A. IRON
o Present in proteins:
1. Hemoglobin 2. Transferrin
3. Ferritin – storage form of iron 4. Cytochrome oxidase
o Enhance absorption of 1. Vit C
2. Copper
o Most important element in engineering o Use: hematinic
o Toxicity:
1. GIT distress 2. Cardiac collapse o Antidote: Dexferroxamine
1. FeSO4 (Iron Sulfate, Copperas, Green Vitriol, Iron Vitriol) - Hematinic, SE: constipation, tarry stool
2. Ferrous gluconate - Fergon®, Advantage: less irritating
3. Ferrous fumarate - Toleron®
4. FeCO3 (Chalybeate pills, Ferruginous pills) - Hematinic
5. FeCl3 - Astringent, Styptic, tannin detection
6. Basham’s Mixture (Iron + NH4 acetate) - Astringent, Styptic 7. Fe4*Fe(CN)6+3 (Ferriferrocyanide or Prussian blue)
8. Fe3*Fe(CN)6+2 (Ferroferricyanide or Turnbull’s blue) B. COBALT
o Essential in development of erythrocyte and hemoglobin o Component of Vit. B12 (cyanocobalamin)
o Deficiency: Megaloblastic anemia and Pernicious anemia
1. CoCl2 Lover’s ink, sympathetic ink - dessicator indicator 2. Cobalt zincate Rinmann’s Green - test for Zn ion 3. Cobalt meta-aluminate Thenard’s blue - test for Al ion C. NICKEL (Old nick’s copper)
o Fossil fuel, fancy jewelries D. OSMIUM
o Heaviest/densest metal
1. Osmic acid and Osmium tetroxide
Both used in staining microorganism for microscopic study especially electron microscopy.
E. PLATINUM - Catalyst in finely divided steel F. PALLADIUM - Catalyst in finely divided steel
Metals present in cytochrome oxidase:
1. Fe 2. Cu
Iron toxicity: Hemochromatosis/Hemosiderosis (Prussian blue stain of the heart)
Schilling’s test
BUFFERS
o pair or related chemical compounds capable of resisting large change in the pH of a solution o composed of a weak acid & its salt (conjugate base) or a weak base & its salt (conjugate acid) Phosphate Buffer System
𝐷𝑖𝑦𝑑𝑟𝑜𝑔𝑒𝑛 + 𝑚𝑜𝑛𝑜𝑦𝑑𝑟𝑜𝑔𝑒𝑛 𝑝𝑜𝑠𝑝𝑎𝑡𝑒
D/A; insolubility of the phosphate salts of metals such as Ag, Zn, and Al and phosphate salt of growth
Sorensen Phosphate buffer system – for ophthalmic (isotonic with body fluids) Borate Buffer System
used in preparations containing metals that would otherwise precipitate in the presence of phosphate
CI in parenterals bec of toxicity of borates
3 Primary Borate Buffer System presently recognized:
1 Feldman’s Buffer System (pH 7-8.2) - boric acid + NaCl, sodium borate 2 Gifford Buffer System (6-7.8) - boric acid + KCl, sodium borate 3 Atkins and Pantin Buffer System (7.6-11) - boric acid + NaCl, sodium carbonate
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(a) Intracellular fluid (K, Mg, PO4) (b) Extracellular fluid: (Na, Cl)
interstitial fluid
plasma and vascular fluid
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Buffer systems that the body utilize:
1. Bicarbonate/Carbonic Acid (HCO3
-/H2Co3) - plasma and kidneys 2. Monohydrogen phosphate (HPO4
2-/H2PO4
-) - cells and kidneys 3. Hemoglobin and proteins - red blood cells Acidosis – below 7.38
Alkalosis – above 7.42
COMPENSATORY MECHANISM OF THE BODY
Conditions Causes Buffer System
Metabolic Acidosis HCO3 deficit (diabetic acidosis, diarrhea, renal failure) HCO3
-/H2Co3
Metabolic Alkalosis HCO3 excess (administration of excess alkali, vomiting) HCO3
-/H2Co3
Respiratory Acidosis H2Co3 excess (cardiac disease, lung damage, drowing) Hemoglobin and protein Respiratory Alkalosis H2CO3 deficit (fever, anoxia, hysteria, salicylate poisoning) HCO3
-/H2Co3
Metabolic acidosis – treated with the sodium salts of bicarbonate, lactate, acetate, and citrate
Metabolic alkalosis – treated with ammonium salts (action is in the kidneys where it retards the Na-hydrogen exchange)
Electrolyte Combination Therapy 1. Fluid Maintenance
to supply normal regrement for water and electrolytes to those who cannot take them orally
should contain at least 5% dextrose to minimize the build-up of metabolites associated with starvation (urea, phosphate and ketone bodies)
general electrolyte composition: Na, Cl, HCO3, Mg & P ions
2. Electrolyte Replacement
needed when there is a heavy loss of water and electrolyte
Official Combination Electrolyte Infusions
Ringer’s Injection – 8.6 g NaCl, 0.3 g KCl and 0.33 g Ca Chloride per liter
Lactated Ringer’s Injection – 600 mg NaCl, 30 mg KCl & 20 mg Ca and 310 mg Na lactate per 100 ml Oral electrolyte solutions – to supply water and electrolyte in amount needed for maintenance
– given to replace mild to moderate fluid loss
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ESSENTIAL AND TRACE IONS
Essential – not synthesized by the body and must be included in the diet
Trace – required for normal functioning but does not need to be included in the diet
Ions Principal Metabolic Functions Clinical Manifestations of Deficiency Iron (Fe2+ or Fe3+) Constituent of hemoglobin Anemia
Iodine (I-) Constituent of thyroxin and triiodothyronine Endemic (simple) goiter Cretinism
Cobalt (Co2+) Constituent of Vit. B12 (cyanocobalamin)
Deficiency of Vit. B12 Pernicious anemia Polycythemia Zinc (Zn2+) Constituent of insulin and carbonic anhydrase
Anemia
Stunted growth Hypogonadism Copper (Cu2+) Formation of hemoglobin (increases iron utilization)
Constituent of oxidase enzymes
Hypochromic anemia Wilson’s disease Sulfur (S2-) Constituent of proteins mucopolsaccharides,
heparin, biotin, detoxication
Cystinuria
Cystine renal calculi Iron – electron carrier in respiration chain; responsible for transport of molecular oxygen
Body Components Containing Iron
Occurrence Iron bound as Mode of Linkage Functions
Blood System 1 hemoglobin Heme Oxygen Transport
2 plasma Transferrin Iron Transport
Tissues 1 Functional Iron (myoglobin, cell hemes Heme Cell respiration
2 Storage Iron a. ferritin
b. hemosiderin Iron pool detoxication
GASTROINTESTINAL AGENTS
Inorganic agents used to treat gastrointestinal disorders include:
1 antacids - products for altering gastric pH 2 protectives for intestinal inflammation 3 adsorbents for intestinal toxins 4 cathartics or laxatives for constipation Stomach pH: 1 when empty to 7 when food is present
Gastritis – specified circumscribed erosion
Peptic ulcer or Esophageal ulcer (heartburn) occurs when the esophageal sphincter is defective due to gastric food entering the esophagus during a belch or upon lying in bed; emotional makeup is also a factor. Malignancy and hemorrhage are common with gastric ulcers. Perforation is more common with duodenal ulcers.
Antacids - alkaline bases used to neutralize the excess gastric HCl associated with gastritis and peptic ulcers a. should not be absorbable or cause systemic alkalosis
b. should not be a laxative or cause constipation
c. should exert the effect rapidly and over a long period of time d. reaction with gastric HCl should not cause a large evolution of gas e. should buffer in the pH 4-6 range
f. should probably inhibit pepsin
COMBINATION ANTACID PREPARATIONS
a. Aluminum Hydroxide Gel-Magnesium Hydroxide (Aludrox, Wingel, Maalox, Creamalin) b. Aluminum Hydroxide Gel-Magnesium Trisilicate (Gelusil, Tricreamalate, Triosgel) c. Magaldrate – Aluminum Hydroxide & Magnesium Hydroxide (Riopan)
d. Simethicone-Containing Antacids (Di-gel, Mylanta, Kremil-S) – simethicone - defoaming agent e. Aliginic Acid-Sodium Bicarbonate-Containing Antacids (Gaviscon, Fomtab)
PROTECTIVES AND ADSORBENTS – mild diarrhea
Diarrhea - when some factor impairs digestion and/or adsoprtion, thereby increasing bulk of intestinal tract Acute Diarrhea - caused by bacterial toxins, chemical poisons, drugs, allergy and disease
Chronic Diarrhea - from GI surgery, carcinomas, chronic inflammatory conditions & various adsorptive defects).
BISMUTH-CONTAINING PRODUCTS
intestinal hydrogen sulfate acts upon bismuth salts to form bismuth sulfate (result: black stools) SALINE CATHARTICS (purgatives)
o Laxatives – mild cathartics, prolonged use causes “Laxative habit”
1. Stimulant Laxatives – act by local irritation
2. Bulk-forming Laxatives – from cellulose and other non-digestible polysaccharides which swell when wet 3. Emollient Laxatives – lubricants or stool softeners (e.g. Mineral Oil)
4. Saline Cathartics – increase osmotic load of GI tract NON-OFFICIAL SALINE CATHARTICS
Sodium Sulfate (Glauber's Salt)
Potassium Phosphate (Dibasic Potassium Phosphate, Dipotassium Hydrogen Phosphate, DKP) Potassium Bitartrate (Cream of Tartar, Potassium Acid Tartrate, Potassium Hydrogen Tartrate) Calomel (Mercurous Chloride, Mild Mercury Chloride)
FLAME TEST
METALS Non-luminous flame Under cobalt glass
Sodium persistent golden yellow nil
Potassium violet crimson
Lithium carmine red purple
Calcium brick red light green
Strontium crimson purple
Barium yellowish green bluish-green
Borate, Cu, Tl, P green
Pb, As, Sb, Bi, Cu blue yellow
Ammonium colorless
GROUPS OF ANION
Group No. - Member Precipitate Formed and Visual Result
with 1 M AgNO3 + 6 M HNO3 with 1 M BaCl2 + HNO3
I – Cl, Br I AgCl *white+
AgBr *cream+
AgI *yellow+
insoluble in HNO3
No ppt
II – NO2
-, S-2, C2H3O4
-(acetate) AgS *black+
soluble in HNO3, NO2 and C2H3O2 *no ppt+
No ppt
III – SO3, CO3-2
, C2O4-2
White ppt soluble in HNO3 White ppt of BaSO4, CaSO4, BaC2O4
soluble in HNO3
IV – PO3-3
, AsO4-3
, CrO4-2
Ag3PO4 *yellow+
Ag3AsO4 *brown+
Ag2CrO4 *red+
all ppt soluble in HNO3
BaCrO4 *yellow+
Ba3(AsO4)2 *white+
all ppt soluble in HNO3
V – NO3
-, ClO- No ppt No ppt
VI – SO4-2
No ppt White ppt soluble in HNO3
GROUPS OF CATION