Natural Pdts & vitamins

Question 1

T/F? A dietary supplement manufacturer doesn’t have to prove a pdt’s safety and effectiveness before it is marketed?

Answer 1

T

Question 2

T/F? Ginkgo biloba increases bleeding risk w/o any effect on INR?

Answer 2

T

Question 3

Whys St. John’s wort called a broad spectrum inducer?

Answer 3

Can’t be used with many drugs e.g. OCPs, transplant drugs, warfarin, etc

Question 4

SEs of St. John’s wort?

Answer 4

Photosensitivity

Serotonergic

Question 5

SEs of some natural pdts e.g. Chaparral, Comfrey, Kava?

Answer 5

Hepatotoxicity

Question 6

What’s principle behind homeopathy?

Answer 6

Based on “the law of similars” or the concept that “like is cured by like”

Question 7

What are medical foods?

Answer 7

These are pdts that can also make health claims, since they are not FDA-approved drugs

Question 8

What may result from Vit B12 (thiamine) deficiency?

Answer 8

Wernicke encephalopathy

Question 9

Whys Vit. D given with calcium?

Answer 9

Vit. D is required for Calcium absorption

Question 10

Why should doses of Calcium be divided?

Answer 10

Bcuz Calcium absorption is saturable

Question 11

Which is preferred, Calcium supplement or dietary Calcium?

Answer 11

Dietary calcium

Question 12

Advantage and disadvantage of Calcium citrate?

Answer 12

Has better absorption, can be taken with or w/o food (315mg Ca)

But, It’s a bigger pill to swallow

Question 13

Calcium carbonate (Tums, Oscal) absorption? How it should be taken? Usual strength?

Answer 13

Acid-base dependent absorption

Should be taken with meals

500-600mg

Question 14

Whats the NIH recommended intake for Vit D in people up to age 70yrs?

Answer 14

600 IU daily

Question 15

Whats the NIH recommended intake for Vit D in people age 71+ yrs?

Answer 15

800 IU daily

Question 16

What supplement is used in renal dx or short-term in adults with deficiency to replenish stores?

Answer 16

50,000 unit Vit. D2 supplement

Question 17

What’s the preferred source of Vit. D?

Answer 17

Cholecalciferol or Vit. D3

Question 18

What supplement should any woman planning to conceive (and all women of child-bearing age) be on?

Answer 18

Folic acid 400-800 mcg/day (0.4-0.8 mg/day)

Question 19

T/F? Folic acid should be taken at least 1 month b4 pregnancy and continued for first 2-3 months of pregnancy?

Answer 19

T

Question 20

What’s the max dose of Vit E per day?

Answer 20

Should not exceed 150 IU daily

Question 21

When do babies require supplement?

Answer 21

Exclusively breastfed infants or babies drinking < 1litre of baby formula need 400 IU of Vit. D daily (Poly-Vi-Sol or generic)

Question 22

At what age do babies need iron supplement?

Answer 22

4-6 months

Question 23

Amt of iron req by breastfed babies?

Answer 23

1mg/kg/day from 4-6 months (until consuming iron-rich food)

Question 24

When do girls become at risk of iron deficiency?

Answer 24

Adolescent girls, once they begin menstruating

Question 25

Which supplement may be required for Metformin?

Answer 25

Vit B12

Question 26

Which supplement may be required for Valproic/Divalproex; Phenytoin; CBZ; Phenobarbital/Primidone?

Answer 26

Selenium Zinc (due to alopecia) Calcium + Vit. D12 Folic acid (phenytoin only)

Question 27

Which supplement may be required for Oxcarbazepine; Lamotrigine?

Answer 27

Selenium Zinc

Question 28

Which supplement may be required for Zonisamide; Topiramate; Acetazolamide?

Answer 28

Ca + Vit. D

Question 29

Which supplement may be required for bile acid sequestrants (Cholestyramine, Colsevelam, Colestipol)?

Answer 29

Multivitamin with A, D, E, K Folic acid (take separately)

Question 30

Which supplement may be required for Orlistat?

Answer 30

Multivitamin with A, D, E, K Beta-carotene

Question 31

Which supplement may be required for Methotrexate?

Answer 31

Folic acid

Question 32

Which supplement may be required for Loops?

Answer 32

K (always needed) Mg (if needed)

Question 33

Which supplement may be required for Aminoglycosides?

Answer 33

K, Mg, Ca

Question 34

Which supplement may be required for Isoniazid?

Answer 34

Vit. B6

Question 35

Which supplement may be required for Bactrim?

Answer 35

Folic acid (if used chronically)

Question 36

Which supplement may be required for Sulfasalazine?

Answer 36

Folic acid due to impaired absorption

Question 37

Which supplement may be required for PPIs?

Answer 37

Mg, Ca

Question 38

Which supplement may be required for OCPs?

Answer 38

Ferrous sulfate Folate

Question 39

Which supplement may be required for Depo-Provera; Corticosteroids (used in excess)?

Answer 39

Ca + Vit. D

Question 40

Which supplement may be required for Mineral oil?

Answer 40

Vitamins A, D, E, K

Question 41

Which supplement may be required for Digoxin?

Answer 41

Mg K

Question 42

Which supplement may be required for Pemetrexed?

Answer 42

Folic acid, Vit. B12

Question 43

Which supplement may be required for Heparin (and possibly LMWH)?

Answer 43

Ca if long-term

Question 44

Which supplement may be required for Alcoholism?

Answer 44

Vit. B12, Folic acid

Question 45

Which supplement may be required for Microcytic anemia?

Answer 45

Ferrous sulfate

Question 46

Which supplement may be required for Macrocytic anemia?

Answer 46

Vit. B12 and/or Folic acid

Question 47

Which supplement may be required for pregnancy?

Answer 47

Folic acid Ca, Vit. D Vit. B6 (nausea)

Question 48

Which supplement may be required for Osteopenia/Osteoporosis; Osteomalacia (Rickets); Hyperparathyroidism & CKD?

Answer 48

Ca + Vit. D

Question 49

Which supplement may be required for Scurvy?

Answer 49

Vit C

Question 50

Which supplement may be required for Crohn's dx (maybe UC too)?

Answer 50

Pt-specific iron, zinc, Folic acid, Ca, Vit D, B

Question 51

Which supplement may be required for Cystosis fibrosis?

Answer 51

Pancrelipase reduce absorption of iron and reduce conc of A, D, E, K and folate

Question 52

Which supplement may be required for DM?

Answer 52

K, Mg

Question 53

Which supplement may be required for Bariatric surgery?

Answer 53

Various pt-specific

Question 54

Which supplement may be required for HF?

Answer 54

K, Ca, Mg due to loop use

Question 55

What supplement does Epoetin alfa/Darbapoetin req to work?

Answer 55

Iron

Question 56

What supplement do all osteoporosis drugs req to work?

Answer 56

Ca + Vit. D

Question 57

What's a concern with natural pdts and vitamins?

Answer 57

Manufacturing may not follow good manufacturing practices (GMP)