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Vitamins/minerals Flashcards

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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
problems related to elevated calcium
hypercalcemia (N/V, constipation, anorexia, polyuria), kidney stones, renal failure, soft tissue calcification
26
what drugs decrease levels of vitamin D
phenytoin, carbamazepine, barbiturates
27
function of vitamin E
antioxidant that protects cell membranes from free radicals
28
high doses of vitamin E decreases
decreased vitamin K production --> warfarin anticoagulation --> increased risk of bleeding
29
functions of vitamin K
bone mineralization and required for normal coagulation (production and activation of clotting factors)
30
causes of vitamin K deficiency
malabsorption, bowel resections, and liver disorders | possible reduced gut bacteria due to antibiotic
31
s/sx of vitamin K deficiency
increased bruising and bleeding (increased PT and INR)
32
vitamin K doses for males > or equal to 19 yo
120 mcg/day
33
vitamin K doses for females > or equal to 19 yo
90 mcg/day
34
vitamin K supplementation interactions
warfarin (INR changes) --> inhibits warfarin ability to anticoagulate
35
functions of vitamin C
antioxidant and helps increase iron absorption
36
dosing of vitamin C should not exceed more than
1500mg of one time
37
doses of ________ vitamin C a day are not recommended
greater than or equal to 4 g/day (associated with greater ade)
38
excess vitamin C can cause
nausea, diarrhea, stomach cramps, and kidney stones
39
vitamin b12
cyanocobalamin
40
functions of b12
myelin formation in CNS and folate methylation and metabolism
41
foods vitamin b12 my be found in
eggs, meat, poultry, milk
42
causes of b12 deficiency
cancer, alcoholism, long-term metformin use, vegetarian or vegan diets, long-term PPI use
43
s/sx of vitamin b12 deficiency
macrocytic anemia, peripheral neuropathy, diarrhea, irritability, forgetfulness
44
vitamin b9
folic acid
45
functions of b9
dna synthesis, rbc maturation; CHO, fat and protein metabolism
46
causes of b9 deficiency
b12 deficiency, alcoholism, liver disease, DHFR inhibitors, anticonvulsants
47
vitamin b6
pyridoxine
48
functions of b6
cofactor for > 60 enzymes and involved in heme production
49
causes of b6 deficiency
alcoholism, sever diarrhea, isoniazid
50
s/sx of b6 deficiency
pellagra-like, peripheral neuropathy
51
vitamin b2
riboflavin
52
functions of b2
hair, skin, nail integrity/growth, vision
53
causes of b2 deficiency
alcoholism and early pregnancy
54
s/sx of b2 deficiency
blurry vision
55
excess b2
bright yellow urine discoloration
56
functions of calcium
bone and teeth health, nerve signaling pathway, muscle contractions, and other intracellular processes
57
causes of calcium deficiency
malabsorption, hypoparathyroidism, vitamin D deficiency, renal deficiency, long-term anticonvulsants, postmenopausal women, patients with lactose intolerance
58
s/sx of calcium deficiency
convulsions, tetany, behavioral and personality disorders, mental and growth retardation, and bone deformities, spontaneous fractures
59
female calcium doses | 18-50 yo
1000 mg/day
60
female calcium doses | > 51 yo
1200 mg/day
61
male calcium doses | 18-70 yo
1000 mg/day
62
male calcium doses | > 70 yo
1200 mg/day
63
how much elemental calcium does calcium carbonate have
40% elemental calcium
64
calcium carbonate product examples
caltrate, tums, rolaids
65
counseling for calcium carbonate
requires acid in stomach for absorption, must take with a meal
66
calcium carbonate is not a good choice for patients on..
PPIs, H2RAs, older patients
67
how much elemental calcium does calcium citrate have
21% elemental calcium
68
counseling for calcium citrate
bioavailability better, so does not need to be taken with food
69
common adverse effects of calcium supplements
gas and constipation
70
DDI with calcium supplements
quinolone antibiotics, tetracycline, levothyroxine, zinc, and iron
71
excessive calcium can cause
renal insufficiency, hyperparathyroidism, and kidney stones | possible risk of CV disease, heart attack and stroke
72
drugs that increase risk of hypercalcemia
thiazide diuretics
73
function of iron
plays an important role in oxygen and electron transport
74
two forms of dietary iron
heme and nonheme
75
heme iron found in
meats and is reasonably well absorbed
76
non heme iron is found in
enriched grains and dark green veggies and is poorly absorbed
77
causes of iron deficiency
poor nutrition, malabsorption, pregnancy/lactation, and blood loss (menstruation, PUD, esophageal varices, cancer, surgery, or traumatic injury)
78
s/sx of iron deficiency
microcytic anemia, split or spoon shaped fingernails, pica
79
elemental iron in ferrous fumarate
33% elemental iron
80
elemental iron in ferrous sulfate
20% elemental iron
81
elemental iron in ferrous gluconate
12% elemental iron
82
adverse side effects of iron supplements
nausea, abdominal pain (try to take on empty stomach if tolerated), and constipation *dark tarry stools*
83
DDI with iron supplements
quinolones, tetracyclines, levothyroxine, zinc and calcium
84
excess iron side effects
vomiting, diarrhea, abdominal pain, electrolyte imbalances, shock, CV collapse

OTC (22 decks)

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