Transcript Chapter 23 The Gastrointestinal System

The Pharmacy Technician
FOUNDATIONS AND PRACTICES
Chapter 23
The Gastrointestinal
System
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Figure 23.1
The digestive system.
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Main Organs of the Digestive System
• Mouth
• Esophagus
• Pharynx
• Stomach
• Small intestine
• Large intestine
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Accessory Organs of the Digestive
System
• Teeth
• Tongue
• Salivary glands
• Liver
• Gallbladder
• Pancreas
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
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Physiology of the Digestive System
• A series of hollow organs connected in a
•
•
long tube
Extends from the mouth to the anus
Lined with protective mucosa that prevents
acid from causing sores or ulcers
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Physiology of the Digestive System
(cont.)
• In the mouth, stomach, and small
•
intestine, the mucosa also contains tiny
glands that produce the liquid digestive
juices that help digest food
Other organs, such as the liver and
pancreas, also produce products that aid
in digestion
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
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Three Categories of Nutrients
• Macronutrients—nutrients that the body
requires in larger quantities
– Carbohydrates
– Proteins
– Fats (lipids)
• Micronutrients—nutrients that the body
requires in small quantities
– Vitamins
– Minerals
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Three Categories of Nutrients (cont.)
• Water—an indispensable component of
the body
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
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Carbohydrates
• Break down into monosaccharides during
•
•
•
digestion
Provide immediate energy
Most readily available sources of food
energy
AMDR for carbohydrates—45 to 65
percent of daily caloric intake
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Proteins
• Break down into amino acids during
•
digestion
The body uses amino acids to make and
repair:
– Body cells
– Tissues
– Muscle
• AMDR for protein—10 to 35 percent of
daily caloric intake
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Fats (Lipids)
• Break down into fatty acids and glycerol
• The body uses fats or lipids to:
–
–
–
–
Provide lubrication
Store fat as an energy reserve
Store fat as insulation to provide warmth
Provide a cushion that act as a shock
absorber to protect vital organs
– Help metabolize carbohydrates and proteins
more efficiently
– Carry fat-soluble vitamins A, D, E, K
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Fats (Lipids) (cont.)
• AMDR for fats—20 to 35 percent of daily
•
caloric intake
Not more than 10 percent of calorie intake
should be saturated fat
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Amino Acids
• The body can produce 11 types of amino
•
acids, referred to as nonessential
There are 9 types of amino acids that the
body requires, but cannot produce
– These are referred to as essential amino
acids
• Essential amino acids have to be derived
from food intake
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Table 23.9
Essential and Nonessential Amino Acids
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
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Vitamin A (Retinol)
• Helps with eyesight and epithelial cells
•
and tissues (skin cells)
Deficiencies in vitamin A may cause:
– Night blindness
– Xerosis (dryness) of the conjunctiva and
cornea
– Xerophthalmia and keratomalacia
– Keratinization of lung, GI tract, and urinary
tract
– Increased susceptibility to infections
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Vitamin A (Retinol) (cont.)
• DRI is 900 µg/day for males and 700
µg/day for females
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
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Vitamin D
• Helps with the absorption of calcium from
•
the intestine to make stronger bones and
teeth
Deficiency causes metabolic bone
softening:
– Called rickets in children
– Called osteomalacia in adults
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
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Vitamin D (cont.)
• DRI is 5 µg/day (ages 19–50) for both
•
males and females
DRI is 10 µg/day (ages 51–70) for both
males and females
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Vitamin E
• A strong antioxidant for lipids
• Deficiency is generally caused by
malabsorption rather than lack of ingestion
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Vitamin E (cont.)
• Vitamin E deficiency may cause:
– Disorders of the reproductive system
– Abnormalities of muscle, liver, and bone
marrow
– Hemolysis of RBCs
– Defective embryo genesis
– Brain dysfunction
– A disorder of capillary permeability
• DRI is 15 mg/day for both males and
females
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Vitamin K
• Necessary for blood coagulation
• Controls formation of coagulation factors
•
•
•
•
II, VII, IX, and X in the liver
Also needed for calcium uptake in bones
Can be used as an antidote for coumadin
overdoses
Deficiency is rare
DRI is 120 µg/day for males and 90
µg/day for females
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B1 (thiamine)
• Necessary for carbohydrate metabolism
• Deficiency causes the disease beriberi
– Affects the peripheral neurologic, cerebral,
cardiovascular, and GI systems
• DRI is 1.2 mg/day for males and 1.1
mg/day for females
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B2 (riboflavin)
• Necessary for the health of the mucous
•
membranes in the digestive tract
Aids absorption of iron and vitamin B6
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Vitamin B2 (riboflavin) (cont.)
• Deficiency leads to:
–
–
–
–
–
–
–
–
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Oral, eye, skin, and genital lesions
Dizziness
Hair loss
Insomnia
Light sensitivity
Poor digestion
Retarded growth
Slow mental responses
Burning feet
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Vitamin B2 (riboflavin) (cont.)
• DRI is 1.3 mg/day for males and 1.1
mg/day for females
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Vitamin B3 (niacin)
• Important in oxidation-reduction reactions
• Vital in protein metabolism
• Deficiency leads to the disease pellagra:
– Affects skin, mucous membranes, GI, and
brain/CNS systems
– Causes photosensitive rash, scarlet
stomatitis, glossitis, diarrhea, and mental
aberrations
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Vitamin B3 (niacin) (cont.)
• Deficiency found in diets high in corn
• DRI is 16 mg/day for males and 14 mg/day
for females
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B5 (pantothenic acid)
• Important for secretion of hormones such
•
•
as cortisone
Important for maintenance of healthy skin,
muscles, and nerves
B5 deficiency extremely rare
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Vitamin B5 (pantothenic acid) (cont.)
• Symptoms of B5 deficiency include:
–
–
–
–
–
Insomnia
Depression
Nausea
Headache
Muscle spasm
• DRI is 5 mg/day for both males and
females
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B6 (pyridoxine)
• Needed for:
–
–
–
–
–
–
Red blood cell formation
Antibody production
Cell respiration
Cell growth
Conversion of tryptophan to niacin
Helps convert stored carbohydrate to glucose
to maintain normal blood sugar levels
– Synthesis of neurotransmitters such as
serotonin and dopamine
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B6 (pyridoxine) (cont.)
• Deficiency can cause:
–
–
–
–
Anemia similar to iron-deficiency anemia
Decreased antibody production
Suppressed immune response
Symptoms such as dermatitis, a sore tongue,
depression, confusion, and convulsions
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B6 (pyridoxine) (cont.)
• DRI is:
– 1.3 mg/day for males and females aged 19 to
50
– 1.7 mg/day males and 1.5 mg/day for females
over the age of 51
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B9 (folic acid)
• Important for:
–
–
–
–
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–
Energy production
Formation of red blood cells
Strengthening immune system
Promoting healthy cell division and replication
Protein metabolism
Preventing depression and anxiety
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B9 (folic acid) (cont.)
• Deficiency can be serious and may result
in:
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–
–
–
–
–
Anemia
Apathy
Digestive disturbances
Fatigue
Growth impairment
Insomnia
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B9 (folic acid) (cont.)
• Deficiency can be serious and may result
in:
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–
–
–
Labored breathing
Memory problems
Paranoia
Weakness
• DRI is 400 µg/day for both males and
females
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B12 (cyanocobalamin)
• Needed for healthy nerve cells, to make
•
•
DNA, and for the formation of RBCs
Deficiency leads to irreversible nerve
damage
Signs and symptoms include:
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B12 (cyanocobalamin) (cont.)
• Signs and symptoms include:
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–
–
–
–
–
–
fatigue
weakness
nausea
constipation
flatulence
loss of appetite
weight loss
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B12 (cyanocobalamin) (cont.)
• Signs and symptoms include:
–
–
–
–
–
difficulty in maintaining balance
depression
confusion
poor memory
soreness of the mouth or tongue
• DRI is 2.4 µg/day for both males and
females
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin C (ascorbic acid)
• Antioxidant
• Essential for collagen formation
• Maintains integrity of connective tissue,
•
•
bone, and teeth
Important for wound healing and recovery
from burns
Helps the absorption of iron
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin C (ascorbic acid) (cont.)
• Severe deficiency results in scurvy:
– Characterized by general weakness, bleeding
gums, anemia, and skin bleeding
• The DRI is 90 mg/day for males and 75
mg/day for females
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Water
• 60% of an adult’s body weight is water
• Forms a major portion of every tissue
• Provides the medium in which most of the
•
•
•
body’s activities are conducted
Facilitates many of the metabolic reactions
that occur in the body
Helps transport vital materials to the cells
Vehicle in which glycogen is transported
into muscle cells
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.