Natural Pdts & vitamins Flashcards

1
Q

T/F? A dietary supplement manufacturer doesn’t have to prove a pdt’s safety and effectiveness before it is marketed?

A

T

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2
Q

T/F? Ginkgo biloba increases bleeding risk w/o any effect on INR?

A

T

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3
Q

Whys St. John’s wort called a broad spectrum inducer?

A

Can’t be used with many drugs e.g. OCPs, transplant drugs, warfarin, etc

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4
Q

SEs of St. John’s wort?

A

Photosensitivity

Serotonergic

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5
Q

SEs of some natural pdts e.g. Chaparral, Comfrey, Kava?

A

Hepatotoxicity

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6
Q

What’s principle behind homeopathy?

A

Based on “the law of similars” or the concept that “like is cured by like”

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7
Q

What are medical foods?

A

These are pdts that can also make health claims, since they are not FDA-approved drugs

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8
Q

What may result from Vit B12 (thiamine) deficiency?

A

Wernicke encephalopathy

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9
Q

Whys Vit. D given with calcium?

A

Vit. D is required for Calcium absorption

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10
Q

Why should doses of Calcium be divided?

A

Bcuz Calcium absorption is saturable

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11
Q

Which is preferred, Calcium supplement or dietary Calcium?

A

Dietary calcium

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12
Q

Advantage and disadvantage of Calcium citrate?

A

Has better absorption, can be taken with or w/o food (315mg Ca)

But, It’s a bigger pill to swallow

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13
Q

Calcium carbonate (Tums, Oscal) absorption? How it should be taken? Usual strength?

A

Acid-base dependent absorption

Should be taken with meals

500-600mg

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14
Q

Whats the NIH recommended intake for Vit D in people up to age 70yrs?

A

600 IU daily

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15
Q

Whats the NIH recommended intake for Vit D in people age 71+ yrs?

A

800 IU daily

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16
Q

What supplement is used in renal dx or short-term in adults with deficiency to replenish stores?

A

50,000 unit Vit. D2 supplement

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17
Q

What’s the preferred source of Vit. D?

A

Cholecalciferol or Vit. D3

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18
Q

What supplement should any woman planning to conceive (and all women of child-bearing age) be on?

A

Folic acid 400-800 mcg/day (0.4-0.8 mg/day)

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19
Q

T/F? Folic acid should be taken at least 1 month b4 pregnancy and continued for first 2-3 months of pregnancy?

A

T

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20
Q

What’s the max dose of Vit E per day?

A

Should not exceed 150 IU daily

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21
Q

When do babies require supplement?

A

Exclusively breastfed infants or babies drinking < 1litre of baby formula need 400 IU of Vit. D daily (Poly-Vi-Sol or generic)

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22
Q

At what age do babies need iron supplement?

A

4-6 months

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23
Q

Amt of iron req by breastfed babies?

A

1mg/kg/day from 4-6 months (until consuming iron-rich food)

24
Q

When do girls become at risk of iron deficiency?

A

Adolescent girls, once they begin menstruating

25
Q

Which supplement may be required for Metformin?

A

Vit B12

26
Q

Which supplement may be required for Valproic/Divalproex; Phenytoin; CBZ; Phenobarbital/Primidone?

A

Selenium

Zinc (due to alopecia)

Calcium + Vit. D12

Folic acid (phenytoin only)

27
Q

Which supplement may be required for Oxcarbazepine; Lamotrigine?

A

Selenium

Zinc

28
Q

Which supplement may be required for Zonisamide; Topiramate; Acetazolamide?

A

Ca + Vit. D

29
Q

Which supplement may be required for bile acid sequestrants (Cholestyramine, Colsevelam, Colestipol)?

A

Multivitamin with A, D, E, K

Folic acid (take separately)

30
Q

Which supplement may be required for Orlistat?

A

Multivitamin with A, D, E, K

Beta-carotene

31
Q

Which supplement may be required for Methotrexate?

A

Folic acid

32
Q

Which supplement may be required for Loops?

A

K (always needed)

Mg (if needed)

33
Q

Which supplement may be required for Aminoglycosides?

A

K, Mg, Ca

34
Q

Which supplement may be required for Isoniazid?

A

Vit. B6

35
Q

Which supplement may be required for Bactrim?

A

Folic acid (if used chronically)

36
Q

Which supplement may be required for Sulfasalazine?

A

Folic acid due to impaired absorption

37
Q

Which supplement may be required for PPIs?

A

Mg, Ca

38
Q

Which supplement may be required for OCPs?

A

Ferrous sulfate

Folate

39
Q

Which supplement may be required for Depo-Provera; Corticosteroids (used in excess)?

A

Ca + Vit. D

40
Q

Which supplement may be required for Mineral oil?

A

Vitamins A, D, E, K

41
Q

Which supplement may be required for Digoxin?

A

Mg

K

42
Q

Which supplement may be required for Pemetrexed?

A

Folic acid, Vit. B12

43
Q

Which supplement may be required for Heparin (and possibly LMWH)?

A

Ca if long-term

44
Q

Which supplement may be required for Alcoholism?

A

Vit. B12, Folic acid

45
Q

Which supplement may be required for Microcytic anemia?

A

Ferrous sulfate

46
Q

Which supplement may be required for Macrocytic anemia?

A

Vit. B12 and/or Folic acid

47
Q

Which supplement may be required for pregnancy?

A

Folic acid

Ca, Vit. D

Vit. B6 (nausea)

48
Q

Which supplement may be required for Osteopenia/Osteoporosis; Osteomalacia (Rickets); Hyperparathyroidism & CKD?

A

Ca + Vit. D

49
Q

Which supplement may be required for Scurvy?

A

Vit C

50
Q

Which supplement may be required for Crohn’s dx (maybe UC too)?

A

Pt-specific iron, zinc, Folic acid, Ca, Vit D, B

51
Q

Which supplement may be required for Cystosis fibrosis?

A

Pancrelipase reduce absorption of iron and reduce conc of A, D, E, K and folate

52
Q

Which supplement may be required for DM?

A

K, Mg

53
Q

Which supplement may be required for Bariatric surgery?

A

Various pt-specific

54
Q

Which supplement may be required for HF?

A

K, Ca, Mg due to loop use

55
Q

What supplement does Epoetin alfa/Darbapoetin req to work?

A

Iron

56
Q

What supplement do all osteoporosis drugs req to work?

A

Ca + Vit. D

57
Q

What’s a concern with natural pdts and vitamins?

A

Manufacturing may not follow good manufacturing practices (GMP)