supplements

Question 1

vitamin C benefits

Answer 1

1. collagen synthesis 2. wound healing 3. capillary integrity

Question 2

vitamin C is bad because…

Answer 2

impair hepatic metabolism of acetaminophen–>system toxicity, risk of blood thinning (increase hemorrhage risk)

Question 3

name ophthalmic vitamin ANTIOXIDANTS

Answer 3

ACE: vitamine C,E,A

Question 4

d-alpha-tocopherol

Answer 4

most bioactive form of vitamin E! fat soluble

Vitamin E 2 forms 1) fat soluble-d-alpha-tocopherol & 2) water soluble–>acetate & succinate (easier to digest, but pee it out easily)

**bioavalability oil>acetate>succinate

Question 5

what does ophthalmoplegia result from?

Answer 5

LACK of vitamin E

if patient LACKS APOLIPOPROTEIN B (defect in gene)–>vitamin E uptake diminished–>ophthalmoplegia result: EOM palsy that lacks the apolipoprotein B in intestine required for intestinal absorption of lipids

Question 6

platelet inhibition result of high doses of what vitamin?

Answer 6

vitamin E

Question 7

which vitamin is there a RISK OF PROSTATE CANCER & what should you add?

Answer 7

vitamin E & add SELENIUM

Question 8

what patients should avoid vitamin A?

Answer 8

patients w/ PAPILLEDEMA (TOXICITY associated w. swollen optic nerve) & FORMER SMOKERS and ALCOHOLICS (risk of CANCER)

Question 9

what supplement is deficient in a patient w/ XEROPHTHALMIA?

Answer 9

deficient in VITAMIN A (impair goblet cell functioning) –>MAJOR WORLDWIDE CAUSE OF BLINDNESS

Question 10

retinitis pigments requires high doses of which vitamin?

Answer 10

vitamin A

ppl w/ RP are deficient in vit A->night blindness! (can’t convert retinol–>retinal)

Question 11

what is the MOST POTENT vitamin?

Answer 11

vitamin A–>doses in MICROGRAMS (vs. mg/milligrams)

Question 12

what transports xanthophyll to the retina?

Answer 12

vitamin A has a role

Question 13

name the different ophthalmic MINERALS

Answer 13

zinc, copper

Question 14

whats zinc’s role?

Answer 14

SUPPORT antioxidant enzymes, help convert retinol –>retinal, NEUROPROTECTIVE in rats w/ glaucoma (heat shock protection), CARBONIC ANHYDRASE ACTIVITY (super oxide dismutase & catalase. impt in antioxident enzymes)

Question 15

what mineral is decreased in macular degeneration?

Answer 15

zinc

Question 16

whats occurs in zinc deficiency?

Answer 16

*mimics vit A deficiency, Zn dependent conversion of retinol–>retinal

Question 17

what is retinol compared to retinal?

Answer 17

retinol: alcohol based storage of vitamin A in body
retinAL: aldehyde based photopigment needed by rods & cones

Question 18

does amount of zinc vs. copper?

Answer 18

zinc: 11mg/dose male & 8 mg/dose female
copper: ONLY 2 mg/d (*quarter or less the does given for zinc)

Question 19

copper’s role?

Answer 19

1. critical enzyme function 2. MAO formation (impt for ANS)

Question 20

what is wrong with ingesting an EXCESSIVE amount of ZINC? what necessary steps should be taken?

Answer 20

DECREASES copper, therefore Cu supplementation required with concomitant Zn administration to prevent Cu-deficiency anemia

Question 21

name antioxident pigments & what they break down into?

Answer 21

FOOD! –>carotenoids –>carotenes–>
lycopene –>1. alpha & beta carotenes
–>2.xanthophylls *vit A transports to retina
–>a. lutein (mesozeaxanthin)
–>b. zeaxanthin

Question 22

which antioxidant pigments protect the retina? what color does it give the retina? how does it protect the retina? which is needed in a HIGHER concentration? structurally how do these 2 compare?

Answer 22

lutein & zeaxanthin, orange/yellow color, filters BLUE LIGHT (absorbs high energy blue light), LUTEIN needed in higher conc. (probably cuz its in peripheral retina), they’re ISOMERS,

Question 23

what foods contain lutein vs. zeaxanthin?

Answer 23

lutein: dark green, zeaxanthin: orange-yellow

Question 24

what is mesozeaxanthin?

Answer 24

a non-dietary ocular pigment produced from lutein in the macula following isomerization

Question 25

where do u find lutein, mesozeaxanthin, & zeaxanthin? what is the ratio of L/Z in the periphery and diet? how do u know these pigments are reduced?

Answer 25

lutein: more peripheral zeaxanthin: macula lutea (in pic..mesozeaxanthin is in the mucula, but it is a isomer of lutein) periphery: L:Z=2:1 diet: L:Z=5:1 macular pigment ocular density will be reduced! patient will report seeing blue light!

Question 26

what if patient has a high macular pigment optical density..what light will they see? what is the benefit of such a device?

Answer 26

LESS BLUE LIGHT-cuz the pigment is absorbing all the blue light determine if the patient needs to take supplements or not

Question 27

what are the effects of omega 3 fatty acids?

Answer 27

1) anti-inflammatory 2) anti-oxident 3) blood thinner (bleeding risk) 4) cholesterol lowering (mixed reviews) 5) helps dry eyes

Question 28

what are sources of omega fatty acids? short & long chain..which one is more bioactive?

Answer 28

short chain: ALA 18C -->plant derived long chain: EPA20C & DHA 22C--> eggs & cold water oily fish **EPA & DHA more bioactive!

Question 29

what is a concern of a patient w/ fish allergies?

Answer 29

allergies to HEAVY METAL in LONG CHAIN fatty acids (DHA & EPA)

Question 30

*Test: bioavailability by formulation? most -->least

Answer 30

MOST! triglyceride (glyceryl) esters> FISH body oil> FREE fatty acids>ethyl esters

Question 31

what's the ratio of omega 6:omega 3 in grass vs. grain fed animal? what is the "ideal ratio" of omega 6 to 3? is omega 6 or 3 over consumed?

Answer 31

grass-fed O6:O3=2:1 vs. GRAIN fed O6:O3=4:1 (more pro inflammatory effects) ideal: O6:O3 1:1 or 1:4 should get more omega 3! **omega 6 is overconsumed! found in meat

Question 32

**test: why should you use supplements in eye care?

Answer 32

1) macular degeneration 2) glaucoma 3) cataracts 4) RP 5) dry eyes 6)diabetic retinopathy

Question 33

what are risk factors for macular degeneration? | CO-MORBIDITIES???

Answer 33

1. smoking 2. UV light 3. poor diet (high BMI & carb intake) 4. light eyes 5. aging 6. family history 7. ethnicity (greater risk caucasian) CO-MORBIDITIES: HTN (hypertension) & obesity

Question 34

what supplements were added in AREDS 1? what was the result? (%)

Answer 34

Vitamins: beta carotene(vitamin A),C,E Minerals: zinc, copper result: reduced rate of advances AMD in people at high risk by 25% over 6 yrs

Question 35

AREDS 2 what changed from AREDS 1? | Results of AREDS 2?

Answer 35

larger pop 89% taking CENTRUM SILVER added CATARACTS *REDUCED ZINC -->NO effect added LUTHEIN & ZEAXANTHIN -->reduced risk by 10% (substitute beta-carotene w/ xanthophylls -->ADDITIONALLY reduced risk by 18%) added OMEGA 3: DHA & EPA -->NO effect results: did NOT reduce risk of developing advanced AMD

Question 36

*TEST: macular degeneration supplement summary BEST DEFINED by ARED

Answer 36

*no A cuz its in the form of..lutein & zeaxanthin 1. C -->500mg 2. E-->400IU 3. zinc-->80mg 4. lutein -->10mg 5. zeaxanthin-->2mg 6. copper-->2mg

Question 37

open angle glaucoma & which supplement has a NEUROPROTECTIVE role?

Answer 37

antioxidant therapy MAY reduce neuronal flu toxicity, no hard evidence 1. Ginkgo biloba *neuroprotective role (improves cerebral blood flow) 2. Marijuana 3. Bilberry

Question 38

CATARACTS-what % of american suffer? according AREDS 2 what supplements reduced cataract development by 30%?

Answer 38

50% of americans who suffer from low vision due to cataracts | ``` vitamin C vitamin E lutein & zeaxanthin NO vit A centrum silver: "some" benefits ```

Question 39

RETINITIS PIGMENTS & what does taking this vitamin in a LARGE doses cause? what cases would u take large doses of this vitamin?

Answer 39

degenerative, HEREDITARY eye disease, onset varies b/w ppl, night blindness *vitamin A: 15,000 IU early-mid stage RP ``` intracranial hypertension large doses treatment of: -acne i.e. acutane -psoriasis -induce leukemia remission ```

Question 40

what would u take for DRY EYE? what vitamin are u usually deficient in? what can this vitamin deficiency cause beside dry eye?

Answer 40

1. omega 3 -->anti inflammatory benefits & replenishes tear film 2. vitamin A--> deficiency-->xerosis (conj/cornea) & alopecia (eye lashes)

Question 41

DIABETIC RETINOPATHY **TEST | what should u take?

Answer 41

1. BILBERRY fruit 2. vitamin D -->deficiency more common in ppl w/ non-insulin dependent diabetes (type 1), lowest in ppl w/ diabetic retinopathy 3. Lutein & Zeaxanthin -->reduce amount of damage seen