Vitamins Flashcards by Divya Adukuzhiyil

Vitamins: What are they?

Organic compounds

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Vitamins: What are they not a source of?

Are not a source of energy

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Vitamins:

What form do several vitamins enter the body as?

Several vitamins are inactive in native form and must be converted to active compounds in the body

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What are vitamins important for?

Required in minute amounts for growth and maintenance of health

Essential for energy transformation and regulation of metabolic processes

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Recommended dietary allowances (RDAs):

What are they?

RDAs represent the average daily dietary intake sufficient to meet the nutrient requirements of nearly all healthy individuals in a particular life stage or gender group

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Recommended dietary allowances (RDAs):

How does it change?

RDAs change as we get older, males vs females, increase in pregnancy & breastfeeding, & illness

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AI = adequate intake –

only an estimate when there’s not enough evidence to establish an RDA

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UL =

highest amount without causing risk

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Vitamins: What are the two major groups?

Fat soluble

Water soluble

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Vitamins:

What are the fat soluble vitamins?

Vitamins A, D, E, K

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Vitamins:

Fat soluble vitamins: How are they absorbed? What does this lead to?

Absorbed by intestines –> lymphatic circulation –> circulating blood

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Vitamins:

Fat soluble vitamins: What enhances their absorption?

Their absorption is enhanced by dietary fat intake

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Vitamins:

Fat soluble vitamins: How can they be stored?

Can be stored in massive amts

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Vitamins:

Fat soluble vitamins: Because they can be stored in massive amounts, what does this lead to?

Extensive storage = less risk for deficiency

Extensive storage = greatly increases potential for toxicity should intake be excessive

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Vitamins:

Water soluble - What are they?

Vitamin C

Vitamin B complex: Thiamin, riboflavin, niacin, pyridoxine, pantothenic acid, biotin, folic acid, cyanocobalamin

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Vitamins:

Water soluble - What kind of change do they undergo in the body?

Undergo minimal storage in the body

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Vitamins:

Water soluble - What is needed to replenish?

Frequent ingestion needed to replenish

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Should we take multivitamins?

Insufficient evidence
No reason to start or stop

Data supports Vitamin B12 for individuals > 50yrs old

Folic acid in childbearing age & pregnancy

Vitamin D + calcium for postmenopausal females & those at risk for fractures

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Vitamin A (Retinol):

Has a role in what?

Has a role in vision (adjust to dim light),

immunity,

skeletal and soft-tissue growth,

cell growth,

skin & mucous membrane maintenance,

antioxidant

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Vitamin A (Retinol):

Where is it stored?

Stored in liver, fatty tissue, lungs, skin, spleen, eyes, and testes.

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Vitamin A (Retinol):

What kind of foods contain Vitamin A?

Foods with beta-carotene

Dairy, fish, meat

Dark colored fruits & vegs: carrots, cantaloupe, mango, tomato, pumpkin, sweet potato, spinach/dark leafy greens

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Vitamin A (Retinol):

Toxicity: What happens if excess is ingested?

Teratogenic in excessive consumption,

liver injury,

bone-related disorders (osteoporosis in postmenopausal women),

harmless orange tint to the skin

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Vitamin A (Retinol):

Deficiency results in:

Night blindness

Xerophthalmia - dry conjuctiva

Keratomalacia – degeneration of cornea

Blindness – severe deficiency

Skin lesions, altered mucous mem

Itching, burning, and red, inflamed eyelids

Age-related macular degeneration

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Xerophthalmia (Having to do with Vitamin A)

dry conjuctiva

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Keratomalacia (Having to do with Vitamin A)

– degeneration of cornea

Vitamins D What does Vitamin D regulate?

Regulates calcium and phosphorus and bone mineralization

Vitamins D What does Vitamin D increase?

Increases bone absorption of calcium

Vitamins D What does toxicity occur in conjunction with?

Toxicity occurs in conjunction with hypercalcemia

Vitamins D What does deficiency cause?

Deficiency causes rickets or osteomalacia

Vitamin E (alpha-tocopherol) What does it do?

Antioxidant properties, protects RBCs from hemolysis, may reduce risks of colds & combo with Vit C delay progression of macular degeneration

Vitamin E (alpha-tocopherol) What are dietary sources?

Dietary sources: Oils, whole-grain products, nuts

Vitamin E (alpha-tocopherol) What can a toxicity lead to?

Toxicity may increase risk for bleeding if deficient in Vit K or receiving anticoagulation and increased risk of hemorrhagic stroke by inhibiting platelet aggregation

Vitamin E (alpha-tocopherol) How common is deficiency? Who does it occur in?

Deficiency rare, exists in those with absorption issues and metabolic disorders

Vitamin K: What is this required for?

Action required for synthesis of prothrombin and other clotting factors (II, VII, IX, X)

Vitamin K What does deficiency lead to?

Deficiency produces bleeding tendencies

Vitamin K: How much are infants born with?

Infants born Vit K deficient

Vitamin K: What do infants receive after delivery?

Receive injection of phytonadione (Vitamin K1) after delivery as routine prophylaxis

Vitamin K Where is it synthesized?

Synthesized by normal flora of gut

Vitamin K What would cause a deficiency?

Deficiency caused by dysfunction of bile salts, malabsorption, antibiotics

Vitamin K Adverse effects

Hypersensitivity reaction- IV, oral, or SQ route preferred

Vitamin K Therapetic use

Correction or prevention of hypoprothrombinemia and bleeding caused by vitamin K deficiency Control of hemorrhage caused by warfarin

Water-Soluble Vitamins Vitamin C (Ascorbic acid): What does it help with? building? production? facilitating? etc...

Builds connective tissue, collagen production, general metabolism, antioxidant, facilitates iron absorption

Water-Soluble Vitamins Vitamin C (Ascorbic acid): What does it help in the conversion of?

Conversion of folic acid

Water-Soluble Vitamins Vitamin C (Ascorbic acid): What does it help regulate?

Regulation of the respiratory cycle in mitochondria.

Water-Soluble Vitamins Vitamin C (Ascorbic acid): What does it help synthesize?

Synthesis of adrenal steroids

Water-Soluble Vitamins Vitamin C (Ascorbic acid): How much do smokers need?

Smokers: an additional 35 mg/day

Water-Soluble Vitamins Vitamin C (Ascorbic acid): What are sources?

Citrus fruits/juices (OJ, Lemon juice), tomatoes, potatoes, strawberries, melons, spinach, broccoli

Water-Soluble Vitamins Vitamin C (Ascorbic acid): What does a deficiency lead to?

tissue bleeding, joint bleeding, bone fractures, poor wound healing tooth loss

Water-Soluble Vitamins Vitamin C (Ascorbic acid): What are ADRs?

ADRs: nausea, abd cramps, diarrhea

Water-Soluble Vitamins Vitamin C (Ascorbic acid): How are illnesses effected by vitamin C intake?

Large doses do not reduce incidence of colds, although intensity or duration of illness may be reduced slightly, nor does it promote wound healing

Vitamin B Complex Niacin (nicotinic acid Vit B3): What is it used for?

Used to reduce cholesterol if given in higher doses

Vitamin B Complex Niacin (nicotinic acid Vit B3): What happens to it when it enters the body?

Gets converted to active form

Vitamin B Complex Niacin (nicotinic acid Vit B3): What does it do?

Essential human nutrient, turns food into energy, cellular respiration

Vitamin B Complex Niacin (nicotinic acid Vit B3): What are sources of it?

Sources: Meats, poultry, fish, peanuts, enriched grains, peanuts, potatoes

Vitamin B Complex Niacin (nicotinic acid Vit B3): What does a deficiency lead to?

Deficiency – GI sx (abdominal pain, diarrhea, soreness of tongue and mouth), CNS memory & irritability, dermatitis, rough skin

Vitamin B Complex Niacin (nicotinic acid Vit B3): What are ADEs?

ADEs: toxic – vasodilation

Vitamin B Complex: Riboflavin (vitamin B2) What does it help with?

Enzymatic reactions

Vitamin B Complex: Riboflavin (vitamin B2) What happens to it in the body?

Gets converted to active form

Vitamin B Complex: Riboflavin (vitamin B2) What are food sources?

Food sources: Dairy, bread, fortified cereals

Vitamin B Complex: Riboflavin (vitamin B2) What does a deficiency lead to?

Deficiency: Cracked lips and mouth corners, swollen & red tongue; dermatitis of scrotum & vulva

Vitamin B Complex: Riboflavin (vitamin B2) What are symptoms of toxicity?

No sx of toxicity

Vitamin B Complex: Thiamin (Vitamin B1) What does it do?

Energy and carbohydrate metabolism

Vitamin B Complex: Thiamin (Vitamin B1) What are sources?

Sources: enriched, fortified, whole-grain products (breads, cereals), pork, legumes

Vitamin B Complex: Thiamin (Vitamin B1) Deficiency – severe Who does it occur in? How does it manifest?

Individuals who misuse alcohol are often deficient. Most common among chronic alcoholics & manifests as Wernicke-Korsakoff syndrome

Vitamin B Complex: Thiamin (Vitamin B1) Deficiency: Most common among chronic alcoholics & manifests as Wernicke-Korsakoff syndrome

Serious CNS disorder (neurologic and psychologic sx)

Vitamin B Complex: Thiamin (Vitamin B1) Deficiency: Most common among chronic alcoholics & manifests as Wernicke-Korsakoff syndrome What are symptoms?

Nystagmus, diplopia, ataxia, inability to remember recent past

Vitamin B Complex: Thiamin (Vitamin B1) Deficiency: Most common among chronic alcoholics & manifests as Wernicke-Korsakoff syndrome Failure to correct this syndrome leads to what?

Failure to correct this --> irreversible brain damage

Vitamin B Complex: Thiamin (Vitamin B1) Deficiency: Most common among chronic alcoholics & manifests as Wernicke-Korsakoff syndrome If this syndrome is suspected, how do you treat it?

If suspected, thiamine adm immediately

Vitamin B Complex: Pyridoxine (Vitamin B6) What does it do?

Involved mainly in metabolism, amino acid absorption, and neurotransmitter synthesis

Vitamin B Complex: Pyridoxine (Vitamin B6) What happens when it enters the body?

Gets converted to active form

Vitamin B Complex: Pyridoxine (Vitamin B6) Deficiency- is caused by what?

Inborn metabolism errors, etoh on LT basis

Vitamin B Complex: Pyridoxine (Vitamin B6) Deficiency- leads to what?

CNS dysfunction

Vitamin B Complex: Pyridoxine (Vitamin B6) Deficiency- what does CNS dysfunction lead to?

hyperirritability, peripheral neuritis, and possible convulsions

Vitamin B Complex: Pyridoxine (Vitamin B6) Which drug causes a deficiency?

Isoniazid

Vitamin B Complex: Pyridoxine (Vitamin B6) Toxicity: What are symptoms of toxicity?

Neuro: Uncoordinated movement and nerve damage has been noted in adults taking more than recommended as supplement

Vitamin B Complex: Pyridoxine (Vitamin B6) Food Sources

Fortified breakfast cereals, organ meat, fish, poultry, potatoes/starchy vegs

Vitamin B Complex: Cyanocobalamin (vitamin B12) What is it essential for?

Essential factor in the synthesis of DNA

Cyanocobalamin (vitamin B12) Where does it mainly function?

Functions mainly in DNA synthesis and cell division

Cyanocobalamin (vitamin B12) Functions mainly in DNA synthesis and cell division- How does it do this?

By permitting utilization of folic acid, B12 influences cell growth & division

Cyanocobalamin (vitamin B12) What does it do to folic acid?

Helps catalyze folic acid  active form

Cyanocobalamin (vitamin B12) How does deficiency of folic acid or Cyanocobalamin (vitamin B12)manifest?

Deficiency of either manifests as megaloblastic/macrocyctic anemia

Cyanocobalamin (vitamin B12) What does it require?

Requires intrinsic factor (secreted by parietal cells of stomach) for absorption

Cyanocobalamin (vitamin B12) What does a deficiency result in? What are other symptoms?

Cyanocobalamin deficiency results in neurologic damage Other sx: fatigue, decr appetite, anemia, glossitis

Cyanocobalamin (vitamin B12) What are good sources of this?

Liver & dairy products good sources

Cyanocobalamin (vitamin B12) What ways of administeration?

Can be given PO, intranasal, IM, subQ

Folic Acid What does an absence lead to?

Absence --> blood cell abnormalities

Folic Acid: What is it necessary for?

Essential factor for DNA synthesis

Folic Acid Food folate versus synthetic folate

Dietary --> must be converted to active form

Folic Acid What are good sources?

Good sources: peas, lentils, oranges, whole-wheat & enriched grain products, asparagus, beets, broccoli, spinach

Folic Acid Where is it absorbed? Where does it go?

Absorbed in upper SI --> liver & tissues --> stored or used

Folic Acid Stability wise how do Food folate compare to synthetic folate

Synthetic form is more stable - PO 400 mcg/day

Folic Acid Where is folic acid available?

U.S. Food and Drug Administration (FDA) ordered synthetic folate to be added to all enriched grain products

Folic Acid Deficiency during pregnancy can lead to what?

Deficiency during pregnancy can impair CNS development

Folic Acid Deficiency during pregnancy can impair CNS development: What does this include?

Can result in neural tube defects, anencephaly, spina bifida Important for any patient who may become pregnant to take additional folic acid

Folic Acid High doses of folic acid is associated with what?

Taking high doses of folic acid (more than 800 mcg/day) is associated with an increased risk for certain cancers, and should be discouraged

Herbal Products: What can it do?

Can interact with conventional drugs

Herbal Products: How is it marketed?

Marketed without proof of safety or efficacy

Herbal Products: What can they cause? (Negative stuff)

Can cause significant harmful effects Increased toxicity & decreased therapeutic effects

Herbal Products: Many supplements lack reliable info on interactions: What can St. John's wort induce?

St John’s wort can induce CYP3A4 & accelerate metabolism of many drugs

Herbal Products: Ginkgo biloba, feverfew, garlic- What do they do? What does this lead to?

Ginkgo biloba, feverfew, garlic suppress platelet aggregation --> increased bleeding risk in pts receiving antiplatelet drugs, ASA, anticoagulants

Herbal Products: Ma huang (ephedra) contains what? What does this do?

Ma huang (ephedra) contains ephedrine --> elevate BP, cardiac & SNS stimulation, intensifying effects of pressor agents, cardiac stimulants & counteract therapeutic effects of antihypertensives & CNS depressants

Vitamins Flashcards

Exam 4 (Final) (101 cards)