Acidosis and alkalosis Table 12 Acidosis and alkalosis

Derangement of acidic-basic state (ABS)	Acidosis		Alkalosis
	Respiratory	Metabolic	Respiratory	Metabolic
Causes	Insufficiency of blood circulation of outer breath excessive intake of CO2	Excessive formation of acidic metabolites, insufficient discharge of acids, loss of bases, excessive intake of acids	Hyperventilation, hypocapnia	Excessive intake of alkaline substances, vomiting, increase os secretion or injection of glucocorticoids
Pathogenesis	Increase of CO2=> 1) spasm of arteriols; 2) vasodilation of brain; 3) increase of tonus of nerve vagus	Increase of [H+] (non volatile acids)=> increase of sodium, potassium, calcium in blood plasma; 2) decrease of CO2 in blood	Increase of [OH]; decrease of sodium, potassium, calcium in blood plasma
Clinical appearances	1) spasm of arteriols => increase of blood pressure and decrease of diuresis; 2) increase of tonus of nerve vagus => spasm of bronchiols and bradycardia	1) Increase of sodium, potassium, calcium in blood plasma => arhytmia, decalcination of bones, decrease of nervous muscular excitability; 2) decrease of CO2 in blood => Kussmaul breath and decrease of vasotonus	Dehydration and disfunction of heart action; increase of nervous muscular excitability
Compensation	1) buffer’s systems of blood: decrease of [H] and increase of [OH]; 2) lung: hyperventilation; 3) kidneys: increase of secretion of H and reabsorption of hydrocarbonates		1) buffer’s systems of blood: neutralization of bases and increase of [H]; 2) lung: hypoventilation; 3) kidneys: restriction of secretion of [H] and decrease of reabsorption of hydrocarbonates

Calcium

This element occurs in acidic-milk products such as curdle, cheese, and milk. It is stored in bones and teeth as Ca10(PO4)6(OH)2 - hydroxyapatit. Biologic role: 1) participation in bones and teeth formation; 2) nervous-muscular excitability; 3) muscular contraction; 4) 1-st mechanism of action of hormones; 5) coagulation of blood.

The normal level in blood is 2.25-2.75mM/L. Increase of calcium is observed in tumors of bones, hyperfunction of parathyroid glands, hypervitaminosis of vitamin D. decrease of calcium in blood is observed in hypofunction of parathyroid glands, hypovitaminosis D.

Phosphorus

This element occurs in fish and sea-products and also in milk and meat. It is stored as calcium in bones and teeth in the kind of apatit. Biologic role: 1) takes part in bones and teeth formation with calcium; 2) it is a part of phosphoproteins, phospholipids, ATP, DNA, RNA, different nucleotides and their derivatives.

The normal level of total phosphorus is 3-5mM/L; inorganic phosphorus – 0.67-1.5mM/L. Increase of phosphorus is observed in hypofunction of parathyroid glands, hypervitaminosis D. Decrease of phosphorus is observed in hyperfunction of parathyroid glands and hypovitaminosis D.

Magnesium: food source – millet, walnut, peas, string bean. Mg is stored in bones and teeth in the kind of phosphate and carbonate’s salts. The biologic role of Mg: 1) activator of kinases and phosphatases; 2) stimulation of peristalsis of intestine; 3) it participates in nerve impulse transmission; 4) relaxes muscles incl. Vessels; 5) participates in glycolysis

Chlorine: food source – NaCl. It is stored in skin in the kind of NaCl. The biologic role: 1) formation of HCl of gastric juice; 2) participates in nerve impulse transmission; 3) maintains osmotic pressure; 4) regulates acid-base balance

Sulfur: food source – onion, garlic, meat. Sulfur is constituent of keratin, glutathione, methionine, all proteins, esterosulfuric acids. So, it is stored in skin and hairs, nails. The biologic role: 1) structural; 2) detoxification; 3) antioxidant

Iron: food source – meat, liver, kidneys. Plant iron is badly absorbed. Iron is stored in the kind of ferritin in liver. Transferrin is transport form of iron. Iron is a constituent of hemoglobin, myoglobin, catalase, peroxidase, cytochromes, iron-sulfur proteins.

Fluorine: food source is water and sea-products. It is stored in bones and teeth in the kind of fluoride-apatites – Ca10(PO)4F2. The biologic role is structural one. Lack of fluorine results in caries; excess of fluorine results in fluorosis.

Microelements

Iodine: food source is water and sea-products. It is stored in thyroid gland in the kind of thyroid hormones (you should revise formation of thyroid hormones). The role is function in thyroid hormones

Copper: food source is liver. It stored in liver too. Transport form is ceruloplasmin. The biologic role: 1) antioxidant role of ceruloplasmin and superoxidedismutase; 2) ceruloplasmin is a protein of acute phase; 3) copper is a constituent of copper-enzyme of skin, superoxidedismutase, cytochrome oxydase; 4) it participates in heamatogenesis and growth

Zinc: food source – cucumbers, liver. It is stored in liver and erythrocytes, gonads and pancreas. The biologic role: 1) stimulates gonads; 2) insulin, superoxide dismutase, carboxypeptidase, carbonic anhydrase contain this element

Cobalt: food source – sherry, cabbage, beet, liver. It is stored in liver. Cobalt is a constituent of vitamin B12. Hence is its role (in methylation and therefore in heamatogenesis, cells division)

Selenium: food source is water, black bread, garlic. It is stored in retina, heart, kidneys. the biologic role: 1) it is a constituent of glutathioneperoxidase (antioxidant role); 2) antitumor function (directly and indirectly); 3) vision; 4) prevents myocardium from infarction

Other macro- and microelements and available information see in textbooks on biochemistry