Vitamin A deficiency,incl. night blindness,xerophthalmia,follic... keratosis,nd its othr effects?

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Vitamin A deficiency,incl. night blindness,xerophthalmia,follic... keratosis,nd its othr effects?
Vitamin A Deficiency (VAD):





Medical Care





In the United States, VAD can easily be prevented by consuming foods recommended in the Diet section below.





Treatment of subclinical VAD includes consumption of vitamin A–rich foods, including liver, beef, chicken, eggs, fortified milk, carrots, mango, sweet potatoes, and leafy green vegetables.





For VAD syndromes, treatment includes daily oral supplements of 600 mcg (2000 IU) for children aged 3 years or younger, 900 mcg (3000 IU) for children aged 4-8 years, 1700 mcg (5665 IU) for children aged 9-13 years, 2800 mcg (9335 IU) for persons aged 14-18 years, and 3000 mcg (10,000 IU) for all adults.





Therapeutic doses for severe disease include 60,000 mcg (200,000 IU), which has been shown to reduce child mortality rates by 35-70%.





Consultations





Consult endocrinologists, gastroenterologists, ophthalmologists, nutritionists, infectious disease specialists, and dermatologists as indicated.





Diet





The 2000 US Department of Agriculture and Department of Health and Human Services Dietary Guidelines for Americans recommend consumption of a variety of foods for a comprehensive nutrient intake.





Liver, beef, chicken, eggs, whole milk, fortified milk, carrots, mango, orange fruits, sweet potato, spinach, kale, and other green vegetables are among foods rich in vitamin A.





Eating at least 5 servings of fruits and vegetable per day is recommended in order to provide a comprehensive distribution of carotenoids.





A variety of foods, such as breakfast cereals, pastries, breads, crackers, and cereal grain bars, are often fortified with 10-15% of the RDA for vitamin A.





The goals of pharmacotherapy are to reduce morbidity and to prevent complications.








Drug Category: Vitamins





Essential for normal DNA synthesis and metabolism of proteins, carbohydrates, and fats. May also work as cofactors used in aerobic cellular respiration.





Drug Name Vitamin A (Del-Vi-A, Del-Vi-A)


Description Cofactor in many biochemical processes.


Adult Dose 3000 mcg (10,000 IU) PO qd


Severe disease: 60,000 mcg (200,000 IU) PO for at least 2 d


Pediatric Dose %26lt;3 years: 600 mcg (2000 IU) PO qd


4-8 years: 900 mcg (3000 IU) PO qd


9-13 years: 1700 mcg (5665 IU) PO qd


14-18 years: 2800 mcg (9335 IU) PO qd


Severe disease: 60,000 mcg (200,000 IU) PO for at least 2 d


Contraindications Documented hypersensitivity; hypervitaminosis A; pregnancy (if dose %26gt;800 mcg/d)


Interactions Cholestyramine, neomycin, and mineral oil may decrease absorption


Pregnancy A - Safe in pregnancy





Precautions Risk of teratogenicity increases in pregnant women at doses %26gt;800 mcg/d (not recommended); parenteral vitamin A in infants of low birth weight may be associated with thrombocytopenia, renal dysfunction, hepatomegaly, cholestasis, ascites, hypotension, and metabolic acidosis (E-Ferol syndrome)