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OTC > Vitamins/minerals > Flashcards

Vitamins/minerals Flashcards

1
Q

examples of patients who have a true need for MVIs

A

inadequate dietary intake, increased metabolic requirements, poor absorption, and iatrogenic situations

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2
Q

inadequate dietary intake patients

A

alcoholics, impoverished, those who have eating disorders, or on trendy diet

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3
Q

increased metabolic requirements patients

A

pregnant and breast feeding women, infants/children, post-surgical, cancer, or trauma patients

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4
Q

poor absorption patients

A

elderly, patients with GI disorders (diarrhea, constipation, IBS), celiac disease, gastric bypass

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5
Q

iatrogenic situation patients

A

taking prolonged ABX, those with drug-nutrient interactions, those receiving parenteral nutrition

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6
Q

deficiencies of fat soluble vitamins occur when

A

fat intake is limited or fat absorption is compromised

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7
Q

diseases that affect fat absorption

A

celiac disease, cystic fibrosis, jaundice, cirrhosis, short bowel syndrome

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8
Q

drugs that affect fat absorption

A

cholestyramine, orlistat, mineral oil

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9
Q

function of vitamin A

A

eyes, analogues for cancers, skin disorders such as acne

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10
Q

s/sx of vitamin A deficiency

A

night blindness, dry eyes, dry skin, poor bone growth

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11
Q

safety concerns of excess vitamin A

A

teratogenic effects at doses > 3000 IU
chronic daily ingestion of > 5000 IU results in toxicity
should not exceed 10,000 IU

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12
Q

functions of vitamin D

A

bone formation and calcium regulation

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13
Q

three forms of vitamin D

A
  1. cholecalciferol
  2. ergocalciferol
  3. calcitrol
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14
Q

when skin is exposed to sunlight UV radiation what happens to vitamin D

A

becomes cholecalciferol

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15
Q

what is cholecalciferol converted into

A

converted by the liver into 25-hydroxycholecalciferol

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16
Q

25-hydroxycholecalciferol is hydroxylated by the kidney into

A

its active form, 1-25 dihydroxycholecalciferol

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17
Q

what does 1-25 dihydroxycholecalciferol do

A

regulates calcium

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18
Q

causes of vitamin D deficiency

A

chronic renal failure, inadequate sun exposure, and chronic phenytoin use

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19
Q

s/sx of vitamin D deficiency

A

osteoporosis, rickets, and muscle weakness

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20
Q

dose of vitamin D for osteoporosis prevention for age 18-70 yo

A

400-600 IU/day

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21
Q

dose of vitamin D for osteoporosis prevention for age > 70 yo

A

600-800 IU/day

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22
Q

dose of vitamin D for osteoporosis treatment for age < 50 yo

A

400-800 IU/day

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23
Q

dose of vitamin D for osteoporosis treatment for age > 50 yo

A

800-1000 IU/day

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24
Q

dietary supplementation of vitamin D should not exceed

A

2000 IU/day

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25
Q

problems related to elevated calcium

A

hypercalcemia (N/V, constipation, anorexia, polyuria), kidney stones, renal failure, soft tissue calcification

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26
Q

what drugs decrease levels of vitamin D

A

phenytoin, carbamazepine, barbiturates

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27
Q

function of vitamin E

A

antioxidant that protects cell membranes from free radicals

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28
Q

high doses of vitamin E decreases

A

decreased vitamin K production –> warfarin anticoagulation –> increased risk of bleeding

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29
Q

functions of vitamin K

A

bone mineralization and required for normal coagulation (production and activation of clotting factors)

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30
Q

causes of vitamin K deficiency

A

malabsorption, bowel resections, and liver disorders

possible reduced gut bacteria due to antibiotic

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31
Q

s/sx of vitamin K deficiency

A

increased bruising and bleeding (increased PT and INR)

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32
Q

vitamin K doses for males > or equal to 19 yo

A

120 mcg/day

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33
Q

vitamin K doses for females > or equal to 19 yo

A

90 mcg/day

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34
Q

vitamin K supplementation interactions

A

warfarin (INR changes) –> inhibits warfarin ability to anticoagulate

35
Q

functions of vitamin C

A

antioxidant and helps increase iron absorption

36
Q

dosing of vitamin C should not exceed more than

A

1500mg of one time

37
Q

doses of ________ vitamin C a day are not recommended

A

greater than or equal to 4 g/day (associated with greater ade)

38
Q

excess vitamin C can cause

A

nausea, diarrhea, stomach cramps, and kidney stones

39
Q

vitamin b12

A

cyanocobalamin

40
Q

functions of b12

A

myelin formation in CNS and folate methylation and metabolism

41
Q

foods vitamin b12 my be found in

A

eggs, meat, poultry, milk

42
Q

causes of b12 deficiency

A

cancer, alcoholism, long-term metformin use, vegetarian or vegan diets, long-term PPI use

43
Q

s/sx of vitamin b12 deficiency

A

macrocytic anemia, peripheral neuropathy, diarrhea, irritability, forgetfulness

44
Q

vitamin b9

A

folic acid

45
Q

functions of b9

A

dna synthesis, rbc maturation; CHO, fat and protein metabolism

46
Q

causes of b9 deficiency

A

b12 deficiency, alcoholism, liver disease, DHFR inhibitors, anticonvulsants

47
Q

vitamin b6

A

pyridoxine

48
Q

functions of b6

A

cofactor for > 60 enzymes and involved in heme production

49
Q

causes of b6 deficiency

A

alcoholism, sever diarrhea, isoniazid

50
Q

s/sx of b6 deficiency

A

pellagra-like, peripheral neuropathy

51
Q

vitamin b2

A

riboflavin

52
Q

functions of b2

A

hair, skin, nail integrity/growth, vision

53
Q

causes of b2 deficiency

A

alcoholism and early pregnancy

54
Q

s/sx of b2 deficiency

A

blurry vision

55
Q

excess b2

A

bright yellow urine discoloration

56
Q

functions of calcium

A

bone and teeth health, nerve signaling pathway, muscle contractions, and other intracellular processes

57
Q

causes of calcium deficiency

A

malabsorption, hypoparathyroidism, vitamin D deficiency, renal deficiency, long-term anticonvulsants, postmenopausal women, patients with lactose intolerance

58
Q

s/sx of calcium deficiency

A

convulsions, tetany, behavioral and personality disorders, mental and growth retardation, and bone deformities, spontaneous fractures

59
Q

female calcium doses

18-50 yo

A

1000 mg/day

60
Q

female calcium doses

> 51 yo

A

1200 mg/day

61
Q

male calcium doses

18-70 yo

A

1000 mg/day

62
Q

male calcium doses

> 70 yo

A

1200 mg/day

63
Q

how much elemental calcium does calcium carbonate have

A

40% elemental calcium

64
Q

calcium carbonate product examples

A

caltrate, tums, rolaids

65
Q

counseling for calcium carbonate

A

requires acid in stomach for absorption, must take with a meal

66
Q

calcium carbonate is not a good choice for patients on..

A

PPIs, H2RAs, older patients

67
Q

how much elemental calcium does calcium citrate have

A

21% elemental calcium

68
Q

counseling for calcium citrate

A

bioavailability better, so does not need to be taken with food

69
Q

common adverse effects of calcium supplements

A

gas and constipation

70
Q

DDI with calcium supplements

A

quinolone antibiotics, tetracycline, levothyroxine, zinc, and iron

71
Q

excessive calcium can cause

A

renal insufficiency, hyperparathyroidism, and kidney stones

possible risk of CV disease, heart attack and stroke

72
Q

drugs that increase risk of hypercalcemia

A

thiazide diuretics

73
Q

function of iron

A

plays an important role in oxygen and electron transport

74
Q

two forms of dietary iron

A

heme and nonheme

75
Q

heme iron found in

A

meats and is reasonably well absorbed

76
Q

non heme iron is found in

A

enriched grains and dark green veggies and is poorly absorbed

77
Q

causes of iron deficiency

A

poor nutrition, malabsorption, pregnancy/lactation, and blood loss (menstruation, PUD, esophageal varices, cancer, surgery, or traumatic injury)

78
Q

s/sx of iron deficiency

A

microcytic anemia, split or spoon shaped fingernails, pica

79
Q

elemental iron in ferrous fumarate

A

33% elemental iron

80
Q

elemental iron in ferrous sulfate

A

20% elemental iron

81
Q

elemental iron in ferrous gluconate

A

12% elemental iron

82
Q

adverse side effects of iron supplements

A

nausea, abdominal pain (try to take on empty stomach if tolerated), and constipation dark tarry stools

83
Q

DDI with iron supplements

A

quinolones, tetracyclines, levothyroxine, zinc and calcium

84
Q

excess iron side effects

A

vomiting, diarrhea, abdominal pain, electrolyte imbalances, shock, CV collapse

OTC (22 decks)

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