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PHAR 153 > Vitamins > Flashcards

Vitamins Flashcards

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1
Q

Do vitamin/mineral needs differ between people?

A

Yes, age is the most important factor that effects vitamin/mineral needs. sex also has an effect

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2
Q

Are natural sources of vitamins and minerals better?

A

Yes, we should promote good diets and vitamins/mineral supplements are secondary. People that really need them, don’t look for them

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3
Q

Why do people take vitamins/minerals?

A

Dietary insurance

For energy (B vitamin supplement effect is 100% pyschological)

To prevent illness (diet is king, supplements won’t ward off cancer or heart disease)

Specific medical reasons (eye vitamins for preventing AMD progression)

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4
Q

Why are B12 vitamins for seniors important?

A

Some people after aging over 50 will have issues with getting B12 from their diet (protein-cleaving issues), so supplements might be needed to help people get B12

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5
Q

Who really needs vitamins?

A

Impoverished groups
alcohol addicts
pregancy/lactation
obese
elderly

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6
Q

What supplements are given to infants automatically in Canada?

A

In Southern Canada
If breast-fed : 400IU
If formula fed: 0IU

If you live in northern areas?
If breast-fed: 800 IU
If formula-fed: 400 IU

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7
Q

Do babies need iron supplements?

A

This the realm of pediatricians. They might recommend a prescribed iron supplement if situation is exceptionally bad

Kids don’t need any iron supplements until 6 months

Iron-enriched baby food is available after 6 months

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8
Q

Do kids really need supplements?

A

Good food is king, but if parents want to cover all of their bases, go ahead and give vitamins

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9
Q

What are the Vitamin D requirements for people by age?

A

Infant (0-12 months): 400 IU, toxicity is 1000-1500 IU

Children and Adults (1-70 years): 600 IU, toxicity is 2500-4000 IU

70+: 800 IU , toxicity is 4000 IU

Vitamin D toxicity is the most concerning and possible out of the fat soluble vitamins

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10
Q

What is the utility of children’s multivitamins?

A

They are so low in dose, that they are effectively sub-therapeutic

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10
Q

What is the utility of children’s multivitamins?

A

They are so low in dose, that they are effectively sub-therapeutic. The selection of what vitamin/minerals included is also arbitary.

Something is better than nothing, just go with favourite character on box

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11
Q

What vitamins do teenagers need?

A

Young girls need to focus on calcium(osteoporosis risk reduction) and iron (loss due to menstruation)

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12
Q

Is it a serious issue if you give someone supplements not for their age group?

A

Not really, getting something is better than nothing

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13
Q

Are 100% complete multivitamins particularly better than other multivitamins?

A

Not really, they might be overkill. We only need multivitamins to top our levels up

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14
Q

How much vitamin D should people take?

A

600 IU a day (7000 IU once per week is also fine and does not pose toxicity concerns)

Toxicity starts after 4000IU per day and everyday. it can happen, so be careful

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15
Q

What is the best source of vitamin D?

A

90% of vitamin D production can be attributed to sunlight

10% of Vitamin D comes from food supplementation

We need to balance concerns between sun exposure causing skin damage and sun exposure promoting the production of Vitamin D

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16
Q

What vitamins do seniors need?

A

1200mg of Calcium
600-800 IU of Vitamin D
2.4 micrograms of Vitamin B12

Declining smell and taste = lower appetite(consuming less vitamins and minerals)

Live alone = eat less

Need less…
B vitamins because lower metabolism
Vitamin A
Iron

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17
Q

What supplements do people with pernicious anaemia take to help with their condition?

A

High dose Vitamin B12 (1000 micrograms and above)

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18
Q

Are the advantages sublingual B12 clinically relevant?

A

No, speed of absorption doesn’t really matter

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19
Q

What vitamins do pregnant women need?

A

Pregnant women are automatically given Materna (folic acid delivery system)

Iron: 27mg
Folate: 400 micrograms
Calcium: 1000mg
Vitamin D: 600 IU

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19
Q

What vitamins do young women need?

A

Pregnant women are automatically given Materna (folic acid delivery system)

Child-bearing age
Iron: 18mg
Folate: 400 micrograms
Calcium 1000mg
Vitamin D: 600mg

Pregnant woman needs
Iron: 27mg
Folate: 400 micrograms + what you were taking before
Calcium: 1000mg
Vitamin D: 600 IU

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20
Q

Why do pregnant women not like taking Materna?

A

People erroneously blame iron or calcium for nausea, but it is mostly from B12.

If meat-eating women does not want to take Materna, thats fine. We are more concerned about vegetarian mothers

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21
Q

Do pregnant women need specifically pregnancy-labelled multivitamins?

A

No, but ensure that there is a good amount of iron, folate, Vitamin D, and calcium

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22
Q

Why do pregnant and young women take folate?

A

It is taken to prevent spinal developmental issues in the fetus. Because 50% of pregnancies are unplanned, women of child-bearing age should take some type of folate. Women need to take at least 400 micrograms of folate.

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23
Does iron content affect multivitamin adherence?
No, it is unfairly blamed. tablet size might play a bigger role in adherence
24
How much calcium should women take daily according to their age?
4-8 years old: 1000mg 9-13 years old: 1300mg 14-18 years old: 1300mg 19-50 years old: 1000mg 51+ years old; 1200mg Side effects only start after 2500mg per day (and even at this dose, side effects are barely perceptible. constipation is the biggest concern)
25
What is the maximum dosing for calcium in one serving?
500mg. The body simply excretes the excess. This means you need to take calcium multiple times in a day to reach RNI (hence BID dosing)
26
What are some common sources of calcium available in a pharmacy?
Calcium carbonate (40% elemental) Ca lactate (13%) Ca gluconate (9%) Citracal (20%) - used for people on protein pump inhibitors Rolaids/Tums has 200 - 400 mg
27
How to improve bone health and density?
Load bearing activities (lifting weights) and Calcium supplements. This especially a concern for women
28
Do Calcium-Magnesium supplements help with leg cramps?
Although the media and doctors may reccomend these products for leg cramps, there isn't clear evidence in support
29
Do calcium and magnesium oppose side effects?
Yes in theory, but the doses are too low in supplements
30
Does excess B vitamins help with energy?
Most people are not B vitamin deficient, and excesses do not give extra energy?
31
What are the best sources of iron?
Heme (meats), but non-heme (plants) sources are fine, but that iron is less accessible
32
What is the women's RNI for Iron?
15-18 mg for females
33
Are iron supplements easily accessible at pharmacies?
No, they are behind the counter and usually the pharmacist will have to ensure that the patient will use them properly
34
Should we take iron supplements without food?
You can, but you will have a metallic after taste
35
What are some common iron supplements?
The only difference between these options is how fast we need iron levels to increase. Ferrous fumarate (33% elemental) Ferrous sulfate (20%) Ferrous gluconate (12%) If doctor of patient does not mention a preference, ferrous sulfate is a good starting point. Use further questioning to change mind of stay with ferrous sulfate.
36
What is the absorption of iron during iron deficiency?
20% of iron that passes through the GI tract is absorbed. Only 10% is absorbed if you have a normal amount of iron
37
How long after iron supplementation does iron defiencieny anemia start to go away?
2-3 weeks
38
What are the side effects of iron?
All of these side effects are dose dependent Constipation - 12% Dyspepsia - 7% Nausea - 6% These numbers go up with higher doses
39
Is iron best absorbed quickly or slowly?
Iron is best absorbed quickly, this is why slow release iron tabs are less efficacious
40
What percentage of poisoning deaths in children are caused by iron?
1/3 = 33%
41
What is the iron RNI for child-bearing and pregnant women?
RNI for women = 18mg pregnant women = 27mg (dose found in Materna)
42
Can vitamin/mineral supplements stave off chronic disease?
No value in... reducing mortality any type of cancer almost any type of cardiovascular disease Diet is more important
43
What was niacin used for?
Poor man's statin (cholesterol management) High amounts needed, niacin causes prickling feeling Not used very commonly for this indication and by the general public
44
Can vitamin and mineral supplements prevent cancer?
No, lifestyle choices and diet are more important (smoking and red meat consumption)
45
Do B vitamins reduce stress?
B vitamin supplements have no real effect on energy, mostly psychological (placebo)
46
What is the RNI for Thiamine (Vitamin B1)?
1mg, excess is simply excreted
47
Can eye vitamins prevent the progression of AMD?
Vitamins that have the AREDS2 formulation can delay progression from Intermediate to Advanced AMD in 1/4 cases This is the only vitamin that we cannot get the same benefit from dietary changes
48
What is the RNI for Magnesium?
320 - 420 mg used mostly for heart health, leg cramps, bone health, anti-constipation
49
What dose of magnesium will cause diarrhea?
800mg to 1g of magnesium will definitely cause diarrhea
50
What is the RNI for potassium?
4700mg
51
Why are potassium levels tracked diligently?
hypo/Hyperkalemia can have negative effects on heart health
52
Can meal replacement drinks provide all of the vitamins and minerals you need?
Yes, they are 100% nutrition.
53
Do all Ensure products provide 100% nutrition?
No, some products do not contain everything you need
54
What is the RNI for Vitamin C in males and females?
Males: 90mg Females: 75mg
55
Does Vitamin C help with colds?
There is no physiologic effect, but we cannot change the minds of the public
56
Does Vitamin E oil have particularly significant effects on scar healing?
It is like any other oil
57
What is the RNI for Vitamin E?
15mg or 22.4 IU
58
What is the role of Vitamin K in the body?
Vitamin K plays a key role in helping the blood clot, preventing excessive bleeding. UNlike many other vitamins, vitamin K is not typically used as dietary supplements Vitamin K1 is the main form found in supplements
59
What is the RNI for Vitamin K?
100micrograms
60
Why is Vitamin K1 the preferred type of Vitamin K in supplements?
K1 is generally the preferred form because it has less concern for toxicity and works faster, but some of the bone work claim K2 is better for that indication.
61
How do fat soluble vitamins and mineral oils interact?
Mineral oils are rarely used, but Vitamins ADEK can leach into the mineral oil and is excreted without full absorption. This effect is almost negligible
62
How does Vitamin E and anticoagulants (Warfarin)?
Need to get to 1000 IU before seeing anticoagulation, but hard to get to this level. Not possible if taking multivitamins
63
How do Iron and Calcium interact with tetracyclines?
Tetracyclines may interact with the divalent charges on Fe and Ca. The tetracyclines are less effective, but not by a lot
64
What is the interaction between calcium and corticosteroids?
Calcium can improve the risk of loosing bone mass following long-term corticosteroid use.
65
What is the interaction between vitamin A and retinoids?
Retinoids were used topically for acne, but some kid took a bunch orally. Vitamin A is a retinoid, so there is a risk for overdose if both are taken orally
66
Are vitamin-drug interactions for the most part clinically insignificant?
Yes, but we should still be cautious about potential adverse effects when doses are high

PHAR 153 (20 decks)

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