Nutrition & the Role of the Pharmacist Flashcards

(60 cards)

1
Q

Who mapped the circulation and when?

A

William Harvey, 1628

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2
Q

Who performed the first successful blood transfusion and when?

A

James Blundell, 1818

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3
Q

Who infused saline for cholera and when?

A

Thomas Latta, 1831

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4
Q

Who infused eggs, milk, and sugar, and when?

A

Claude Bernard, 1843

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5
Q

Who analyzed blood nitrogen and when?

A

Otto Folin, 1911

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6
Q

Who discovered that bacterial remnants are pyrogens, and when?

A

Florence Seibert, 1925

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7
Q

Who discovered that BMR is best related to BSA and when?

A

FG Benedict, 1930

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8
Q

Who identified the essential AAs and when?

A

WC Rose, 1930

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9
Q

Who discovered injury’s effect on protein turnover and when?

A

George Whipple, 1932

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10
Q

Who discovered the catabolic response to injury and when?

A

DP Cuthbertson, 1936

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11
Q

Who administered casein hydrolysates instead of plasma for protein and when?

A

Robert Elman, 1936

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12
Q

Who formulated TPN and when?

A

Dudrick, Rhoads, Vars @ UPenn in 1967

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13
Q

How does fatty liver come about?

A

1) increased glucose
2) increased insulin
3) glucose stored in liver, not adipose

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14
Q

What is the fluid requirement to prevent pulmonary edema?

A

less than 3500 mL

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15
Q

What happens when fluid exceeds 3500 mL?

A

pulmonary edema

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16
Q

What is a consequence of using D15W?

A

thrombosis if used in peripheral veins

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17
Q

What form of dextrose solution should be used in peripheral veins?

A

d5

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18
Q

What IV fluid solution is best for long-term therapy?

A

ringers

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19
Q

Why is NS not generally used for long-term TPN?

A

acidosis

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20
Q

What is the caloric density of a CHO?

A

3.4 kcal/g

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21
Q

What is the caloric density of fat?

A

9 kcal/g

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22
Q

What was travenol’s protein product?

A

hydrolysates of beef blood fibrin

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23
Q

What was abbot’s protein product?

A

casein hydrolysates

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24
Q

What were the disadvantages of the early protein TPN products?

A

1) crude products –> uremia, not enough usable protein
2) bacterial contamination
- – aseptic technique not used

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25
How were new TPN protein formulations improved?
1) 100% synthetic L-alpha 2) increased acetate to repel microbes 3) Renal & hepatic formulas
26
What were the disadvantages of the new TPN protein formulations?
vitamin, trace element deficiencies
27
What is the Na concentration in a TPN product?
77 mEq/L
28
What is the K concentration in a TPN product?
40 mEq/L
29
What is the Ca concentration in a TPN product?
8 mEq/L
30
What is the PO4 concentration in a TPN product?
15 mmols/L
31
What is the Cl concentration in a TPN product?
77 mEq/L
32
What is the acetate concentration in a TPN product?
50 mEq/L
33
What are the essential fatty acids?
1) linoleic acid | 2) linolenic acid
34
What is the most important essential fatty acid in EFAD?
linoleic
35
Which IV fat product is best for EFAD?
Intralipid
36
Describe the composition of intralipid.
1:1 linoleic/linolenic derived from soybean oil
37
Describe the composition of liposyn.
20/80 linoleic/linolenic derived from safflower oil | -- same composition as human breast milk
38
What is the maximum recommended percentage for calories from essential FAs?
60%
39
What other components are in iv fat products?
glycerin
40
What is the purpose of glycerin in an IV fat product?
for iso-osmolarity
41
What is the usual IV fat administration for EFAD?
500 mL 10% fat emulsion Q week
42
What is the common IV fat administration?
250mL of 20% lipid
43
What lipid emulsion strengths are available?
10, 20, 30%
44
What lab is measured to ensure clearance of TGs?
serum TG
45
What is vitamin B1?
Thiamine
46
What is vitamin B2?
Riboflavin
47
What is vitamin B3
niacinamide
48
What is vitamin B5?
dexpanthanol
49
What is vitamin B6?
pyridoxine
50
What is vitamin C?
ascorbic acid
51
What is vitamin A?
retinol
52
What is vitamin D?
ergocalciferol
53
What is vitamin E?
di-alpha-tocopheryl acetate
54
What 12 components are in an MVI-12 infusion w/o K? How are they separated?
Upper chamber --- ADE B1-6 C Lower chamber --- B12, biotin, folic acid
55
What trace elements are included in Maurice Shil's formula?
1) Fe 2) Zn 3) Cu 4) Cr 5) Mn 6) F 7) I 8) Mb 9) Se
56
Who designed the first trace element solutions?
MDs (Maurice Shil)
57
What are the disadvantages to TPN?
1) infection 2) fatty liver 3) GI atrophy
58
How is GI atrophy with TPN avoided?
TPN combined with trophic (enteral) feeding
59
What does ASPEN stand for?
American Society for Parenteral and Enteral Nutrition
60
What does BCNSP stand for?
Board Certified Nutritional Support Pharmacist