Minerals EXAM 2

Question 1

Function of Calcium

Answer 1

-major component of bones and teeth
- Activates a number of enzymes and is required for acetylcholine synthesis

Question 2

Calcium benefits in metabolism

Answer 2

-Increases cell membrane permeability
-aids in vitamin B12 absorption
-regulates muscle contraction and relaxation
-catalyzes several steps in the activation of plasma clotting factor

Question 3

Common Indication of Calcium Supplementation

Answer 3

Treatment of Osteoarthritis in elderly

max dose at once 600 mg, so for someone who takes 1200 mg a day -> divide in two doses

Question 4

Symptoms of Calcium deficiency

Answer 4

-short term can cause convulsions, tetany
-behavioral and personality disorders, mental and growth retardation

long term: causes bone deformities

Question 5

Toxicities of Calcium

Answer 5

-Dose greater than 3g daily can cause renal stones –anorexia, nausea, vomiting, constipation, and polyuria

Question 6

Calcium carbonate

Answer 6

-Insoluble in water -> Should be taken with meals to increase absorption at low pH

-40% elemental calcium: 1000 mg calcium carbonate = 400 mg elemental calcium

-supplement with the highest amount of elemental calcium

Question 7

If a patient uses antiacids which calcium supplement is the best option?
EXAM

Answer 7

Calcium Citrate
-works best in a basic environment
-21 % elemental calcium
-more expensive

Question 8

Functions of Iron

Answer 8

-oxygen and electron transport

Question 9

Reasons for deficiency and symptoms

Answer 9

-iron loss is blood loss, inadequate intake or increased demand

-Symptoms are pallor, fatigue, poor concentration, cognitive impairment, increased susceptibility
to infection

Question 10

Toxicity of Iron

Answer 10

-irritable the GI mucosa and may cause nausea, abdominal pain, constipation, and diarrhea

Question 11

Ferrous Sulfate

Answer 11

-Gold standard of iron supplementation

-Typical dose: 325 mg/tablet
-Percent Elemental Iron: 20% (65 mg/tablet)

There are 2 alternative salt forms, other formulations if preferred for patients

Question 12

Ferrous Gluconate

Answer 12

-No advantage over ferrous sulfate, May be better tolerated by some patients

-Typical dose: 225 mg/tablet
-Percent Elemental Iron: 12 % (27 mg/tablet)

Question 13

Ferrous Fumarate

Answer 13

-No advantage over ferrous sulfate, may be better tolerated by some patients

-Typical dosage: 60 mg/tablet
-Percent Elemental: 33% (20 mg/tablet)

Question 14

How does concurrent Vitamin C intake improve Iron absorption?

Answer 14

Because Iron is best absorbed at low pH
BUT it also contributes to more GI distress

Question 15

How does Vitamin K interfere with blood thinning and clotting (Warfarin)

Answer 15

-Vitamins A and E interfere with Vitamin K (blood clotting) absorption -> can increase anticoagulation and bleeding -> decrease the dose of Warfarin when Vitamin A and E is on board

-Vitamin K will antagonize the effects of warfarin (blood thinner) -> may need a higher dose of Warfarin

Question 16

Effect of Antiepileptics to Vitamins

Answer 16

-Epiletpitcs: carbamazepine, phenytoin, barbiturates

-Increase Vitamin D metabolism

Question 17

How does Metformin affect Vitamins?

Answer 17

depletes Vitamin B12 over time

Question 18

How do PPIs affect Vitamins?

Answer 18

decrease absorption of Vitamin B12, Calcium and magnesium

Question 19

How does Methotrexate affect Vitamins?

Answer 19

antagonizes folic acid (B9) metabolism
-> Supplement when taking Methotrexate (inflammatory arthritis)

Question 20

How does Isoniazid affect Vitamins?

Answer 20

antagonizes Vitamin B6 absorption

Question 21

How are Tetracyclines, fluoroquinolones, and levothyroxine affected by Minerals?

Answer 21

decreased drug absorption with cations (Ca2+, Mg2+, Fe2+) due to chelation

Question 22

How do antacids and PPIs affect Minerals?

Answer 22

-Antacids: decreased absorption of calcium, phosphorous, and iron

-PPIs and H2RA’s: decreased absorption of calcium
carbonate due to increased gastric pH

Question 23

What are the Prenatal Vitamins?

Answer 23

-Folic acid (B9) to prevent brain and spinal cord damage (400 mcg)
-Iodine to support brain and thyroid development - 150 mcg daily

-Iron to support red blood cell growth in the mother: at least 27 mg daily
-Calcium to support bone health - at least 1000 mg daily

Question 24

Vitamins for Energy

Answer 24

-Centrum Specialist® Energy Multivitamin
->Contains 200-300% B-complex vitamins
->Contains Ginseng Root
-May reduce fatigue and stress

Olly Daily Energy
->Contains 12,500% Vitamin B12, Goji Berry: lower BP and stimulate the immune system

-Coenzyme Q-10: stimulates the immune system, and acts as an antioxidant

Question 25

What are Vitamins for children?

Answer 25

-for children over the age of 4
-gummies and chewable
-contains a limited amount of Fe

Question 26

What to counsel on with Vitamins for Men, Women, Seniors

Answer 26

-Products for older patients may contain higher amounts of vitamins and minerals

-counsel about the right amount of vitamins, bc some products do not contain the recommended amount

Question 27

Hair, Skin, & Nails Vitamins

Answer 27

-Biotin (Necessary for carbohydrate, fat, and amino acid metabolism)
-B-Complex (multiple B vitamins B1-B12)
-Vitamins A, C, D, and E
-PABA (Para-Aminobenzoic Acid) - non-essential vitamin B complex
-Hydrolyzed collagen