12 - Common Vitamins & Minerals Flashcards
(43 cards)
Which calcium has the highest percentage of elemental calcium?
Calcium carbonate
For optimal absorption, calcium doses should not exceed ___ mg of elemental calcium
500
What should be done if more than 500 mg of calcium supplementation is needed?
Divide it throughout the day (BID or TID)
Where does the best calcium absorption occur?
Acidic environment, so should be taken w/ meals
What should calcium supplements not be taken w/?
High fiber meals and foods like spinach, nuts, beans, seeds, and wheat bran b/c may decrease absorption
Which type of calcium is first line?
Calcium carbonate
What is a potential side effect of calcium supplements?
Constipation, so fiber can help this, just don’t consume fiber and calcium together
When is calcium citrate recommended?
Px on PPI’s or H2 blockers, inflammatory bowel disease, or absorption disorders
Does calcium citrate need to be taken w/ food?
No, can be taken on an empty stomach
What is an advantage to calcium citrate over calcium carbonate?
Calcium citrate has increased absorption, especially in px w/ high gastric pH
Are natural preparations of calcium from oyster shells or bone meal safe?
May contain lead, but calcium blocks lead absorption
What are some consequences of calcium overdose?
- Kidney stones
- Milk-alkali syndrome
- Renal insufficiency
Iron supplements containing more than ___ mg of elemental iron are schedule 2
30 mg
Which type of iron is more readily absorbed?
Ferrous iron (not ferric)
Where does majority of iron absorption occur?
Distal duodenum and proximal jejunum
Are enteric coated or sustained release iron supplements effective?
Not if iron is released past the duodenum or jejunum
Where is excess iron stored and what can this lead to?
- Tissues and organs
- Cirrhosis, heart failure
What are the different formulations of iron from least to most elemental iron?
- Least = ferrous gluconate
- Ferrous sulfate
- Ferrous fumarate
Should iron salts be taken w/ food or on an empty stomach?
Empty stomach
Which foods can impair iron absorption?
- Cereals
- Dietary fiber
- Tea, coffee
- Eggs
- Milk
What can be done if iron salts cause stomach irritation?
- Take w/ food
- Switch to product w/ less elemental iron
- Smaller, less frequent doses
- Switch to liquid formulation for smaller titrations (however not very palatable)
Which medications can decrease absorption of iron?
- Antacids, PPI’s, H2 blockers
- Take iron 2 hours before or 4 hours after antacids
What can be done if px on PPI’s need iron supplementation?
- Changing timing of dosing won’t help
- Want to choose a product that won’t interact or doesn’t require acid
What are some GI side effects of iron?
- Abdominal discomfort
- N/V
- Diarrhea, constipation
- Dark stools
