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OTC Therapeutics > Final- Infant formulas, vitamins/minerals, colic, dry skin > Flashcards

Final- Infant formulas, vitamins/minerals, colic, dry skin Flashcards

1
Q

2 main starting points for infant formulas

A

1) cow milk, then modify to be as close to breast milk as possible (protein is cow based)
2) soy protein source (can’t take dairy for health, cultural or religious reasons)

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2
Q

which infant formalas have iron

A

all, some just lower

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3
Q

upgrade to a formula at this age

A

6 months; optional, not that big of a difference

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4
Q

use infant formula (as an alternative to breast milk) up until this age

A

9 to 12 months

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5
Q

when pasteurized whole milk can be introduced

A

9 to 12 months, continue until 2 years

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6
Q

when skim milk is appropriate for infants

A

after 2 years

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7
Q

iron in breastmilk

A

much more available than cow protein based formulas

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8
Q

follow up formulas- necessary?

A

in second 6 months of life, for when eating solid foods, not necessary very similar

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9
Q

when pasteurized whole milk can be introduced

A

9 to 12 months, continue until 2 years (full fat important)

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10
Q

follow up formulas- necessary?

A

in second 6 months of life, for when eating solid foods, not necessary very similar

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11
Q

infant formula with thickener

A

don’t recommend

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12
Q

natural vs synthetic vitamins

A

natural always better EXCEPT B12 and folate

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13
Q

kind of folic acid to use after age 50

A

synthetic- easier to breakdown, natural sources of it become hard for body to break down and use

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14
Q

single vitamin deficiencies are common?

A

no

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15
Q

vitamin D in infants

A

400-800 (if hardly any sun or months October to April-therefore recommend because babies shouldn’t be in sun anyway) IU if breastfed, 0-400 IU if formula (because already should be enriched with it).
**Standard 400 IUs

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16
Q

vitamin D in infants

A

400-800 (if hardly any sun or months October to April-therefore recommend because babies shouldn’t be in sun anyway) IU if breastfed, 0-400 IU if formula (because already should be enriched with it).
**Standard 400 IUs; D-Drops= good! Put on your finger to give, 400 IU/drop

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17
Q

Fe in infants

A

before 6 months, stores are enough. After, need supplementation (iron enriched cereals, etc)

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18
Q

Vitamin D age 1-13 years

A

1000-2000 IU (need more in winter). 600-800 is okay (health canada) because will get some from diet (very little) and sun

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19
Q

Iron in children

A

8-10 mg

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20
Q

multivitamin in children

A

chose most broad spectrum- vitamins AND minerals

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21
Q

mg of Ca per glass of milk

A

300 mg

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22
Q

difference between mens and womens vitamins

A

not much- if any change, not significant amount

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23
Q

vitamin D in adults

A

1000 IUs

  • 400-1000 if less than 50 and healthy
  • 800-2000 if over 50 and healthy
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24
Q

vitamin D pregnancy

A

consider 2000 IUs

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25
Q

Too much vitamin D bad?

A

yes, but high safety range. Don’t go above 2000 IUs. 5 min sun exposure enough vitamin D.

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26
Q

osteoporosis and vitamin D recommendations

A

-regardless of age 800-2000 IUs

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27
Q

difference between mens, womens and seniors vitamins

A

not much- if any change, not significant amount

-should add separate vitamin D and Ca (usually never enough Ca in multivitamin or pill would be huge) if needed

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28
Q

vitamin D in adults

A

1000 IUs

  • 400-1000 if less than 50 and healthy
  • 800-2000 if over 50 and healthy* (over 70)
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29
Q

osteoporosis and vitamin D recommendations

A

-regardless of age 800-2000 IUs

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30
Q

cod liver oil benefits

A

-too high vitamin A, too low vitamin D, not enough omega to make good

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31
Q

Ca age 31-50

A

1000 mg

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32
Q

Ca age 51-70

A

needs go up after 50 from 1000 to 1200 mg

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33
Q

Ca over 70

A

needs go up after 50 from 1000 to 1200 mg

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34
Q

B12 requirement adults

A

stays same age 30 and up; 2.4 ug

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35
Q

b12 safety

A

water soluble so very safe, even at 500x RNI, but don’t need

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36
Q

prenatal vitamins: iron

A

child bearing- 18mg

pregnancy- 27 mg (supplement with 16-20)

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37
Q

prenatal vitamins: folate

A

child bearing- 400 ug

pregnancy- 600 ug during and before in addition to food

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38
Q

prenatal vitamins: calcium

A

1000 mg, no change during pregnancy unless under 18 add 300 mg

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39
Q

prenatal vitamins: vitamin d

A

600 IUs, no change in pregnancy, but can consider up to 2000 IUs

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40
Q

natural folate sources

A

OJ, fruits, veg

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41
Q

natural iron

A

meat

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42
Q

prenatal vitamins: folate

A

child bearing- 400 ug
pregnancy- 600 ug during and before in addition to food….1mg*
-take at least 3 months ahead pregnancy

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43
Q

natural iron

A

meat

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44
Q

materna for pregnancy vitamin?

A

good, take before, during, and at least 6 weeks after pregnancy

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45
Q

spinal bifida/neural tube defects

A
  • prevent with folic acid
  • 3rd-4th week of development
  • 50% pregnancies unplanned, for recommend multivitamin to all women of child bearing years
  • 1 mg folic acid sufficient unless high risk- rx doctor 5mg
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46
Q

Ca age 4-8

A

1000 mg

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47
Q

Ca age 9-18

A

1300 mg

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48
Q

recommended Ca in vitamin

A

500 mg od, rest can come from diet. Rarely do you need bid, but if do only take 500 at once, this is all your body can absorb

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49
Q

Ca free of side effects up until

A

2500 mg

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50
Q

should Ca be given with food?

A

yes, helps cleave elemental Ca

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51
Q

vitamin A requirements

A

2000-3000 IUs, way too much may interact with Ca and have negative effects on bone health

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52
Q

forms of Ca

A
  • carbonate (40% elemental, best)
  • lactate (13%)
  • gluconate (9%)
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53
Q

best bone health combo

A

vitamin D, Ca and weight bearing exercise

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54
Q

best bone health combo

A

vitamin D, Ca and weight bearing exercise

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55
Q

theory of adding mg to Ca

A

helps with leg cramps and reverses constipation (helps)- questionable, probably not

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56
Q

theory of adding mg to Ca

A

helps with leg cramps and reverses constipation (helps)- questionable, probably not

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57
Q

RDA protein

A
  1. 8 g/kg/day

1. 6 if strength training

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58
Q

during work out AAs lost

A

75% recylced into muscles, 25% lost

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59
Q

BCAAs in workout

A

theory is drive more muscle in to workouts because targeted- unlikely

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60
Q

BCAAs in workout

A

theory is drive more muscle in to workouts because targeted- unlikely

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61
Q

creatine

A
  • body makes 2g/day, another 2 g from food
  • reduces muscle breakdown during workouts, leads to more muscle mass
  • no significant increase in performance, better from diet
62
Q

creatine

A
  • body makes 2g/day, another 2 g from food
  • reduces muscle breakdown during workouts, leads to more muscle mass
  • no significant increase in performance, better from diet
63
Q

heme iron

A

most available form

64
Q

RNA elemental iron in F

A

15-18 mg

65
Q

ferrous fumarate (color and percent iron in salt)

A

blue, 33%, more iron faster

66
Q

ferrous sulfate (color and percent iron in salt)

A

red, 20% (ex//, in 300 mg tablet, get 60 mg iron)

67
Q

ferrous gluconate (color and percent iron in salt)

A

green, 12%, easiest tolerated in gut

68
Q

vitamin c, food and iron

A

c helps absorbtion, food makes more tolerable

69
Q

avoid with iron because decrease BA

A

coffee/tea, protein, Ca, antacids

70
Q

slow release iron

A

no sense, immediate is better

71
Q

discoloration in feces from Fe

A

fine if happens from start, if after or continuing could be blood see doc

72
Q

pediatrics an iron

A

toxicity is big deal

73
Q

pediatrics an iron

A

toxicity is big deal

74
Q

upper limit of Fe

A

45 mg (60 will still be okay though)

75
Q

reduce mortality, cancer, CV risk, stress, energy, fatigue, depression anxiety etc (vit)

A

NONE

76
Q

niacin

A
  • aka nicotinic acid
  • nicotinamides or niacinamides decrease flush SE but no help with cholesterol (same with inositol)
  • statins are most effective
  • if use, must be in high doses but amp up slowly or could be very irritating
77
Q

AMD (acute macular degeneration)

A

aging disease, see blurred central vision (faces, etc), cholesterol laying down in eyes

  • dry type (cholesterol, 90%)
  • wet type, more serious (10%)
  • AREDs vitamins can potentially delay progression (intermediate to advanced, but can recommend at any stage)
  • can’t reverse any stage, but might slow
78
Q

smokes and AMD

A

take out beta carotene, vitalux s

79
Q

smokes and AMD

A

take out beta carotene (lung cancer possibility), vitalux s

80
Q

smokes and AMD

A

take out beta carotene (lung cancer possibility), vitalux s

81
Q

magnesium amount

A

320-420 mg. Diarrhea at increased strength? Would need 30-60mL of 400mg/5ml.

82
Q

Potassium amount

A

4700 mg, 2300 lowers BP by 3 points

83
Q

Ensure vs pediasure

A

kids can take ensure too! meal supplement

84
Q

glucerna

A

targetted to diabetics

85
Q

drug interactions with vitamins

A

most not super significant

86
Q

vitamin k amount

A

4700 mg

87
Q

vitamin c amount

A

65-90 mg

88
Q

Fe adult male

A

8mg

89
Q

betacarotene is a source of

A

vitamin A (2000 beta is 200 A)

90
Q

betacarotene is a source of

A

vitamin A (2000 beta is 200 A)

91
Q

colic diagnosis

A

by exclusion; baby is fine between crying bouts, feeds well and gains weight. True colic is 3 hours 3 days a week for 3 weeks, baby inconsolable, usually in evening, disappears suddenly
-seems to be independent of breastfeeding vs formula

92
Q

colic vs teething peaks

A

3 months vs 4 of age

93
Q

types of lactose intolerance

A

1) normal= result of aging in some
2) result of illness (ex// stomach flu)
3) congenital

94
Q

things to try with colic (non drug)

A
  • no one way
  • non drug= swaddle, reposition, stimulation (clothes dryer and music), change formulas
  • drug:
95
Q

simethicone (Oval)

A

for colic=defoaming agent, GI discomfort via trapped gas, give after each feeding, minimal effectiveness but no side effects. Zero value if not caused by gas. 1st recommended agent in colic

96
Q

dicuclomine (bentylol)

A

antispasmodic for colic, better than placebo but doesn’t actually work for colic! Not for infants under 6 months, used for IBS, but SEs are drowsiness and constipation

97
Q

Gripe water

A

sodium bicarbonate, almost no SEs, leap of faith for colic, GERD can cause colic so may have some effect…but unlikely

98
Q

probiotics and colic

A

-third choice (gripe water and oval* are first), breastmilk has naturally, show promise, decent results in reducing crying,

99
Q

cocyntal

A

useless homeopathic for colic

100
Q

number of cigarettes to start step 2 at

A

10 cig (14 mg) (about 1 mg per cig, so 21, 14, 7 correspond)

101
Q

eczema is

A

1) lack of filaggrin (skin protein)
2) dysfunction/deficiency in ceramide
3) lack of NMF (natural moisturizing factors like urea which reduces water loss by being hygroscopic, keratolytic by softening skin, is protective and antipruritic) (also lactic acids and amino acids

102
Q

non pharm methods for dry skin

A
  • cut back bath/shower
  • use less hot water
  • try sponge
  • pat dry don’t rub
  • apply loting/cream while skil still damp
  • water intake and humidifier won’t help much
103
Q

danger of bath oil for dry skin

A

slip in tub (elderly), also only low level therapeutics but have no SEs

104
Q

colloidal ointment treatment benefits

A

protective and water holding, slightly anti infla,. anti itch

105
Q

what emollients and moisturizers try to do

A

mimic skin components (NMF, ceramide, etc)

106
Q

NMFs

A

natural moisturizing factors (urea=hygroscopic, ketaolytic (softens), antipruretic, fillagrin, ceramide

107
Q

o/w emollients/moisturizers

A

normal

108
Q

w/o emollients/moisturizers

A

extra strength. Ointment would be next stage

109
Q

benefits of ceramide products

A

not much over regular

110
Q

straight vaseline (petrolatum) for dry skin

A

heaviest hitter, most occlusive

111
Q

increased petrolatum for dry skin

A

increased occlusion, hydration, perfusion, but less is better for acne prone areas

112
Q

young vs old skin

A 
young= more fluid supplying upper layers of skin
old= less glandular secretion and fluid delivery into upper levels makes more prone to dry skin
113
Q

dry skin factors

A

excessive bathing and showering

  • aging
  • soaps
  • mechanical rubbing
  • low humidity
  • medical conditions
114
Q

dimethicone skin products

A

very smooth, silicone product, good for acne prone

115
Q

low in eczematous skin

A

ceramide

116
Q

dimethicone skin products

A

very smooth, silicone product, good for acne prone (decreased occlusion)

117
Q

low in eczematous skin

A

ceramide

118
Q

humectants and examples

A
  • hygroscopic, attract and hold water to prevent fluid loss

- glycerin, prop glycol, phospholipids, urea

119
Q

keratin softening agents: concentration needed

A

at least 5-10% for average person effect

120
Q

20% keratin softening agents for-

A

not average dry skin person, it has more intense keratin dissolving effect and will be itchy and prickle when on. Give for more irritated/rough skin

121
Q

examples of keratin softening agents

A

urea, AHA (alphahydroxy acid)

122
Q

vitamins added to dry skin products to help sell better, some truth only

A

Vitamin C/A/E

  • coenzyme Q
  • nicacinamide
123
Q

most products have __% in common with each other for dry skin ingredients, go for ____

A
  • 80%

- glycerin, dimethicone and petrolatum

124
Q

what to do for dry, cracked heels

A

-keep clean
-pare down keratin (debride- skin won’t heal if built up skin not removed)
-liquid bandaids=good option
-use ANY
moisturizer
-can use strapping (hold cracks together while heals), insoles to prevent thick skin development, heel cups to keep skin from expanding sideways
-podiatrists can glue tissue until healed

125
Q

moisturizer to use on cracked heels

A

ANY

126
Q

cause of dry cracked heels

A

prolonged standing

  • mechanical factors
  • overweight
  • open back on shoes
  • medical conditions (hypothyroid, diabetes)
  • skin conditions
127
Q

cause of dry cracked heels

A

prolonged standing

  • mechanical factors
  • overweight
  • open back on shoes
  • medical conditions (hypothyroid, diabetes)
  • skin conditions
128
Q

used to decrease age spots (hyperpigmentation aka liver spots)

A
  • retinoids (can be around eyes or mouth), takes few months
  • hydroquinone (5% rx, 2% cosmetics)/monobenzene can get rid of pigment in spot shooting depigmentation
  • monobenzene is rx only and more potent
129
Q

used to decrease age spots (hyperpigmentation aka liver spots)

A
  • retinoids (can be around eyes or mouth), takes few months
  • hydroquinone (5% rx, 2% cosmetics)/monobenzene can get rid of pigment in spot shooting depigmentation
  • monobenzene is rx only and more potent
130
Q

your complexion is based on

A

sun exposure, heredity, occupation, smoking

131
Q

help with wrinkles

A

AHA (must be 5-10%) and retinoids, preventative with suncreens

132
Q

presence or absence of rash with itch

A

rash and itch=skin disease

no rash and itch=systemic

133
Q

will normal benedryl or claritin help with regular itch

A

no, won’t help with standard itch of dry skin

134
Q

hives

A

-use antihistimines, 2nd gen in seniors. Use claritin-less SEs and more targetted

135
Q

mosquito bites

A

use benedryl because of histimine release, for 1-2 bites can use a corticosteroid or tough it out

136
Q

drugs that can induce itch

A

opioids

137
Q

benedryl (oral) uses

A

histamine release only

138
Q

more or less lanolins in dry skin lotion?

A

less

139
Q

is eczema grade good for everyone?

A

yes

140
Q

calamine for typical dry skin itch

A

NO- it will suck out moisture and increase loss leader to dryer skin

141
Q

calamine for typical dry skin itch

A

NO- it will suck out moisture and increase loss leader to dryer skin

142
Q

what can you use calamine for

A

first aid (insect bites, poison ivy)

143
Q

menthol at low strength (less than 1%)

A

an antipruritic

-above this, it is a counter irritant and can make things worse

144
Q

never recommend powder, anti itch or lotion for ___

A

a cut

145
Q

should you use local anesthetics on dry skin?

A

no- can use for first aid (bites) and possibly minor cuts and burns

146
Q

a large topical application of benedryl can

A

be harmful systemically

147
Q

OTC topical steroids strength:

A

1= high potency, 7=low

148
Q

occlusive ingredients in moisturizers

A

oils, petrolatum, dimethicone. All are emollients to protect skin

149
Q

why is water first ingredient in dry skin lotions often

A

makes product easier to apply

150
Q

can you absorb collagen and elastin from external sources?

A

no, must be made in body

OTC Therapeutics (5 decks)

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