﺪة‬
‫ﯾﻤﻜﻦ إﻋﻄﺎء ﻓﯿﺘﺎﻣﯿﻦ ﺑﻤﻔﺮده‬
‫أو ﻣﻊ ﻣﺴﺘﺤﻀﺮ ﻣﺘﻌﺪد‬
vitamin may be given alone or along with a multivitamin preparation.
‫ ﻧﻘﺺ اﻟﺜﯿﺎﻣﯿﻦ‬.‫اﻟﻔﯿﺘﺎﻣﯿﻨﺎت‬
.‫ﺷﺎﺋﻊ ﻓﻲ ﻣﺪﻣﻨﻲ اﻟﻜﺤﻮل‬
‫ﺗﺸﻤﻞ اﻷﺳﺒﺎب ﻋﺪم ﻛﻔﺎﯾﺔ‬
Thiamine deficiency is common in alcoholics. Reasons include
‫ ﯾﺤﺪث ﻧﻮع‬، ‫اﻟﻤﺪﺧﻮل اﻟﻐﺬاﺋﻲ‬
‫واﺣﺪ ﻣﻊ ﻧﻘﺺ اﻟﺒﯿﺮﯾﺪوﻛﺴﯿﻦ‬
‫وﯾﺘﻢ ﺗﺨﻔﯿﻔﮫ ﻋﻦ طﺮﯾﻖ إﻋﻄﺎء‬ inadequate dietary intake , One type occurs with pyridoxine deficiency
.‫اﻟﺒﯿﺮﯾﺪوﻛﺴﯿﻦ‬

and is relieved by administration of pyridoxine.

، ‫ﻓﻘﺮ اﻟﺪم اﻟﻀﺨﻢ اﻷروﻣﺎت‬
‫اﻟﺬي ﯾﺘﻤﯿﺰ ﺑﻮﺟﻮد ﺧﻼﯾﺎ دم‬
، ‫ﺣﻤﺮاء ﻛﺒﯿﺮة وﻏﯿﺮ ﻧﺎﺿﺠﺔ‬
‫ﯾﺤﺪث ﻣﻊ ﻧﻘﺺ ﺣﻤﺾ اﻟﻔﻮﻟﯿﻚ‬
Megaloblastic anemia's, characterized by abnormally large, immature
‫ إذا ﻛﺎن‬.12 ‫أو ﻓﯿﺘﺎﻣﯿﻦ ب‬
‫ﻓﻘﺮ اﻟﺪم اﻟﻀﺨﻢ اﻷروﻣﺎت‬
‫ ﻓﻌﺎدة ﻣﺎ ﯾﺘﻢ اﻟﺒﺪء ﻓﻲ‬، ‫ﺷﺪﯾﺪًا‬
red blood cells, occur with deficiency of folic acid or vitamin B12. If
‫اﻟﻌﻼج ﺑﺎﺳﺘﺨﺪام ﺣﻤﺾ‬
‫ ﻓﻲ‬.12 ‫اﻟﻔﻮﻟﯿﻚ وﻓﯿﺘﺎﻣﯿﻦ ب‬
‫ ﯾﺠﺐ‬، ‫ﺣﺎﻻت ﻓﻘﺮ اﻟﺪم اﻟﺨﺒﯿﺚ‬ megaloblastic anemia is severe, treatment is usually instituted with both
‫ ﻋﻦ‬12 ‫إﻋﻄﺎء ﻓﯿﺘﺎﻣﯿﻦ ب‬
‫طﺮﯾﻖ اﻟﺤﻘﻦ ﻷن اﻷﺷﻜﺎل‬
‫اﻟﻔﻤﻮﯾﺔ ﻻ ﯾﺘﻢ اﻣﺘﺼﺎﺻﮭﺎ ﻣﻦ‬ folic acid and vitamin B12. In pernicious anemia, vitamin B12 must be
.‫اﻟﺠﮭﺎز اﻟﮭﻀﻤﻲ‬

given by injection because oral forms are not absorbed from the GI
tract. ‫اﺿﻄﺮاﺑﺎت ﻓﯿﺘﺎﻣﯿﻦ ﺳﻲ‬

Disorders of Vitamin C
‫ﯾﺘﻀﻤﻦ ﻋﻼج ﻧﻘﺺ‬ Treatment of vitamin C deficiency involves increased intake
‫ﻓﯿﺘﺎﻣﯿﻦ ج زﯾﺎدة ﺗﻨﺎول‬
‫ﻓﯿﺘﺎﻣﯿﻦ ج ﻣﻦ اﻟﻤﺼﺎدر‬
.‫اﻟﻐﺬاﺋﯿﺔ أو اﻟﺼﯿﺪﻻﻧﯿﺔ‬ of vitamin C from dietary or pharmaceutical sources. Vitamin
‫ﯾﺘﻮﻓﺮ ﻓﯿﺘﺎﻣﯿﻦ ج ﺑﻤﻔﺮده‬
‫ﻟﻺﻋﻄﺎء ﻋﻦ طﺮﯾﻖ اﻟﻔﻢ أو‬
‫( أو ﻋﻦ‬IM) ‫اﻟﻌﻀﻞ‬
‫ ﻛﻤﺎ أﻧﮫ‬.‫طﺮﯾﻖ اﻟﻮرﯾﺪ‬
C is available alone for oral, intramuscular (IM), or IV
‫ﻋﻨﺼﺮ ﻓﻲ ﻣﻌﻈﻢ‬
‫ﻣﺴﺘﺤﻀﺮات اﻟﻔﯿﺘﺎﻣﯿﻨﺎت‬
‫ﻟﻼﺳﺘﺨﺪام اﻟﻔﻤﻮي أو‬
administration. It is also an ingredient in most multivitamin
‫ﺑﺎﻟﺤﻘﻦ‬

preparations for oral or parenteral use

‫اﺳﺘﺨﺪام اﻟﻔﯿﺘﺎﻣﯿﻨﺎت ﻋﻨﺪ ﻛﺒﺎر اﻟﺴﻦ‬

Use of vitamins in Older Adults

‫ﻣﺘﻄﻠﺒﺎت اﻟﻔﯿﺘﺎﻣﯿﻨﺎت ھﻲ‬
‫ﻧﻔﺴﮭﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺒﺎﻟﻐﯿﻦ‬ Vitamin requirements are the same as for younger adults. However,
، ‫ وﻣﻊ ذﻟﻚ‬.‫اﻷﺻﻐﺮ ﺳﻨًﺎ‬
‫ﻓﺈن اﻟﻨﻘﺺ ﺷﺎﺋﻊ ﻋﻨﺪ ﻛﺒﺎر‬
‫ وﺧﺎﺻﺔ اﻟﻔﯿﺘﺎﻣﯿﻨﺎت‬، ‫اﻟﺴﻦ‬ deficiencies are common in older adults, especially of vitamins A and
،D‫و‬A
‫واﻟﺴﯿﺎﻧﻮﻛﻮﺑﺎﻻﻣﯿﻦ‬
‫ وﺣﻤﺾ‬، (B12)
، ‫ واﻟﺮﯾﺒﻮﻓﻼﻓﯿﻦ‬، ‫اﻟﻔﻮﻟﯿﻚ‬
D, cyanocobalamin (B12), folic acid, riboflavin,
‫ ﻣﻊ ﻓﯿﺘﺎﻣﯿﻦ ب‬.‫واﻟﺜﯿﺎﻣﯿﻦ‬
، ‫ ﻋﻠﻰ ﺳﺒﯿﻞ اﻟﻤﺜﺎل‬، 12
‫ﯾُﻘﺪر أن ﻛﺒﺎر اﻟﺴﻦ‬
and thiamine. With vitamin B12, for example, it is estimated that older
٪30 ‫ إﻟﻰ‬٪10 ‫ﯾﻤﺘﺼﻮن‬
‫ﻓﻘﻂ ﻣﻦ اﻟﻜﻤﯿﺔ اﻟﻤﻮﺟﻮدة‬
‫ﻓﻲ اﻟﻄﻌﺎم‬ adults absorb only 10% to 30% of the amount found in food.

III
 PHARMACOLOGY Lec 17 Dr.Labeeb
‫اﻟﻤﻌﺎدن واﻹﻟﻜﺘﺮوﻟﯿﺘﺎت‬

Minerals and Electrolytes

‫اﻟﻤﻌﺎدن واﻹﻟﻜﺘﺮوﻟﯿﺘﺎت ھﻲ‬ Minerals and electrolytes are essential constituents of bone, teeth, cell
‫ﻣﻜﻮﻧﺎت أﺳﺎﺳﯿﺔ ﻟﻠﻌﻈﺎم‬
‫واﻷﺳﻨﺎن وأﻏﺸﯿﺔ اﻟﺨﻼﯾﺎ‬
‫واﻟﻨﺴﯿﺞ اﻟﻀﺎم واﻟﻌﺪﯾﺪ ﻣﻦ‬
‫ ﺗﻌﻤﻞ‬.‫اﻹﻧﺰﯾﻤﺎت اﻷﺳﺎﺳﯿﺔ‬
membranes, connective tissue, and many essential enzymes. They
‫ﻋﻠﻰ اﻟﺤﻔﺎظ ﻋﻠﻰ ﺗﻮازن‬
‫اﻟﺴﻮاﺋﻞ واﻟﻜﮭﺎرل وﺗﻮازن‬
‫اﻟﻘﺎﻋﺪة اﻟﺤﻤﻀﯿﺔ ؛ اﻟﺤﻔﺎظ‬
function to maintain fluid, electrolyte, and acid base balance; maintain
‫ﻋﻠﻰ اﻟﻀﻐﻂ اﻻﺳﻤﻮزي‬
‫اﻟﺤﻔﺎظ ﻋﻠﻰ وظﯿﻔﺔ‬
.‫اﻷﻋﺼﺎب واﻟﻌﻀﻼت‬ osmotic pressure; maintain nerve and muscle function; assist in transfer
‫ﺗﺴﺎﻋﺪ ﻓﻲ ﻧﻘﻞ اﻟﻤﺮﻛﺒﺎت‬
‫ﻋﺒﺮ أﻏﺸﯿﺔ اﻟﺨﻼﯾﺎ ؛‬
.‫واﻟﺘﺄﺛﯿﺮ ﻋﻠﻰ ﻋﻤﻠﯿﺔ اﻟﻨﻤﻮ‬ of compounds across cell membranes; and influence the growth
process.

‫اﻟﻤﻐﺬﯾﺎت اﻟﻜﺒﯿﺮة اﻟﻤﻘﺪار‬

Macronutrients
Some minerals (calcium, phosphorus, sodium, potassium,
، ‫ﺑﻌﺾ اﻟﻤﻌﺎدن )ﻛﺎﻟﺴﯿﻮم‬
، ‫ ﺻﻮدﯾﻮم‬، ‫ﻓﺴﻔﻮر‬
، ‫ﺑﻮﺗﺎﺳﯿﻮم‬ magnesium, chlorine, sulfur) are required in relatively large amounts
‫اﻟﻤﻐﻨﯿﺴﯿﻮم واﻟﻜﻠﻮر‬
‫واﻟﻜﺒﺮﯾﺖ( ﻣﻄﻠﻮﺑﺔ ﺑﻜﻤﯿﺎت‬
100 <) ‫ﻛﺒﯿﺮة ﻧﺴﺒﯿًﺎ‬
‫ﻣﺠﻢ( وﺑﺎﻟﺘﺎﻟﻲ ﺗﺴﻤﻰ أﺣﯿﺎﻧًﺎ‬
(>100 mg) and thus are sometimes called macronutrients
‫اﻟﻤﻐﺬﯾﺎت اﻟﻜﺒﯿﺮة أو اﻟﻌﻨﺎﺻﺮ‬
‫ اﻟﻌﻨﺎﺻﺮ اﻟﻨﺰرة‬.‫اﻟﻨﺰرة‬
‫)اﻟﻜﺮوم واﻟﻜﻮﺑﺎﻟﺖ واﻟﻨﺤﺎس‬
Micronutrients or trace elements. trace elements (chromium, cobalt,
‫واﻟﻔﻠﻮراﯾﺪ واﻟﯿﻮد واﻟﺤﺪﯾﺪ‬
(‫واﻟﺴﯿﻠﯿﻨﯿﻮم واﻟﺰﻧﻚ‬
copper, fluoride, iodine ,iron, selenium, and zinc)
‫ﻣﺒﺎدئ اﻟﻌﻼج‬
‫ﻋﻨﺪﻣﺎ ﯾﺘﻢ إﻋﻄﺎء ﻣﻌﺪن‬ Principles Of Therapy
، ‫ﻟﺘﺼﺤﯿﺢ ﺣﺎﻟﺔ اﻟﻨﻘﺺ‬
‫ھﻨﺎك‬
.‫ﺧﻄﺮ إﻧﺘﺎج ﺣﺎﻟﺔ ﻓﺎﺋﻀﺔ‬ When a mineral is given to correct a deficiency state, there is
‫ﻷن ﻛﻼً ﻣﻦ ﺣﺎﻻت اﻟﻨﻘﺺ‬
، ‫واﻟﺰﯾﺎدة ﻗﺪ ﺗﻜﻮن ﺿﺎرة‬
‫ﻓﺈن ﻛﻤﯿﺔ اﻟﻤﻜﻤﻼت اﻟﻤﻌﺪﻧﯿﺔ‬
‫ﯾﺠﺐ ﻣﻌﺎﯾﺮﺗﮭﺎ ﺑﺸﻜﻞ وﺛﯿﻖ‬
a risk of producing an excess state. Because both deficiency and excess
‫ﻣﻊ اﻟﻜﻤﯿﺔ اﻟﺘﻲ ﯾﺤﺘﺎﺟﮭﺎ‬
‫اﻟﺠﺴﻢ‬
states may be harmful, the amount of mineral supplement
should be titrated closely to the amount needed by the body.

‫اﺧﺘﯿﺎر اﻟﺪواء‬

Drug Selection
‫ﯾﻔﻀﻞ اﻟﻤﺴﺘﺤﻀﺮات‬
‫اﻟﺪواﺋﯿﺔ اﻟﺘﻲ ﺗﺆﺧﺬ ﻋﻦ‬
Oral drug preparations are preferred, when feasible, for preventing
‫ ﻋﻨﺪﻣﺎ‬، ‫طﺮﯾﻖ اﻟﻔﻢ‬
، ً ‫ﯾﻜﻮن ذﻟﻚ ﻣﻤﻜﻨﺎ‬
‫ﻟﻠﻮﻗﺎﯾﺔ ﻣﻦ اﻻﺿﻄﺮاﺑﺎت‬
or treating mineral disorders. They are safer, less likely to produce
.‫اﻟﻤﻌﺪﻧﯿﺔ أو ﻋﻼﺟﮭﺎ‬
‫ وأﻗﻞ‬، ‫ﻓﮭﻲ أﻛﺜﺮ أﻣﺎﻧًﺎ‬
‫ وأﻛﺜﺮ‬، ‫ﻋﺮﺿﺔ ﻟﻠﺘﺴﻤﻢ‬ toxicity, more convenient to administer, and less expensive than
‫ وأﻗﻞ‬، ‫ﻣﻼءﻣﺔ ﻟﻺدارة‬
‫ﺗﻜﻠﻔﺔ ﻣﻦ اﻟﺘﺤﻀﯿﺮ‬
‫ﺑﺎﻟﺤﻘﻦ‬ parenteral preparation

IV