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RD Polytechnic Year 2 Semester 2 > 252 Pharmacology - Vitamins and Minerals > Flashcards

252 Pharmacology - Vitamins and Minerals Flashcards

1
Q

What are vitamins and their role in the body?

A
  • Organic molecules needed in small quantities for normal metabolism and other biochemical functions, such as growth or repair of tissue
  • Attach to enzymes or coenzymes and help them activate anabolic (tissue-building) processes
  • Natural sources from both plants and animals
  • Insufficient amounts result in various deficiencies
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2
Q

What are water-soluble vitamins?

A
  • Can be dissolved in water
  • Easily excreted in the urine
  • Cannot be stored by the body over long periods
  • Daily intake required to prevent deficiencies
  • Controversy about “megadosing”
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3
Q

List two water-soluble vitamins.

A
  • B-complex group of vitamins
  • Vitamin C
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4
Q

What are fat-soluble vitamins?

A
  • Present in both plant and animal foods
  • Stored primarily in the liver
  • Exhibit slow metabolism or breakdown
  • Excreted via the feces
  • Can be toxic when consumed in excess
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5
Q

List four fat-soluble vitamins.

A
  • Vitamin A
  • Vitamin D
  • Vitamin E
  • Vitamin K
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6
Q

Where are fat-soluble vitamins stored?

A

Liver and fatty tissues

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7
Q

What are other names for Vitamin A?

A

Also known as: Retinol, retinyl palmitate, and retinyl acetate

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8
Q

What are some food sources of Vitamin A?

A
  • liver
  • fish
  • dairy products
  • egg yolks
  • dark green leafy vegetables
  • and yellow-orange vegetables and fruits
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9
Q

Where does Vitamin A come from?

A

Vitamin A comes from carotenes, which are found in plants (green and yellow vegetables and yellow fruits).

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10
Q

List the functions of Vitamin A

A
  • Required for growth and development of bones and teeth (morphogenesis)
  • Essential for night and normal vision (rhodopsin)
  • Necessary for other processes
    • Reproduction
    • Integrity of mucosal and epithelial surfaces
    • Cholesterol and steroid synthesis
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11
Q

What are the indications for Vitamin A?

A
  • Dietary supplement
    • Infants and pregnant and nursing women
  • Deficiency states
    • Hyperkeratosis of the skin
    • Night blindness
    • Other conditions
  • Used to treat skin conditions
    • Acne, psoriasis, keratosis follicularis
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12
Q

What interaction is there for Vitamin A?

A

Concurrent use of isotretinoin and Vitamin A can result in additive effects and possible toxicity

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13
Q

What are the physical consequences of Vitamin A toxicity?

A
  • Irritability, drowsiness, vertigo, delirium, coma, vomiting, diarrhea
  • Increased intracranial pressure in infants
  • Generalized peeling of the skin and erythema over several weeks
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14
Q

List the characteristics of Vitamin D

A
  • Fat soluble
  • “Sunshine vitamin”
  • Responsible for proper utilization of calcium and phosphorus
  • Vitamin D2 (ergocalciferol)
    • Plant vitamin D
    • Obtained through dietary sources
  • Vitamin D3 (cholecalciferol)
    • Produced in the skin by ultraviolet irradiation
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15
Q

Which foods contain vitamin D2?

A
  • Fish liver oils, saltwater fish
  • Fortified foods: milk, bread, cereals
  • Animal livers, tuna fish, eggs, butter
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16
Q

What are the functions of vitamin D?

A
  • Works with parathyroid hormone to regulate absorption of and use of calcium and phosphorus.
  • Necessary for normal calcification of bone and teeth
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17
Q

What are the indications for Vitamin D?

A
  • Dietary supplement
  • Treatment of vitamin D deficiency
  • Treatment and correction of conditions related to long-term deficiency: rickets, tetany, osteomalacia
  • Prevention of osteoporosis
  • Other uses: treatment of osteodystrophy, hypocalcemia, hypoparathyroidism, pseudohypoparathyroidism, hypophosphatemia
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18
Q

What are physical consequences of vitamin D toxicity?

A
  • Hypertension, dysrhythmias, weakness, fatigue, headache, drowsiness
  • Anorexia, dry mouth, metallic taste, nausea, vomiting, constipation
  • Decreased bone growth, bone pain, muscle pain
  • Polyuria, albuminuria, increased blood urea nitrogen level
  • Can progress to impairment of renal function and osteoporosis if left untreated.
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19
Q

List four different forms of vitamin D

A
  • calcifediol
  • calcitriol (Rocaltrol®)
  • dihydrotachysterol
  • ergocalciferol (Osto-D2®)
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20
Q

List the characteristics of Vitamin E

A
  • Fat soluble
  • Four biologically active chemical forms: alpha(α)-, beta(β)-, gamma(γ)-, and delta(δ)- tocopherol
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21
Q

What are plant sources of vitamin E?

A
  • Fruits, grains, fortified cereals, vegetable oils, wheat germ, nuts
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22
Q

What are animal sources of vitamin E?

A

ØEggs, chicken, meats, fish

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23
Q

What are the functions of Vitamin E?

A
  • The exact biological function of vitamin E is unknown.
  • Believed to act as an antioxidant
  • Unproved theory that vitamin E has beneficial effects for patients with cancer, heart disease, Alzheimer’s disease, premenstrual syndrome, and sexual dysfunction
  • Results from the Heart Outcomes Prevention Evaluation trial showed no benefit of vitamin E supplementation.
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24
Q

What are the indications for Vitamin E?

A
  • Dietary supplement
  • Antioxidant
  • Treatment of deficiency
    • Highest risk of deficiency in premature infants
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25
Q

What are the adverse effects of vitamin E?

A
  • Very few acute adverse effects
    • Gastrointestinal (GI) tract
    • Central nervous system (CNS) effects
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26
Q

List the characteristics of vitamin K.

A
  • Fat soluble
  • Three types: phytonadione (vitamin K1), menaquinone (vitamin K2), and menadione (vitamin K3)
  • Body does not store large amounts of vitamin K.
  • Vitamin K2 is synthesized by the intestinal flora
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27
Q

What are dietary sources of K1?

A
  • Green leafy vegetables (broccoli, Brussels sprouts, cabbage, spinach, kale)
  • Cheese
  • Soybean oils
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28
Q

What are the functions of vitamin K?

A
  • Essential for synthesis of blood coagulation factors in the liver
  • Vitamin K–dependent clotting factors
    • Factor II (prothrombin)
    • Factor VII (proconvertin)
    • Factor IX (Christmas factor)
    • Factor X (Stuart-Prower factor)
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29
Q

What are the indications for vitamin K?

A
  • Dietary supplementation
  • Treatment of deficiency states (rare)
    • Antibiotic therapy
    • Newborn malabsorption
  • Given prophylactically to newborn infants
  • Reverses the effects of certain anticoagulants (warfarin)
    • Patient becomes unresponsive to warfarin for approximately 1 week after vitamin K administration.
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30
Q

List the 7 B vitamins that make up the Vitamin B complex.

A
  • Thiamine (B1)
  • Riboflavin (B2)
  • Niacin (B3)
  • Pantothenic acid (B5)
  • Pyridoxine (B6)
  • Folic acid (B9)
  • Cyanocobalamin (B12)
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31
Q

What is vitamin B1?

A

Thiamine

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32
Q

What is Vitamin B2?

A

Riboflavin

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33
Q

What is vitamin B3?

A

Niacin

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34
Q

What is Vitamin B5?

A

Pantothenic acid

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35
Q

What is vitamin B6?

A

Pyridoxine

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36
Q

What is vitamin B9?

A

Folic acid

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37
Q

What is vitamin B12?

A

Cyanocobalamin

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38
Q

What is another name for Vitamin C?

A

ascorbic acid

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39
Q

What are the characteristics of water-soluble vitamins?

A
  • Can dissolve in water
  • Present in plant and animal food sources
  • Excessive amounts excreted in the urine, not stored in the body
  • Toxic reactions very rare
  • Act as coenzymes or oxidation-reduction agents
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40
Q

What are food sources of Vitamin B1 (thiamine)?

A
  • Enriched whole grain breads and cereals
  • liver
  • beans
  • yeast
41
Q

What does a vitamin B1 deficiency lead to?

A
  • Beriberi
    • Brain lesions, polyneuropathy of peripheral nerves, serous effusions, cardiac anatomical changes
  • Wernicke’s encephalopathy
    • Aka cerebral beriberi
42
Q

What are the functions of Vitamin B1 (Thiamine)?

A
  • Essential for:
    • Carbohydrate metabolism
    • Many metabolic pathways, including Krebs cycle
  • Maintains integrity of:
    • Peripheral nervous system
    • Cardiovascular system
    • GI tract
43
Q

What are the indications for Vitamin B1 (Thiamine)?

A
  • Treatment of thiamine deficiency
    • Beriberi
    • Wernicke’s encephalopathy
    • Peripheral neuritis associated with pellagra
    • Neuritis of pregnancy
  • Metabolic disorders
  • Malabsorption
  • Management of poor appetite, ulcerative colitis, chronic diarrhea, and cerebellar syndrome or ataxia
  • Suggested as oral insect repellent, but studies do not support this.
44
Q

What are food sources for Vitamin B2 (Riboflavin)?

A
  • Green, leafy vegetables
  • Eggs, dairy products
  • Nuts, legumes
  • Meats, liver
  • Yeast, enriched whole-grain products
45
Q

What are some causes of Vitamin B2 (riboflavin) deficiency?

A
  • Alcoholism a major cause
  • Also caused by:
    • Intestinal malabsorption
    • Long-standing infections
    • Liver disease
    • Malignancy
    • Probenecid therapy
46
Q

What are the functions of vitamin B2 (riboflavin)?

A
  • Converted into two coenzymes essential for tissue respiration
  • Required to activate vitamin B6 (pyridoxine)
  • Converts tryptophan into niacin
  • Maintains erythrocyte integrity
47
Q

What are the consequences of a vitamin B2 (riboflavin) deficiency?

A
  • Deficiency results in cutaneous, oral, and corneal changes:
    • Cheilosis (chapped or fissured lips)
    • Seborrheic dermatitis
    • Keratitis
48
Q

What are the indications for Vitamin B2 (riboflavin)?

A
  • Dietary supplement
  • Treatment of deficiency
  • Microcytic anemia
  • Acne
  • Migraine headaches
49
Q

What is an effect of vitamin B2 (riboflavin) on that body to let patients know about?

A

Large doses discolour urine yellow orange

50
Q

What are food sources of Vitamin B3 (niacin)?

A
  • Beans, turkey, tuna, liver, yeast, peanuts
  • Enriched whole-grain breads and cereals, wheat germ
  • Also synthesized from tryptophan (an essential amino acid obtained from protein digestion)
51
Q

What are the functions of Vitamin B3 (niacin)?

A
  • Once ingested, converted to nicotinamide
  • Nicotinamide is converted to two coenzymes.
  • These enzymes are required for:
    • Glycogenolysis and tissue respiration
    • Carbohydrate, lipid, protein, and purine metabolism
52
Q

What are the indications for vitamin B3 (niacin)?

A
  • Prevention and treatment of pellagra
  • Management of dyslipidemia
  • Beneficial effect in peripheral vascular disease
53
Q

What is a consequence of vitamin B3 deficiency?

A
  • Pellagra: niacin deficiency
    • Mental: various psychotic symptoms
    • Neurological: neurasthenic syndrome
    • Cutaneous: crusting, erythema, desquamation of skin, scaly dermatitis
    • Inflammation of mucous membranes: oral, vaginal, and urethral lesions; glossitis
    • GI: diarrhea or bloody diarrhea
54
Q

What are the adverse effects of vitamin B3 (niacin) at higher doses?

A
  • Adverse effects seen when higher doses are used in the treatment of dyslipidemia:
    • Flushing
    • Pruritus
    • GI distress
55
Q

What are food sources of Vitamin B6 (pyridoxine)?

A
  • Whole grains, wheat germ, yeast, fortified cereals
  • Fish, organ meats, poultry, meats, eggs
  • Peanuts, nuts, vegetables, bananas
56
Q

What are the three compounds of vitamin B6 (pyridoxine)?

A
  • Composed of three compounds
    • Pyridoxine
    • Pyridoxal
    • Pyridoxamine
  • All three are converted in the erythrocytes to active forms of B6
57
Q

What are the functions of vitamin B6 (pyridoxine)?

A
  • Necessary for many metabolic functions
    • Protein, lipid, and carbohydrate utilization
    • Conversion of tryptophan to niacin
  • Necessary for integrity of peripheral nerves, skin, mucous membranes, hematopoietic system
58
Q

What are signs and symptoms of vitamin B6 (pyridoxine) deficiency?

A
  • Sideroblastic anemia
  • Neurological disturbances
  • Seborrheic dermatitis
  • Cheilosis (chapped, fissured lips)
  • Xanthurenic aciduria
59
Q

What are the causes of vitamin B6 (pyridoxine) deficiency?

A
  • Inadequate intake
  • Poor absorption
  • Uremia, alcoholism, cirrhosis, hyperthyroidism, malabsorption, heart failure
  • Drug-induced
    • Isoniazid for tuberculosis
    • Hydralazine for hypertension
60
Q

What indications are there for vitamin B6 (pyridoxine)?

A
  • Vitamin B6 deficiency
  • Seizures that are unresponsive to usual therapy
  • Morning sickness during pregnancy
  • Patients with various metabolic disorders may respond to pyridoxine therapy.
61
Q

True or false. Neurotoxicity is possible with large doses of vitamin B6 (pyridoxine)?

A

True

62
Q

How is Vitamin B12 (cyanocobalamin) synthesized?

A

˜Synthesized by microorganisms present in the body

63
Q

What are food sources of vitamin B12 (cyanocobalamin)?

A
  • Liver, kidney, fish, shellfish, poultry, milk
  • Eggs, blue cheese, fortified cereals
64
Q

What are the functions of vitamin B12 (cyanocobalamin)?

A
  • Present as two different coenzymes
  • Required for many metabolic pathways
    • Fat and carbohydrate metabolism
    • Protein synthesis
    • Growth, cell replication
    • Hematopoiesis
    • Nucleoprotein and myelin synthesis
65
Q

What is the most common manifestation of untreated cyanocobalamin deficiency?

A

pernicious anemia

66
Q

What does a vitamin B12 (cyanocobalamin) deficiency lead to?

A
  • Neurological damage
  • Megaloblastic anemia
67
Q

What causes a vitamin B12 (cyanocobalamin) deficiency?

A
  • Malabsorption
  • Poor dietary intake of animal-origin foods (as in vegetarians)
68
Q

What is required for the oral absorption of vitamin B12 (cyanocobalamin)?

A
  • Oral absorption of vitamin B12 (extrinsic factor) requires presence of the intrinsic factor.
  • The intrinsic factor is a glycoprotein secreted from the gastric parietal cells.
69
Q

What are food sources of Vitamin C (ascorbic acid)?

A
  • Citrus fruits, strawberries
  • Tomatoes, potatoes
  • Broccoli, spinach, Brussels sprouts
  • Cabbage, green peppers
  • Liver
70
Q

True of false. Vitamin C (ascorbic acid) can also be synthesized.

A

True

71
Q

What are the functions of Vitamin C (ascorbic acid)?

A
  • Acts in oxidation-reduction reactions
  • Required for several metabolic activities:
    • Collagen synthesis
    • Maintenance of connective tissue
    • Tissue repair
    • Maintenance of bone, teeth, and capillaries
    • Folic acid metabolism
    • Erythropoiesis
  • Enhances absorption of iron
  • Required for the synthesis of:
    • Lipids
    • Proteins
    • Steroids
  • Aids in cellular respiration
  • Aids in resistance to infections
72
Q

What can a prolonged deficiency in vitamin C (ascorbic acid) lead to?

A
  • Prolonged deficiency results in scurvy
    • Weakness
    • Gingivitis and bleeding gums
    • Loss of teeth
    • Anemia
    • Subcutaneous hemorrhage
    • Bone lesions
    • Delayed healing of soft tissues and bones
    • Hardening of leg muscles
73
Q

What are indications for vitamin C (ascorbic acid)?

A
  • Dietary supplement
  • Prevention and treatment of scurvy
  • Urinary acidifier
  • Most large controlled studies have shown that ascorbic acid has little or no value as a prophylactic for the common cold
74
Q

What are the effects of megadoses of vitamin C (ascorbic acid)?

A
  • Megadoses may cause:
    • Nausea, vomiting, headache, and abdominal cramps
    • Acidified urine, with possible stone formation
  • Discontinuing megadoses may result in scurvy-like symptoms
75
Q

What are the characteristics of minerals?

A
  • Essential nutrients
  • Inorganic compounds
  • Bind with enzymes or other organic molecules
  • Help to regulate many bodily functions
    • Muscle contraction
    • Nerve transmission
    • Production of hemoglobin
  • Building blocks for many body structures
  • Required for intracellular and extracellular body fluid electrolytes
  • Macrominerals
  • Microminerals, or trace elements
76
Q

What is the most abundant mineral element in the body?

A

Calcium

77
Q

What other vitamin must be present in adequate amounts for calcium to be absorbed?

A

Vitamin D

78
Q

What are food sources of calcium?

A
  • Especially milk and dairy products
  • Fortified cereals
  • Calcium-fortified orange juice
  • Sardines, salmon
79
Q

What are the functions of calcium?

A
  • Essential for normal maintenance and function of:
    • Nervous, muscular, and skeletal systems.
    • Cell membrane and capillary permeability.
  • Catalyst in many enzymatic reactions
  • Essential in many physiologic processes
    • Transmission of nerve impulses
    • Contraction of cardiac, smooth, and skeletal muscles
    • Renal function, respiration, and blood coagulation
80
Q

What are the physical consequences of hypocalcemia?

A
  • Infantile rickets
  • Adult osteomalacia
  • Osteoporosis
81
Q

What are some common causes of calcium deficiency?

A
  • Inadequate intake of calcium or vitamin D
  • Hypoparathyroidism
  • Malabsorption syndrome
82
Q

What are the indications for calcium?

A
  • Achlorhydria
  • Alkalosis
  • Chronic diarrhea
  • Hyperphosphatemia
  • Hypoparathyroidism
  • Menopause
  • Pancreatitis
  • Pregnancy and lactation
  • Premenstrual syndrome
  • Renal failure
  • Sprue
  • Steatorrhea
  • Vitamin D deficiency
  • Adult osteomalacia
  • Hypoparathyroidism
  • Infantile rickets or tetany
  • Muscle cramps
  • Osteoporosis
  • Kidney insufficiency
83
Q

What are physical consequences of hypercalcemia?

A
  • Anorexia
  • Nausea
  • Vomiting
  • Constipation
  • Severe hypercalcemia can cause:
    • Heart irregularities
    • Delirium
    • Coma
84
Q

What drug interactions of note are there for calcium?

A
  • Chelation
    • Calcium salts will bind (chelate) with tetracyclines to produce an insoluble complex
  • If hypercalcemia is present in patients taking digoxin, serious cardiac dysrhythmias can occur.
85
Q

What is magnesium required for?

A
  • One of the principal cations of intracellular fluid
  • Essential for enzyme systems associated with energy metabolism
  • Required for:
    • Nerve function
    • Muscle contraction
86
Q

What are dietary sources of magnesium?

A
  • Green leafy vegetables
  • Meats, seafood, milk, cheese, yogurt
  • Bran cereal, nuts
87
Q

With what diets is magnesium required in higher amounts?

A

Required in higher amounts for those with diets high in protein-rich foods, calcium, and phosphorus

88
Q

What are causes of hypomagnesemia?

A
  • Malabsorption
  • Alcoholism
  • Long-term intravenous feedings
  • Diuretics
  • Metabolic disorders (hyperthyroidism, diabetic ketoacidosis)
89
Q

What are indications for magnesium?

A
  • Magnesium deficiency
    • Anticonvulsant in magnesium deficiency
    • Pre-eclampsia and eclampsia
    • Tocolytic drug for inhibition of uterine contractions in premature labour
    • Pediatric acute nephropathy
    • Cardiac dysrhythmias
    • Constipation (short-term treatment)
90
Q

What adverse effects can be caused by hypermagnesemia?

A
  • Tendon reflex loss
  • Difficult bowel movements
  • CNS depression
  • Respiratory distress
  • Heart block
  • Hypothermia
91
Q

What are food sourced of phosphorus?

A
  • Milk, yogurt, cheese
  • Peas, meats, fish, eggs
92
Q

What are non-dietary causes of phosphorus deficiency?

A
  • Malabsorption
  • Extensive diarrhea or vomiting
  • Hyperthyroidism
  • Long-term use of aluminum or calcium antacids
  • Liver disease
93
Q

What are the functions of phosphorus?

A
  • Required precursor for the synthesis of essential body chemicals
  • Building block for body structures
  • Required for the synthesis of:
    • Nucleic acid
    • Adenosine diphosphate
    • Adenosine monophosphate
    • Adenosine triphosphate
  • Responsible for cellular energy transfer
  • Necessary for the development and maintenance of the skeletal system and teeth
94
Q

What are the adverse effects of phosphorus?

A
  • Diarrhea
  • Nausea and vomiting
  • Other GI disturbances
  • Confusion
  • Weakness
  • Breathing difficulties
95
Q

Name an important trace element in the body.

A

Zinc

96
Q

What are the functions of zinc?

A
  • Essential in metabolic reactions of proteins and carbohydrates
  • Important for normal tissue growth and repair, especially wound repair
97
Q

What are food sources of zinc?

A
  • Red meats, liver,
  • oysters
  • milk products,
  • eggs,
  • beans,
  • nuts,
  • whole grains,
  • fortified cereals,
  • certain seafoods
98
Q

What assessments do you complete when administering vitamins and minerals?

A
  • Assess nutritional status.
  • Assess baseline lab values (hemoglobin, hematocrit, white blood cell count, red blood cell count, protein, albumin levels).
  • Assess history and medication history.
  • Assess for contraindications.

RD Polytechnic Year 2 Semester 2 (25 decks)

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