An overdose of vitamins
Vitamins And Dietary Supplements / / August 12, 2017
Poisoning by drugs
Most vitamins has a low acute toxicity and is generally well tolerated, even in excessive doses.However, there may be cases of toxic manifestations of chronic administration of vitamins (2-4 weeks or more) associated with the violation of the balance of vitamins and the development of allergic reactions.Of interest side reactions occur after a single dose of water-soluble vitamins, associated with heightened individual sensitivity.
Water-soluble vitamins Vitamin B1
Thiamine (vitamin B1) may cause allergic reactions up to anaphylactic shock both single and repeated administration.Therefore the intravenous administration of thiamine prohibited.The main symptoms are: fever, followed by a burning sensation, paresthesia (numbness and burning sensation) in the extremities, often across the surface of the body, swelling of body parts, sharp pain in the epigastric region, squeezing pain in the heart, severe headache with no loss of consciousness.When significant reaction: cyanosis, con
Treatment Resuscitation guidelines when collaptoid reactions and anaphylactic shock.
Nicotinamide (niacin, vitamin PP).Upon receipt of 1-1.5 grams per day can be marked by pronounced skin reactions, pain in the epigastric region, hyperglycemia and glucosuria, increased frequency of angina attacks.Chronic administration of vitamin E may reduce the lipotropic effect of other medicines used to treat liver disease.Against the background of long-term use are exacerbated symptoms of angina, chronic gastritis and peptic ulcer disease.
treatment - removal of the drug.
pyridoxine (vitamin B6).Described rare cases of anaphylactic shock after a single administration of a therapeutic dose (2.5% - 1 ml intramuscularly) with a sharp drop in blood pressure, swelling of the eyelids and lips, the advent of multiple blisters on the skin of the abdomen, chest, involuntary discharge of urine and feces.
Treatment - urgently introduced 2 ml kordiamina and camphor, 1 ml of 0.05% strofantina solution, 20 ml of 40% glucose intravenously;ephedrine 5% - 1 ml subcutaneously;Promethazine - 2.5% 1 mL intramuscularly.Warming the victim, humidified oxygen supply.
pangamat calcium (vitamin B15).Adverse reactions observed during chronic administration (16 days) the therapeutic dose (0.05 g, 3 times a day).Irritability, insomnia, gait disorders, the appearance of significant edema in the feet and legs, rash, tremor of the fingers.
treatment - removal of the drug.
Ascorbic acid (vitamin C).Side effects occur only when very large doses (1-1.5 g) and are expressed in insomnia, hot flashes and headaches, increased blood pressure.There was also an excessive formation of glucose and estrogen, lengthening the time of blood clotting, excessive formation of oxalic acid.
treatment - removal of the drug.
Cyanocobalamin (Vitamin B12) described isolated cases of anaphylactic shock.The doses that cause allergic reactions, ranging from 10 to 200 micrograms (0,00001-0,0002 g).Fat-soluble vitamins
Most water-soluble vitamins do not have material cumulation and does not accumulate in the body.Accumulation and related chronic toxicity up to the development of acute poisoning pictures marked only in fat-soluble vitamins: retinol (vitamin A) and calciferol (vitamin D).
Retinol (vitamin A).The picture of acute poisoning is marked with a single dose of pure vitamin at a dose equal to 1000000 ME (infants under 370000 ME and more) and by eating 100-150 grams of liver of polar animals and birds, differ very high in vitamin A. The main symptom of this poisoning is sharpincreased intracranial pressure due to the increase in membrane permeability and hypersecretion CSF.The clinical picture of poisoning is characterized by the appearance of headache, nausea and vomiting on the first day, sleepiness, confusion, seizures, vision disorders.On the second day - the emergence of a common rash over large areas of the skin followed by peeling krupnoplastinchatym, starting from the face.
Acute more severe in children and is accompanied by a rise in temperature to 39 ° C, vomiting, insomnia, restlessness, followed by drowsiness.When viewed from the large bulging fontanelle, exanthema and petechiae on the skin, oliguria, sometimes signs of asphyxia from edema of the larynx.Poisoning in children develops at a daily intake of a teaspoon of cod liver oil (ME 240000 after 1-2 months), and adults - when receiving 50,000 ME per day for 6 months.Pediatric Clinic of chronic hypervitaminosis developing faster and more severe.
Treatment - for high pressure measures to eliminate liquor introduction of osmotic diuretics, especially urea water without pre-load.To eliminate the pressurized liquor in the treatment of cerebral edema using glycerol introduced into the stomach or intravenously as a 30% solution (1-1.5 g per 1 kg body weight by 20% sodium ascorbate solution).Introduction of concentrated protein preparations (albumin or blood plasma).Therapeutic effects of acute and chronic poisoning Retinol has vitamin D, which is to speed up the effect is taken as an alcoholic solution.
ergocalciferol (vitamin D2).Cases of poisoning vitamin D most frequently observed in children with an overdose of vitamin for the prevention of rickets, while lack of attention to the initial manifestations of intoxication and when receiving large doses of vitamin alcoholic solution.Acute poisoning in adults observed in case of accidental single dose of 1,6-120 million ME, chronic administration of a daily dose of 100-150 thousand. ME.Toxic effects of ergocalciferol potentiated while intense solar irradiation, contributes to its accumulation, and nephritis, complicates its isolation.
poisoning defined clinical picture sharp increase in Ca ion concentration in the blood line, leading to calcification infarction, renal tubular epithelium, alveoli, vascular wall cornea.There was a sharp headache, weakness and pain in the muscles, increased blood pressure, tachycardia, decrease in relative density of urine, albuminuria, significant ECG changes.
treatment - removal of the drug, the introduction of 0.003-0.004 g vitamin A (5000-10000 ME 1-2 times a day), thiamine (0,004-0,005 g), ascorbic acid (0.3 g), 20% glucose solution with insulinintravenously.For binding serum ionized Ca - intramuscular injection of 25% solution of magnesium sulfate (0.2 g / kg), the introduction of chelators.Prevention oliguria.Cardiac glycosides administered with caution, Ca excluded from the diet.
Some vitamins are not compatible with each other and with other drugs: the introduction of inadmissible in one syringe of ascorbic acid and vitamin B12;Vitamins B1 and B6;Vitamins B1, B2 and B12;sodium nicotinate and B12;B12 with pantothenic acid;vitamin E and folic acid;Vitamin B2 is neutral and acidic solutions of other pharmacological agents;vikasolom ascorbic acid and pantothenic acid.All B vitamins are incompatible with aminophylline solution.