Vitamins, Minerals + Electrolytes Flashcards Preview

Pharmacy Pre-Registration 20/21 > Vitamins, Minerals + Electrolytes > Flashcards

Flashcards in Vitamins, Minerals + Electrolytes Deck (36)
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1
Q

Which vitamin should be avoided in pregnancy, what is It found in?

A

Vitamin A- found in liver products, fish liver oils, carrots, eggs

Vitamin A helps with eye sight

2
Q

What is vitamin B1, and what do we need it for?

A

Thiamine

Need it for nerves (hence why lack of it can cause Wernickes encephalopathy- biochemical lesions of the central nervous system causing memory loss and confusion)

3
Q

What is vitamin B6, what do we need it for?

A

Pyridoxine

Key role in the nervous system- decreases the risk of Neuropathy associated with Isoniazid use (TB drug)

Itself can cause neuropathy if used for long time at high doses!

4
Q

What is vitamin B12 and what does it cause in deficiency?

A

B12= Cobalamin

Deficiency = Pernicious Anaemia (a type of Megaloblastic anaemia- MCV high, Heamoglobin low)

Replacement= Hydroxycobalamin

5
Q

What is Ascorbic acid? What is it used to treat?

A

Vitamin C- in oranges, peppers, broccoli

Used to treat scurvy (bleeding and inflamed gums and opening of wounds)

6
Q

Name some of the Vitamin D analogues we give for vitamin D deficiency? What kind of conditions do you see these in?

A

For prevention of osteoporosis
Hypocalceamia
Rickets
They help promote calcium absorption

Ergocalciferol (vit D2 + calciferol)

Colecalciferol (Vit D3)

alfacalcidol (hydroxylated vit D)

Calcitriol (hydroxylated vit D)

7
Q

What forms of Vitamin D should be given in renal impairment, and why?

A

Vitamin D requires hydroxylation by the kidney into its active form. Therefore in renal impairment, hydroxylated vitamin D is given in the form of:

Alfacalcidol
Calcitriol

If not renally impaired, standard Egocalciferol or Colecalciferol (Non hydroxylated) can be used.

8
Q

What is the main function of Vitamin K? What foods is it found in?

A

Blood clotting- used for major bleeds with warfarin

It is found in green leafy vegetables- broccoli and spinach

9
Q

What is the name of the Vitamin K used to reverse warfarin overdose bleeding? When should a patient stop taking warfarin and receive this?

A

Phytomenadione by Slow IV injection

INR > 8, or any major bleeding: Stop taking- A & E- phytomenadione + dried prothrombin complex

INR > 8, minor bleeding: stop taking, A & E: Phytomenadione injection

INR > 8, No bleeding: stop taking, A & E, phytomenadione BY MOUTH

INR > 5: minor bleeding: stop warfarin, A & E: Phytomenadione BY MOUTH

INR > 5: no bleeding: Miss 1 or 2 doses of warfarin, reduce maintenance dose

10
Q

What are the synthetic derivatives of folate, and when do we use these?

A

Folic acid- used for prevention of NTD’s
Folic acid 400mcg in women of low risk
Folic acid 5mg for those at high risk

Folic acid 5mg for Megaloblastic anaemias

Folinic acid- given with methotrexate treatment to reduce methotrexates side effects

11
Q

What drugs can produce a folate deficiency? (4)

A

Methotrexate

Phenytoin

trimethoprim-sulfamethoxazole

sulfasalazine

12
Q

What kind of anaemia does folate deficiency cause?

A

Megaloblastic anaemia

High Mean Cell Volume, Low Heamoglobin level

13
Q

Can Vitamins be prescribed on NHS Rx’s as dietary supplements?

A

No- only for deficiency states

14
Q

What is the risk of injectable Iron?

A

Serious Hypersensitivity Reaction with injections

15
Q

What would be the signs of Magnesium deficiency?

A

Apathy (lack of enthusiasm) and muscle weakness

16
Q

Symptoms of Low potassium?

Usually when potassium falls below 2.5 mmol/ L

A
Weakness, drowsiness
Muscle cramps
Low BP (dizziness)
Palpitations (arrhythmias)
tingling/ numbness
Confusion
Constipation!!
17
Q

Symptoms of Low sodium (Hyponatreamia)?

A
CONFUSION
drowsiness
Nausea & Vomiting
Personality changes
Muscle cramps
Weakness
18
Q

What is a benefit of using potassium sparing diuretics over potassium salts to correct potassium levels?

A

Potassium salts can cause nausea and vomitting

19
Q

What is the normal potassium range?

What is classed as severe Hyperkaleamia?

A

3.5 - 5.3 mmol/ L

Severe: > 6.5 mmol/ L (risk of cardiac arrest- treat with calcium gluconate then insulin or bicarbonate)

20
Q

Symptoms of Hyperkaleamia?

A
V similar to Hypokaleamia:
Arrhythmias
muscle weakness, 
tingling sensations,  
nausea
21
Q

What is the normal sodium range?

A

133 - 146 mmol/L

22
Q

What drugs may cause Hypernatreamia? (3)

A

Corticosteroids
Phenytoin
Lithium

23
Q

What drugs may cause Hyponatreamia? (5)

A
Diuretics- thiazide & Loop
SSRI's
Vasopressin (used in diabetes insipidus)
Carbamazepine
Sulfonylureas
24
Q

What is the rationale behind Oral Rehydration salts?

A

Intestinal absorption of sodium and water is enhanced by Glucose.
There ORT contains sodium, potassium and glucose/ another carbohydrate (RICE) to replenish electrolytes lost in diarrhoea.

25
Q

What can too rapid injection of Calcium salts cause?

A

Arrhythimas

26
Q

What can magnesium salts cause and therefore be used as?

A

Diarrhoea
Used as osmotic laxative

Also used for seizures in pre-eclampsia and eclampsia (hypertension in pregnancy (pre-eclampsia) leading to convulsions- eclampsia)

27
Q

What are acute prophoryias?

A

A hereditary disorder of Haem biosynthesis- list of drugs in the BNF that are unsafe in this condition eg HRT, COC’s, POP’s

28
Q

Drugs causing Hypokaleamia (4)?

A

Thiazide & related diuretics
Loop diuretics (e.g. furosemide)
Beta 2 agonists (e.g. salbutamol)
Insulin

29
Q

Drugs causing Hyperkaleamia (5)?

A

K sparing diuretics (e.g. amiloride, Triamterene) + Aldosterone agonists (e.g. spironolactone, eplerenone)
ACE inhibitors confusion, muscle twitching or spasms,
NSAIDs
Heparin

30
Q

Drugs causing Hypermagnesaemia?

A

Antacids
Mg supplements
Remember Mg may cause diarrhoea

31
Q

Drugs cause Hypomagnesaemia? (4)

A

Thiazide and related diuretics
Loop diuretics (e.g. furosemide)
Digoxin
Aminoglycosides (e.g. gent, vanc)

32
Q

Hypernatreamia- symptoms?

A

Major symptom= thirst
confusion
muscle twitching/ spasms,

33
Q

What electrolyte disturbance can long term PPI therapy (3 months- 1 year) cause ?

A

HypoMAGNESAEMIA

34
Q

What can we use to correct Hypercalcaemia?

A

Bisphosphonates- they bind calcium! e.g. pamidronate

35
Q

Vitamin C deficiency signs?

A

swollen gums, bleeding gums, gum hyperplasia

36
Q

Vitamin B12 deficiency signs?

A

Cracked mouth
Mouth sores
Extreme tiredness
Headaches

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