The History Use And Effectiveness Of Medicinal Essay

The History, Use, And Effectiveness Of Medicinal D Essay, Research Paper

The History, Use, and Effectiveness of Medicinal DrugsI. The History, Use, and Effectiveness of Medicinal Drugs A. Introduction ( Pg & # 8217 ; s 1-2 ) II. Aspirin ( Pg & # 8217 ; s 3-6 ) A. Its Beginning B. Dosages C. Relative Effectiveness D. Side Effects E. Alternate TreatmentIII. Sulfa Drugs ( Pg & # 8217 ; s 7-10 ) A. Its Beginning B. Dosages C. Relative Effectiveness D. Side Effects E. Alternate TreatmentIV. Antibiotics ( Pg & # 8217 ; s 11-14 ) A. Its Beginning B. Dosages C. Relative Effectiveness D. Side Effects E. Alternate TreatmentV. Antihistamines ( Pg & # 8217 ; s15-17 ) A. Its Beginning B. Dose and Use C. Relative Effectiveness D. Side Effects E. Alternate TreatmentVI. History, Use and Effectiveness of Vitamins ( Pg & # 8217 ; s 18-31 ) and Nutrient SupplementsVII. Future Prospects and Trends in Pharmacology ( Pg & # 8217 ; s 32-42 ) VIII. Recipe ( Pg & # 8217 ; s 43-44 ) Endnotes ( Pg & # 8217 ; s 45-46 ) Bibliography ( Pg & # 8217 ; s 47-48 ) THE HISTORY, USE, AND EFFECTIVENESSOF MEDICINAL DRUGS The scientific discipline and ambidextrousness of treating, diagnosis, and forestalling disease is known as the field of Medicine. In ancient times Medicine was a obscure field, largely incorporated with thaumaturgy and superstitious notion, it was non like our modern medical system of scientific analysis. Early Amputation Tools Shown here are the contents of a instance of amputation instruments dating from about 1800. Within medicine the most important constituent, besides the professional Doctors, Nurses and Pharmacologists are the drugs that make it possible for 1000000s of worlds mundane to overmaster their complaints. Within the field of Medicine, Pharmacology is the survey and methodological analysis behind the actions of drugs and their reactions in the human organic structure. Many early interventions didn & # 8217 ; t really mend the patient, but merely gave him a little euphory from the hurting. ( Pg 1 ) In today & # 8217 ; s civilization, the medical specialties of our ascendants are now considered to be harmful to oneself and are classified as illegal such as the drugs of marihuana and opium which were key in the Chinese, and Native American medical system. The beginning of drugs vary from common workss, ( Aspirin, Digitalis, Ergot, Opium, Quinine, Reserpine ) to minerals, ( Boric Acid, Epsom Salts, Iodine ) or man-made compounds. The difference in a drug from being helpful to being deathly is all in the dose, which is determined by the sum of the drug that is found in the blood, this procedure is known as Serum Monitoring. The risk-to-benefit ratio of drug usage is besides highly of import, a drug could wholly assist one complaint but in bend cause another such as the drug niridazole, which helps schistosomaisis but is known to do malignant neoplastic disease. Even the national authorities has some control over the ordinance of drug usage. Proprietary drugs are sold over the counter and promote less dependence that Ethical drugs which can merely be obtained lawfully by a written prescription by a registered physician. Legal power of illegal drugs which produce a strong dependence is given to the Drug Enforcement Administration of the U.S. Department of Justice. The most of import article about physician prescribed drugs is that the physician is cognizant about other drugs in which the patient is taking, because one drug alone may be helpful but administered with another could do inauspicious side effects forestalling recovery for the patient. ( Pg 2 ) ASPIRIN 1 & # 8243 ; Acetylsalicylic acid, normally known as acetylsalicylic acid is one of the most widely used anodynes in the universe & # 8221 ; . Used by Ancient Greeks and Native Americans it was used to cut down febrility and hurting and could besides be used as an anti-inflammatory agent. It interferes with tissue contractions of the prostaglandin & # 8217 ; s which are chemicals involved in the production of redness and hurting. It modifies the temperature-regulating part of the encephalon, distending blood vass in the tegument and additions sudating which in bend cools the organic structure cut downing febrility. Aspirin besides prevents the production of thromboxane which plays a cardinal function in curdling cascade, which slows blood curdling and is helpful in forestalling bosom onslaughts and shots. It is derived from the bark of the willow tree, and its activity is produced from chemicals called salicylates. ( Pg 3 ) 2 & # 8243 ; Charles Gerhardt a Gallic chemist foremost synthesized the acetyl derived function from the salicylic acid in 1853 developing the first type of acetylsalicylic acid, & # 8221 ; but Felix Hoffman a German chemist was the first to recognize its medical value in 1893. Over a long period of changeless usage acetylsalicylic acid can do Fe lack, stomachic ulcers, kidney harm and if given to kids holding chicken syphilis or grippe could do the hazard of undertaking the fatal encephalon disease known as Reye & # 8217 ; s syndrome. Use of Aspirin varies. Short term usage of about 3 & # 8243 ; 6-10 yearss & # 8221 ; is recommended without physician supervising but long term usage requires periodic ratings and dose limitations. ( Pg 4 ) Side effects besides vary with the person, they could include mild sleepiness, allergic reactions, skin roseola, urtications, rhinal discharge, tummy annoyance, bosom burn, sickness, purging, irregularity and in utmost instances eroding of the tummy liner, activation of a peptic ulcer, bone marrow depression, hepatitis, and kidney harm. Overdosing on this drug produces side effects such as tummy hurt, sickness, purging, pealing in the ears, sudating, daze, deep and rapid external respiration, vellication, and whirls. Aspirin was the first non-steroidal anti-inflammatory drug ( NASID ) but by far non the last. 4 & # 8243 ; One and a half million Americans suffer from bosom onslaughts each twelvemonth and about 200,000 suffer from bosom related deceases & # 8221 ; . Aspirin helps 1000000s of people each twelvemonth because it prevents premature blood curdling. No other NSAID can compare with the monetary value or efficaciousness of acetylsalicylic acid but isobutylphenyl propionic acid can come really near. Where aspirin might take up to 12 doses to alleviate hurting over a long period a strong dose of isobutylphenyl propionic acid could assist the patient in one dosage. Even though Ibuprofen works every bit good as acetylsalicylic acid attention must be taken with its use, although it does non annoy the tummy every bit much as acetylsalicylic acid it accelerates the damaging of the kidneys. Another job between acetylsalicylic acid and isobutylphenyl propionic acid is monetary value. 5 & # 8243 ; A 30 twenty-four hours supply of acetylsalicylic acid could be $ 3.95 where a 30 twenty-four hours supply of isobutylphenyl propionic acid could be $ 22.95 & # 8243 ; . ( Pg 5 ) New surveies prove that acetylsalicylic acid besides has consequence over megrim concerns, cataracts, bilestones, diabetic oculus jobs, insomnia, weight loss for adult females, wheat intolerance, Hansen’s disease and even hip replacing complications. Aspirin plays an of import function in maintaining our organic structures resistant against assorted unwellnesss and assisting in times of hurt. ( Pg 6 ) SULFA DRUGS Sulfonamides, the chemical name for sulpha drugs were the first chemical compounds to supply safe and effectual intervention to most common bacterial infections. Before the usage of penicillin after the mid 1940 & # 8217 ; s, Sulfa drugs played a major function in antibacterial intervention which resulted in a crisp lessening in deceases due to such bacterial infections. In today & # 8217 ; s modern medical system sulpha drugs are used to handle patients of urinary piece of land infections. SulfurSulfur in its natural signifier is a tasteless, odorless, light xanthous solid, one time forcefully fedto kids in the belief that it was good for their wellness. Sulfur compounds, found indairy merchandises and eggs, are an indispensable dietetic ingredient. Alternatively of killing bacteriums sulpha drugs prevent them from multiplying, doing it easier for the organic structures natural defences to get the better of and destruct them. Bacteria require certain chemicals know as 6 & # 8243 ; para-aminobenzoic acids & # 8221 ; to multiply, sulfa drugs resemble the chemical construction of the acids and can be absorbed by the bacteriums. The sulpha drugs combine with the outer shells of the bacteriums hence non leting the existent acids to perforate. ( Pg 7 ) All bacteriums are non reactant to sulfa drugs and have to be screened by the doctor to see if it is necessary to take a more serious action. Sulfa drugs can be taken orally which is most common, or by an injection merely beneath the tegument. In former medical history they were used to handle pneumonia, dysentery, blood poising, cellulitis, bubonic pestilence, and pinkeye. Since the acknowledgment of penicillin as an effectual bacterial attacker and some bacteriums going resistant to sulfa drugs doctors have been less likely to order them since the late 1940 & # 8217 ; s. The combination of Gantanol and trimethoprim have given a new use for sulpha drugs, now they can be used for such complaints as in-between ear infections, bacillary dysentery and repeating urinary piece of land infections. ( Pg 8 ) 7 & # 8243 ; Paul Gelmo in 1908 discovered the first sulfa drug & # 8221 ; by chance while looking for dies to better colour woolen vesture unaware its hereafter lye in the medical profession. In 8 & # 8243 ; 1953 a German diagnostician named Gerhard Domagk & # 8221 ; reported that this dye killed streptococcic bacteriums in mice taking to the first research in to the bacteriums contending drug. Major jobs included with the first line of the drug sulfanilamide were included in the disposal of the drug. It sometimes crystallized in the piss of the patient doing kidney harm. Later development of H2O soluble sulpha drugs solved the job of crystallisation in the piss and gave the hope of a longer life span to people populating in the 1930 & # 8217 ; s. ( Pg 9 ) ( Pg 10 ) ANTIBIOTICS In the ancient linguistic communication of Greek the term antibiotic meant 8 against life. They are chemical substances produced by one being that in bend are destructive to another. This procedure traditionally has been called antibiosis and is the antonym of mutualism. An antibiotic is a type of chemotherapeutic agent, it has a toxic consequence on certain types of disease-producing micro-organisms without moving perilously on the patient. Some chemotherapeutic agents differ from antibiotics in that they are non secreted by micro-organisms, as are antibiotics, but instead are made synthetically in a chemical research lab. 9 & # 8243 ; Alternately illustrations are quinine, used against malaria ; arsphenamine, used against pox ; the sulpha drugs, used against a broad assortment of diseases, notably pneumonia ; and the quinolones, used against hospital-derived infections ( zoonotic diseases ) & # 8221 ; . A few antibiotics, among them penicillin and Chloromycetin, have now been produced synthetically besides. The first observation of what would now be called an antibiotic consequence was made in the 10 & # 8243 ; 19th century by the Gallic chemist Louis Pasteur & # 8221 ; , who discovered that certain saprophytic bacteriums can kill splenic fever sources. Around the twelvemonth 11 & # 8243 ; 1900 the German bacteriologist Rudolf von Emmerich isolated a substance called pyocyanase & # 8221 ; , which can kill the sources of cholera and diphtheria in the trial tubing. It was non utile, nevertheless, in bring arounding disease. In the 12 & # 8243 ; 1920s the British bacteriologist Sir Alexander Fleming, who subsequently discovered penicillin & # 8221 ; , found a substance called muramidase in many of the secernments of the organic structure such as cryings and perspiration, and in certain other works and carnal substances. Lysozyme has strong antimicrobic activity, but chiefly against harmless bacteriums. ( Pg 11 ) ( Sir Alexander Fleming ) Discovery of PenicillinThe research of Alexander Fleming in 1928 led to the find of penicillin, an importantantibiotic derived from the cast Penicillin notatum. Penicillin is effectual against a widerange of disease-causing bacteriums. It acts by killing bacteriums straight or by inhibitingtheir growing. Penicillin, the original of antibiotics was discovered by accident in 13 & # 8243 ; 1928 by Fleming & # 8221 ; , who showed its effectivity in research lab civilizations against many disease-producing bacteriums, such as those that cause gonorrhoea and certain types of meningitis and bacteriums ( blood toxic condition ) ; nevertheless, he performed no experiments on animate beings or worlds. Penicillin was foremost used on worlds by the British scientists 14 & # 8243 ; Sir Howard Florey and Earnest Chain during the 1940-41 winter & # 8221 ; . ( Pg 12 ) The first antibiotic to be used in the intervention of human diseases was tyrothricin ( one of the purified signifiers of which was called gramicidin ) , which was isolated from certain dirt bacteriums by the American bacteriologist 15 & # 8243 ; RenT Dubos in 1939 & # 8243 ; . This substance was excessively toxic for general usage, but it is employed in the external intervention of certain infections. Other antibiotics produced by actinomycetes, filiform and ramifying bacteriums, happening in dirt have proved more successful. One of these, streptomycin, discovered in 15 & # 8243 ; 1944 by the American microbiologist Selman Waksman and his associates & # 8221 ; , is effectual against many diseases, including several in which penicillin is useless, particularly TB. Since so, such antibiotics as Chloromycetin, the Achromycins, Erythrocin, neomycin, nystatin, amphotericin, Mefoxins, and Kantrexs have been developed and may be used in the intervention of infections caused by some bacteriums, Fungis, viruses, rickettsia, and other micro-organisms. In clinical intervention of infections, the causative being must be identified and the antibiotics to which it is sensitive must be determined in order to choose an antibiotic with the greatest chance of killing the infecting being. Recently, strains of bacteriums have arisen that are immune to normally used antibiotics ; for illustration, gonorrhea-causing bacteriums that high doses of penicillin are non able to destruct may reassign this opposition to other bacteriums by exchange of familial constructions called plasmids. Some bacteriums have become at the same time immune to two or more antibiotics by this mechanism. New antibiotics that circumvent this job, such as the quinolones, are being developed. ( Pg 13 ) The Mefoxins, for case, kill many of the same beings that penicillin does, butthey besides kill strains of those bacteriums that have become immune to penicillin. Often the

immune beings arise in infirmaries, where antibiotics are used most frequently, particularly toprevent infections from surgery. Another job in infirmaries is that many old and really sick patients develop infections from beings that are non infective in healthy individuals, such as the common enteric bacteria Escherichia coli. New antibiotics have been synthesized to battle these beings. Fungus infections have besides become more common with the increasing usage of chemotherapeutic agents to contend malignant neoplastic disease, and more effectual fungicidal drugs are being sought. The hunt for new antibiotics continues in general, as research workers examine dirt casts for possible agents. Among those found in the 16 & # 8243 ; 1980s, for illustration, are the monobactams & # 8221 ; , which may besides turn out utile against hospital infections. Antibiotics are found in other beginnings every bit good, such as the household of magainins 17 & # 8243 ; discovered in the late eightiess in toads ; although untested in worlds as yet, they hold wide possibilities & # 8221 ; . Antibiotics have besides been used efficaciously to further growing in animate beings. Concern has arisen, nevertheless, that this widespread usage of

antibiotics in animal feed can foster the emergence of antibiotic-resistant organisms that may then be transmitted to human beings. (Pg 14) ANTIHISTAMINES Antihistamines are drugs that block the action of histamine. Histamine, also known as histamine phosphate, an amine (beta-imidazolyl-ethylamine, ergamine, or ergotidime) that is a normal constituent of almost all animal body cells. Histamine is also found in small quantities in ergot and purified meat products and is produced synthetically for medicinal purposes. In the body, it is synthesized in a type of leukocyte called a basophil or mast cell. In response to certain stimuli these cells release histamine, which immediately effects a dilation of the blood vessels. This dilation is accompanied by a lowering of blood pressure and an increased permeability of the vessel walls, so that fluids escape into the surrounding tissues. This reaction may result in a general depletion of vascular fluids, causing a condition known as histamine poisoning or histamine shock. Allergic reactions in which histamine is released, resulting in the swelling of body tissue, show similarities to histamine poisoning; the two may be basically similar, and the two conditions are treated similarly. The release of histamine might also be partly responsible for difficult breathing during an asthma attack. 18?In the 1930s the Italian pharmacologist Daniel Bovet who live in 1907-1972, working at the Pasteur Institute in Paris”, discovered that certain chemicals counteracted the effects of histamine in guinea pigs. The first antihistamines were too toxic for use on humans, but 19?by 1942 they had been modified for use in the treatment of allergies”. More than 25 antihistamine drugs are now available. (Pg 15) Histamine also causes contraction of involuntary muscles, especially of the genital tract and gastrointestinal canal, with an accompanying secretion by associated glands. Because histamine stimulates the flow of gastric juices, it is used diagnostically in patients with gastric disturbances. One drug effective in treating gastric ulcers acts by antagonizing the action of histamine. The ability of the body to localize infections may be due to the secretion of histamine and the subsequent increased local blood supply and increased permeability of the blood vessels. Antihistamines are used primarily to control symptoms of allergic conditions such as hay fever. They alleviate runny nose and sneezing and to a lesser extent, minimize conjunctivitis and breathing difficulties. Antihistamines can also alleviate itching and rash caused by food allergy. Chemically, antihistamines comprise several classes and a person who does not obtain relief from one type may benefit from another. Side effects of these drugs can include drowsiness, loss of concentration, and dizziness. People taking antihistamines should not drink alcoholic beverages or perform tasks requiring mental alertness, such as driving. A few antihistamines, such as terfenadine and astemizole, are nonsedating. Although antihistamines are included in many over-the-counter cold remedies, their usefulness in such preparations is questionable. (Pg 16) Antihistamines may relieve symptoms of allergy accompanying a cold, or they may have an anticholinergic effect that dries cold secretions, but they do not have any influence on viral infections, which are the cause of colds . Moreover, the drying effect may be undesirable, especially for persons with bronchial infection, glaucoma, or urinary tract difficulties. Although there are not many alternate drugs that have the same properties as antihistamines some non-drug treatments are also effective against allergies. The use of High-Efficiency-Particulate-Arresting (HEPA) filters, eliminate microscopic particles which cause allergies. The use of mattress covers decrease the reaction to dust mites in the mattress itself. These treatments are not equivalent to drug use but could decrease the amount of allergenic agents in the house hold air. Vitamin C also plays a role in the elimination of allergic reactions. 20?Researchers at the University of California have found that patients that suffer from atopic dermatitis benefited from large dosages of vitamin C”. (Pg 17) THE HISTORY, USE AND EFFECTIVENESS OF VITAMINS AND NUTRIENT SUPPLEMENTS A Vitamin is any organic compound required by the body in small amounts for metabolism, to protect health, and for proper growth in children. Vitamins also assist in the formation of hormones, blood cells, the chemicals of the nervous-system, and genetic material. The various vitamins are not chemically related, and most differ in their physiological actions. They generally act as catalysts, combining with proteins to create metabolically active enzymes that in turn produce hundreds of important chemical reactions throughout the body. Without vitamins, many of these reactions would slow down or stop. The intricate ways in which vitamins act on the body, however, are still far from clear. The 13 well-identified vitamins are classified according to their ability to be absorbed in fat or water. The fat-soluble vitamins A, D, E, and K are generally consumed along with fat-containing foods, and because they can be stored in the body’s fat, they do not have to be consumed every day. The water-soluble vitamins, the eight B vitamins and vitamin C, cannot be stored and must be consumed frequently, preferably every day. The body can manufacture only vitamin D, all others must be derived from the diet. Lack of them causes a wide range of metabolic and other dysfunction’s. In 21?the U.S., since 1940, the Food and Nutrition Board of the National Research Council has published recommended dietary allowances for vitamins, minerals, and other nutrients”. Expressed in milligrams or international units for adults and children of normal health, these recommendations are useful guidelines not only for professionals in nutrition (Pg 18)but also for the growing number of families and individuals who eat irregular meals and relyon prepared foods, many of which are now required to carry nutritional labeling. A well-balanced diet contains all the necessary vitamins, and most individuals who follow such a diet can correct any previous vitamin deficiencies. However, persons who are on special diets, who are suffering from intestinal disorders that prevent normal absorption of nutrients, or who are pregnant or lactating may need particular vitamin supplements to bolster their metabolism. Beyond such real needs, vitamin supplements are also often believed to offer cures for many diseases, from colds to cancer; but in fact the body quickly eliminates most of these preparations without absorbing them. In addition, the fat-soluble vitamins can block the effect of other vitamins and even cause severe poisoning when taken in excess. Vitamin A is a pale yellow primary alcohol derived from carotene. It affects the formation and maintenance of skin, mucous membranes, bones, and teeth, vision, and reproduction. An early deficiency symptom is night blindness which is the difficulty in adapting to darkness. Other symptoms are excessive skin dryness, lack of mucous membrane secretion, causing susceptibility to bacterial invasion, and dryness of the eyes due to a malfunctioning of the tear glands, a major cause of blindness in children in developing countries. The body obtains vitamin A in two ways. One is by manufacturing it from carotene, a vitamin precursor found in such vegetables as carrots, broccoli, squash, spinach, kale, and sweet potatoes. The other is by absorbing ready-made vitamin A from plant-eating organisms. In animal form, vitamin A (Pg 19)is found in milk, butter, cheese, egg yolk, liver, and fish-liver oil. Although one-third ofAmerican children are believed to consume less than the recommended allowance of vitamin A,sufficient amounts can be obtained in a normally balanced diet rather than throughsupplements. Excess vitamin A can interfere with growth, stop menstruation, damage red bloodcorpuscles, and cause skin rashes, headaches, nausea, and jaundice. Known also as vitamin Bcomplex, these are fragile, water-soluble substances, several of which are particularlyimportant to carbohydrate metabolism. Thiamine, or vitamin B1, a colorless, crystalline substance, acts as a catalyst in carbohydrate metabolism, enabling pyruvic acid to be absorbed and carbohydrates to release their energy. Thiamine also plays a role in the synthesis of nerve-regulating substances. Deficiency in thiamine causes beriberi, which is characterized by muscular weakness, swelling of the heart, and leg cramps and may, in severe cases, lead to heart failure and death. Many foods contain thiamine, but few supply it in concentrated amounts. Foods richest in thiamine are pork, organ meats such as liver, heart, and kidney, brewer’s yeast, lean meats, eggs, leafy green vegetables, whole or enriched cereals, wheat germ, berries, nuts, and legumes. Milling of cereal removes those portions of the grain richest in thiamine; consequently, white flour and polished white rice may be lacking in the vitamin. Widespread enrichment of flour and cereal products has largely eliminated the risk of thiamine deficiency, although it still occurs today in nutritionally deficient alcoholics. Riboflavin, or vitamin B2, like thiamine, serves as a coenzyme, one that must combine with a portion of another enzyme to be effective, in the metabolism of carbohydrates, fats, and, especially, respiratory proteins. It (Pg 20)also serves in the maintenance of mucous membranes. Riboflavin deficiency may be complicatedby a deficiency of other B vitamins; its symptoms, which are not as definite as those of alack of thiamine, are skin lesions, especially around the nose and lips, and sensitivity tolight. The best sources of riboflavin are liver, milk, meat, dark green vegetables, wholegrain and enriched cereals, pasta, bread, and mushrooms. Niacin, or vitamin B3, also works as a coenzyme in the release of energy from nutrients. A deficiency of niacin causes pellagra, the first symptom of which is a sunburnlike eruption that breaks out where the skin is exposed to sunlight. Later symptoms are a red and swollen tongue, diarrhea, mental confusion, irritability, and, when the central nervous system is affected, depression and mental disturbances. The best sources of niacin are liver, poultry, meat, canned tuna and salmon, whole grain and enriched cereals, dried beans and peas, and nuts. The body also makes niacin from the amino acid tryptophan. Megadoses of niacin have been used experimentally in the treatment of schizophrenia, although no experimental proof has been produced to show its efficacy. In large amounts it reduces levels of cholesterol in the blood, and it has been used extensively in preventing and treating arteriosclerosis. Large doses over long periods cause liver damage. Pyridoxine, or vitamin B6, is necessary for the absorption and metabolism of amino acids. It also plays roles in the use of fats in the body and in the formation of red blood cells. Pyridoxine deficiency is characterized by skin disorders, cracks at the mouth corners, smooth tongue, convulsions, dizziness, nausea, anemia, and kidney stones. The best sources of pyridoxine are whole (but not enriched) grains, cereals, bread, liver, avocados, spinach, green beans, and bananas. (Pg 21)Pyridoxine is needed in proportion to the amount of protein that is consumed. Cobalamin, or vitamin B12, one of the most recently isolated vitamins, is necessary in minute amounts for the formation of nucleoproteins, proteins, and red blood cells, and for the functioning of the nervous system. Cobalamin deficiency is often due to the inability of the stomach to produce glycoprotein, which aids in the absorption of this vitamin. Pernicious anemia results, with its characteristic symptoms of ineffective production of red blood cells, faulty myelin (nerve sheath) synthesis, and loss of epithelium the membrane lining of the intestinal tract. Cobalamin is obtained only from animal sources such as liver, kidneys, meat, fish, eggs, and milk. Vegetarians are advised to take vitamin B12 supplements. Folic acid, or folacin, is a coenzyme needed for forming body protein and hemoglobin; its deficiency in humans is rare. Folic acid is effective in the treatment of certain anemias and sprue. Dietary sources are organ meats, leafy green vegetables, legumes, nuts, whole grains, and brewer’s yeast. Folic acid is lost in foods stored at room temperature and during cooking. Unlike other water-soluble vitamins, folic acid is stored in the liver and need not be consumed daily. Pantothenic acid, another B vitamin, plays a still-undefined role in the metabolism of proteins, carbohydrates, and fats. It is abundant in many foods and is manufactured by intestinal bacteria as well. Biotin, a B vitamin that is also synthesized by intestinal bacteria and widespread in foods, plays a role in the formation of fatty acids and the release of energy from carbohydrates. Its deficiency in humans is unknown. This well-known vitamin is important in the formation and maintenance of collagen, theprotein that supports many body structures and plays a major (Pg 22)role in the formation of bones and teeth. It also enhances the absorption of iron from foodsof vegetable origin. Scurvy is the classic manifestation of severe ascorbic acid deficiency. Its symptoms are due to loss of the cementing action of collagen and include hemorrhages,loosening of teeth, and cellular changes in the long bones of children. Assertions thatmassive doses of ascorbic acid prevent colds and influenza have not been borne out bycarefully controlled experiments. In other experiments, however, ascorbic acid has beenshown to prevent the formation of nitrosamines which are compounds found to produce tumorsin laboratory animals and possibly also in humans. Although unused ascorbic acid is quicklyexcreted in the urine, large and prolonged doses can result in the formation of bladder andkidney stones, interference with the effects of blood-thinning drugs, destruction of B12,and the loss of calcium from bones. Sources of vitamin C include citrus fruits, freshstrawberries, cantaloupe, pineapple, and guava. Good vegetable sources are broccoli,Brussels sprouts, tomatoes, spinach, kale, green peppers, cabbage, and turnips. This vitamin is necessary for normal bone formation and for retention of calcium and phosphorus in the body. It also protects the teeth and bones against the effects of low calcium intake by making more effective use of calcium and phosphorus. Also called the sunshine vitamin, vitamin D is obtained from egg yolk, liver, tuna, and vitamin-D fortified milk. It is also manufactured in the body when sterols, which are commonly found in many foods, migrate to the skin and become irradiated. Vitamin D deficiency, or rickets, occurs