Alcoholism niacin

Nicotinyl alcohol (3-pyridinylcarbinol, 3-pyridinemethanol) (27) has use as an antilipemic and peripheral vasodilator. It is available from either the reductions of nicotinic acid esters or preferably, the reduction of the nitrile to the amine followed by dia2otation and nucleophilic displacement. It is frequently adininistered in the form of the tartrate (Eig. 7). Nicotinic acid is frequently used as a salt in conjunction with basic dmgs such as the peripheral vasodilator xanthinol niacinate (28). Nicotinic acid and its derivatives have widespread use as antihyperlipidemic agents and peripheral vasodilators (1). 

Niacin is contraindicated in patients with known hypersensitivity to niacin, active peptic ulcer, hepatic dysfunction, and arterial bleeding. The drug is used cautiously in patients with renal dysfunction, high alcohol consumption, unstable angina, gout, and pregnancy (Category C). 

Drugs that may affect HMG-CoA reductase inhibitors include alcohol, amiodarone, antacids, azole antifungals, bile acid sequestrants, cimetidine, cyclosporine, diltiazem, erythromycin, gemfibrozil, isradipine, nefazodone, niacin, nicotinic acid, omeprazole, phenytoin, propranolol, protease inhibitors, ranitidine, rifampin, St. John s wort, and verapamil. 

Primary increases of VLDL also reflect a genetic predisposition and are worsened by factors that increase the rate of VLDL secretion from liver, ie, obesity, alcohol, diabetes, and estrogens. Treatment includes addressing these issues and the use of fibrates or niacin as needed. Marine omega-3 fatty acids are a valuable adjuvant. 

Vitamin B6 occurs naturally in three related forms pyridoxine (6.26 the alcohol form), pyridoxal (6.27 aldehyde) and pyridoxamine (6.28 amine). All are structurally related to pyridine. The active co-enzyme form of this vitamin is pyridoxal phosphate (PLP 6.29), which is a co-factor for transaminases which catalyse the transfer of amino groups (6.29). PLP is also important for amino acid decarboxylases and functions in the metabolism of glycogen and the synthesis of sphingolipids in the nervous system. In addition, PLP is involved in the formation of niacin from tryptophan (section 6.3.3) and in the initial synthesis of haem. 

Several of the B vitamins function as coenzymes or as precursors of coenzymes some of these have been mentioned previously. Nicotinamide adenine dinucleotide (NAD) which, in conjunction with the enzyme alcohol dehydrogenase, oxidizes ethanol to ethanal (Section 15-6C), also is the oxidant in the citric acid cycle (Section 20-10B). The precursor to NAD is the B vitamin, niacin or nicotinic acid (Section 23-2). Riboflavin (vitamin B2) is a precursor of flavin adenine nucleotide FAD, a coenzyme in redox processes rather like NAD (Section 15-6C). Another example of a coenzyme is pyri-doxal (vitamin B6), mentioned in connection with the deamination and decarboxylation of amino acids (Section 25-5C). Yet another is coenzyme A (CoASH), which is essential for metabolism and biosynthesis (Sections 18-8F, 20-10B, and 30-5A). 

Vitamin B3 is a pyridine compound found in fish, meat, liver, cereal husks, nuts, and pulses. Niacin deficiency produces pellagra, which manifests as dermatitis, diarrhea with enteritis, nausea and vomiting, dementia with headache, insomnia, loss of memory, and disturbances of motor and sensory neurons. Anemia and hypoprotcincrnia are common in pellagra chronic alcoholics have more tendency to suffer from pellagra. Com eaters suffer from pellagra because com... 

Treatment Weight reduction (if necessary) is of primary Importance. Dietary restriction of controlled carbohydrate, modified fat, low alcohol consumption. If necessary, drug therapy includes niacin and/or gemfibrozil (or clofibrate), or lovastatin (or mevastatin). 

Niacin occurs as white or light yellow crystals or as a crystalline powder. One gram of sample dissolves in 60 mL of water. It is freely soluble in boiling water and in boiling alcohol and... 

At present, pellagra is encountered most often in patients with chronic alcoholism, often referred to as alcoholic pellagra encephalopathy (APE). APE patients often show only disturbances of consciousness, but may also manifest myoclonus and ataxia. Administration of niacin is recommended in APE patients showing myoclonus and ataxia even without the classical symptoms found in endemic pellagra patients (Sakai et al., 2006). 

Sakai K, Nakajima T, Fukuhara N (2006) A suspected of alcoholic pellagra encephalopathy with marked response to niacin showing myoclonus and ataxia as chief complaints. No To Shinkei 58(2) 141-144... 

NAD% the oxidized form of NADH, is a biological oxidizing agent capable of oxidizing alcohols to carbonyl compounds (it forms NADH in the process). NAD is synthesized from the vitamin niacin, which can be obtained from soybeans among other dietary sources. Breakfast cereals are fortified with niacin to help people consume their recommended daily allowance of this B vitamin. 

Deficiency of water-soluble vitamins is far less precarious than a deficit of fat-soluble vitamins. While the first condition is generally rare, it can nevertheless often be observed in severe alcoholism. In liver cirrhosis, it was possible to detect a reduced amount of vitamins B2, Bg, Bi2, C and niacin or pantothenic acid in the liver as well as hypofunction of vitamins Bi, B2, Bg, C and folic acid. Hypovitaminosis may develop due to the reduced formation of specific transport proteins or the decreased acti-... 

NAD tends to be an electron acceptor in catabolic reactions involving the degradation of carbohydrates, fatty acids, ketone bodies, amino acids, and alcohol. NAD is used in energy-producing reactions. NADP, which is cytosolic, tends to be involved in biosynthetic reactions. Reduced NADP is generated by the pentose phosphate pathway (cytosolic) and used by cytosolic pathways, such as fatty acid biosynthesis and cholesterol synthesis, and by ribonucleotide reductase. The niacin coenzymes are used for two-electron transfer reactions. The oxidized form of NAD is NAD". There is a positive charge on the cofactor because the aromatic amino group is a quaternary amine. A quaternary amine participates in four... 

Fermentation. Selective fermentation of foodstuffs for preservation, enhancement of nutritive value, improvement of flavor, or preparation of alcoholic beverages has been practiced probably since prehistoric times by peoples of nearly every civilization (110). During fermentation of foods, one often can find a net increase in content of certain B vitamins, such as riboflavin and niacin, because of microbial synthesis. However, depending upon other processing steps, the fermented food may or may not retain the newly synthesized nutrients. 

Niacin, U5P. Niacin, nicotinic acid, 3-pyridine carboxylic acid, vitamin Bi. iK-curs as white crystals or as a cry.stal-linc powder. It is odorless or may have a slight odor. One gram of nicotinic acid dissolves in 60 mL of water. It is freely soluble in boiling water, boiling alcohol, and solutions of alkali hydroxides and carbonates but is almost insoluble in ether. A % aqueous solution has a pH of 6. Nicotinic acid has a pK of 4.85. Nicotinic acid is stable under normal. storage conditions. It sublimes without decomposition. 

Niacin is a nutritional supplement used during periods of deficiency known as pellagra and for the treatment of dyslipidemia. Niacin needs may increase during chronic illness such as diabetes mellitus, malignancy, metabolic diseases, hyperthyroidism, infections, chronic fever, alcoholism, and during pregnancy and lactation. 

Properties Colorless needles odorless sour taste. Mp 236C, sublimes above melting point, d 1.473. Soluble in water and alcohol insoluble in most lipid solvents, quite stable to heat and oxidation. A vasodilator in high concentration. Amounts of niacin are expressed in milligrams. 

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