Pharm final (Vitamins and Birth Control stuff) Flashcards
1
Q
What is the view of medicine that focuses on prevention rather than treatment?
A
FUNCTIONAL MEDICINE
2
Q
What are the three antioxidant vitamins?
A
Vitamin A
Vitamin C
Vitamin E
3
Q
What are the fat soluble vitamins?
A
ADEK
4
Q
_____ soluble vitamins are stored in fat and do not need to be _________ everyday
A
FAT soluble; do not need replenished daily
5
Q
Fat soluble vitamins are easy to _________ on….
A
Overdose
6
Q
What are the water soluble vitamins?
A
B and C
7
Q
_______ soluble vitamins are excreted in urine and must be ___________ daily
A
Water soluble vitamins need to be replenished daily
8
Q
Vitamin A is also known as ________
A
Retinol
9
Q
What vitamin is key for proper eye and skin health?
A
Vitamin A
10
Q
What are the possible toxicities for Vitamin A?
A
birth defects
liver injury
bone related (too much vitamin A can lead to improper absorption of Vitamin D)
11
Q
What are the possible consequences for low Vitamin A?
A
Night blindness
Xeropthalmia
Keratomalacia
Blindness
12
Q
What are the uses for vitamin A supplement uses?
A
treating eye conditions
stopping diarrhea in a malnourished child
decreases bronchopulmonary dysplasia in infants
measles, acne (isotretinoin)
13
Q
What vitamin is necessary for normal body functioning and hormonal and cellular signaling?
A
Vitamin D
14
Q
Vitamin ____ regulates calcium and phosphorus?
A
D
15
Q
What are the risk for low vitamin D?
A
Rickets and Osteomalacia
16
Q
What is the best source of vitamin A?
A
THE SUN
17
Q
How to you get some vitamin D while being outside?
A
Sunscreen blocks absorption of vitamin D, so be outside for like 10 minutes a day without the sunscreen!!!
18
Q
Sources of vitamin D?
A
Sardines, liver, eggs, tuna, shrimp
Mushrooms, butter, natural cheese, fortified milk and seeds
19
Q
What is the better supplementation option for Vitamin D?
A
D3»_space;»> D2
20
Q
What is the traditional recommendation for D supplementation?
A
400-800 IU a day
21
Q
What is the current recommendation for D supplemenation?
A
2,000-3,000 IU a day
22
Q
What should the blood level of vitamin D be??
A
40-60 ng/mL
23
Q
What vitamin has antioxidant properties?
A
Vitamin E
24
Q
What are dietary sources of Vitamin E?
A
Fresh greens, seeds, and oils
25
What are the possible toxicity of Vitamin E?
Platelet inhibition that may cause too much bleeding.
26
What vitamin is necessary for the synthesis of the prothrombin and other clotting factors?
Vitamin K
27
What are the consequences of a vitamin K deficiency?
BLEEDING
28
What are the possible AE of Vitamin K?
Hypersensitivity when too quick IV
Hyperbilirubinemia when it is given IM to infants
29
What is given in the event of a vitamin K OD?
Warfarin; people do not normally need Vitamin K supplementation
30
What vitamin is important in the production of collagen and compound that bind cells together, needed for the adrenal steroids?
Vitamin C
31
What vitamin helps absorb iron?
IRON
32
What are dietary sources of Vitamin C?
Citrus, tomatoes, potatoes, strawberries, melons, spinach, and broccoli
33
What are the consequences of Vitamin C deficiency?
Scurvy
34
What vitamin is also considered Niacin/Nicotinic Acid?
Vitamin B3
35
What is the consequence of Vitamin B3 deficiency?
Pellagra: scaling and cracking of sun exposed areas of the skin
GI disturbances: CNS changes
36
What are the possible toxicities of too much B3/Niacin?
Large doses used for high cholesterol can cause vasodilation, flushing, dizziness, and nausea
37
What is the use for vitamin B3/Niacin?
Topically for acne
Large doses for cholesterol
38
Vitamin B1 is also known as?
Thiamine
39
What vitamin is important in carbohydrate metabolism, so you need higher levels in pregnancy and lactation?
Vitamin B1/Thaimine
40
What are the two kinds of chronic B1 deficiencies?
Beriberi
Wenicke-Korsakoff
41
What chronic deficiency is associated with fluid accumulation in legs, cardiovascular complications, and ultimately circulatory collapse
Wet Beriberi
42
What is the chronic B1 deficiency that is associated with neuro and motor deficiet, but there are no cardiac complications?
Dry beriberi
43
What is the treatment for WET beriberi?
Thiamin replacement; this normally works fast so there is no need for a diuretic
44
What is the treatment for DRY beriberi?
Thiamine replacement; will have a slower recovery than wet beriberi
45
What is the most common cause of thiamine deficiency?
Wenicke-Korsakoff
46
What are the serious CNS AE of Wernicke Korsakoff?
Nystagmus
Diplopia
Short term amnesia
Ataxia
47
What is the B vitamin that is important for enzyme activity?
Riboflavin (B2)
48
What are the uses of Vitamin B2 (Riboflavin)
Deficiency (will see cracked edges of the mouth)
Relief of migraines after 3 months of use
49
What is the B vitamin that can be low because of poor diet, isozoanid use, or inborn errors of metabolism?
Vitamin B6 (Pyridoxine)
50
What are the consequences of a low B6?
Microcytic anemia
Dermatitis
Mouth sores
Cracked lips
51
What is the B vitamin that if it is too low, it can cause neuro damage?
B12 (Cyancobalamin)
52
What is the B vitamin that is found in many foods but is ESSENTIAL IN PREGNANT WOMEN????
Vitamin B9 FOLIC ACID
53
What herbal supplement is used for symptoms of menopause, almost ass effective as estrogen
Black Cohosh
54
Black cohosh potentiates what?
antihypertensive drugs, hypoglycemics, insulin, and estrogen giving them a stronger effects
55
What are the AE of black cohosh
safe for routine use
caution with hepatotoxic drugs
GI symptoms are most common
56
What herbal supplement is used for nasal allergy symptoms and migraine prevention?
Butterbur
57
What are the AE of Butterbur?
bleeding, headaches, fatigue, may have cross sensitivity with ragweed and some flowers
58
What herbal supplement is a potent antioxidant that is used in cardiac conditions, improves male infertility, statin associated myopathy
Coenxyme Q-10
59
What are the DI that are associated with Coenzyme Q-10
ANTAGONIZES the effects of Warfarin
60
What herbal supplement prevents UTI and helps with odor for urinary incontinence, benefit is only for teens-20s and elderly women
Cranberry Juice
61
What are the AE of Cranberry juice?
too much = kidney stones
May increase INR in patients on Warfarin
62
What is the herbal supplement that commonly used for anti-inflammatory properties, also has immunostimulant effects, not proven
Echineacea
63
What are the possible AE of Echinacea?
Fever, N/V, allergic reactions
64
Long term use of _________ can lead to immunosupression?
Echinacea
65
What is used in migraine prohylaxis?
Feverfew
66
What are the possible AE of Feverfew?
AE: well tolerated, mild GI reactions, suppression of platelet aggregation --> bleeding
67
What is the consideration of Feverfew before surgery?
Discontinue 2 weeks before surgery, and do not take with warfarin
68
What herbal supplement is a plant fiber that is used for dyslipidemia and constipation?
Flaxseed?
69
What is the interaction of flaxseed with other meds?
Take 1 hour before meds or 2 hours after other medications
70
What is the herbal supplement that lowers BP, antiplatlet, and may reduce risk of cancer?
Garlic
71
TO BE EFFECT..... (for Garlic to be useful)
must be raw, 1-2 cloves daily, most garlic products do not contain the active ingredient
72
What are the possible AE of Garlic?
Minimal
Bad breath, GI issues, strong platelets for a risk of bleeding
73
What is the herbal supplement that is used for vertigo, N/N, and RA?
Ginger root
74
What are the possible AE of ginger root?
CNS depression, Cardiac arrythmias, stimulation of the uterus
75
What are drug interactions for ginger root?
Suppress platelet aggregation, lower blood sugar
76
What herbal supplement shows possible improvement for PAD, dementia, and other conditions?
Gingko Bilboa (leaves only)
77
What are the possible drug interactions for Gingko Bilboa?
Can suppress coagulation, promote seizures, and lowers the seizure threshold
78
What is the herbal supplement that is used for osteoarthiritis?
Glucosamine
79
What are the possible AE of Glucosamine?
GI disturbances, increased risk of bleeding, and caution with shellfish allergy
80
What tea has the most caffeine?
Green --> black tea --> oolong tea
81
What is the use for green tea?
Mental clarity, weight loss, reduce the risk of cancer
82
What are the possible AE of Green tea?
Caffeine OD, HA, N/V, insomnia, increased HR and urination
83
What are the possible drug interactions that are associated with green tea?
Vasodilation, Vitamin K may interact with Warfarin
84
What herbal supplement is associated with the use for IBS, intestinal bacterial overgrowth, abdominal pain, tension headaches
Peppermint
85
What are the possible AE of Peppermint?
GERD, allergic reactions, perianal burning and renal problems
86
What herbal supplement can be used for diarrhea, UC, IBS, and reduction for H. Pylori for PUD?
Probiotics
87
What are the possible AE of probiotics
DO NOT GIVE TO PATEINTS WITH A CENTRAL LINE --> Risk for fungal infection
88
What administration consideration should be kept in mind when giving probiotics?
Give 2 hours after antibacterial or antifungal drug
89
What are food sources for probiotics?
Fermented foods, sauerkraut, yogurt, kefir, miso soup, pickles, kimchi, tempeh, kombucha, natto, chocolate
90
What is the herbal supplement that is found in wine, grape skin, grape juice, blueberries, cranberries, and peanuts --> antioxidant
Resveratol
91
What are the drug interactions associated with Resveratol
antiplatelet actions, mimics estrogen must be used with caution in women with estrogen dependent breast CA, increases insulin sensitivity
92
What are the essential omega fatty acids because they cannot be created in the body
Omega 3 and Omega 6
93
What omega fatty acid can be made in the body
Omega 9
94
What is the omega 3 fatty acid that is found in flaxseed, nuts, and green leafy veggies?
Alpha-linolic acid
95
What is the omega 3 fatty acid that is found in fatty fish, mackeral, and some fish oils?
DHA (Docosahexaenoic acid)
96
What is the omega 6 fatty acid that is found in many vegetables and vegetable oils, no need to supplement
Linoleic Acid
97
What is the omega 6 fatty acid that is found in borage, primroses, and black currant oil, very minimal in the diet
Gamma-linoleic acid (GLA)
98
What is the omega 6 fatty acid that is found in eggs, fish, meat, and not normally requiring supplementation?
Arachidonic Acid
99
You need to have a 3:1-6:1 ratio of Omega-___ and Omega-___ above inflammatory
Omega 6 ; Omega 3
100
What is the herbal supplement that may be effective in treating BPH, antiplatelt and antiadrenergic effects?
Saw Palmetto
101
What is the herbal supplement that is used to reduce hot flashes, can reduce risk of estrogen dependent breast CA, but should not be used with antiestrogen medications (tamoxifen)
Soy
102
What herbal supplementation is used for depression?
St. John's Wart
103
What are the possible AE of St. John's Wart?
allergies, CNS disturbances, GI discomfort, phototoxic at high doses
104
St. John's Wart interacts with........
MANY OTHER DRUGS; do not give with SSRI
105
What herbal supplement is a mild sedative, helps with anxiety will potentiate CNS depression with other drugs?
Valerian
106
What is the harmful supplement that leads to veno-occlusive disease and liver damage?
Comfrey
107
What is the harmful supplement that can lead to severe hepatic damage?
Kava
108
What is the harmful supplement that can elevate BP, and stimulate the heart and CNS
Ma Huang
109
What is the harmful supplement that impairs brain development in adolescence, increase risk of psychiatric conditions and suicide in adults
Cannabis
110
RA is a disease where there is no cure... Therapy is directed at __________ symptoms and maintaining ________
Reduce symptoms
Maintain mobility
111
What is the general first line treatment for RA?
NSAIDS
112
What is the difference between 1st line and 2nd line NSAIDS in RA?
2nd generation has less GI irritation
113
What are the 2 glucocorticoids that can be used in the treatment of RA?
Prednisone and Prednisolone
114
When giving glucocorticoids for RA, keep in mind it is ______________ dosing so it can cause lots of SE
Pharmocological dosing
115
What is the most rapid acting DMARD, that is used second line, but it is the first line DMARD?
Methotrexate
116
What is the MOA of Methotrexate?
Suppresses B and T lymphocytes
117
How long does it take methotrexate to work?
3-6 weeks; it is given once a week at a low dose
118
What are the possible AE of methotrexate?
Hepatic fibrosis
Bone marrow suppression
GI ulceration
pneumonitis
119
What are the 3 important things to monitor for a patient on Methotrexate?
LFT
Kidney function
CBCs
120
You need to give _____ ______ with methotrexate?
folic acid
121
What is the second line DMARD for RA?
Etanercept
122
_______ is used after methotrexate
Etanercept
123
__________ is more effective than methotrexate but has worse AE
Etanercept
124
What are the AE of Etanercept
Risk of serious infection allergic reaction
heart failure
hematological disorders
liver injury
CSN demyelination
TB, and SJS in the first 28 days
125
What are the two tests that need to be monitored for a patient taking etanercept?
CBC and LFT
126
WHAT IS THE MAJOR TEACHING POINT FOR A PATIENT TAKING ETANERCEPT?
NO LIVE VACCINES BC OF IMMUNE SUPPRESSION
127
What is the DMARD that cannot be given to patient's with a sulfa allergy
Sulfasalazine
128
What is the DMARD that reduces RA symptoms and slows disease progression but can cause an infusion reaction?
Rituximab
129
What is the DMARD that is normally given after etanercept?
Abatacept
130
What are the possible AE of Abatacept?
HA
URI
Nasopharyngitis
Nausea and infections
131
What is the hormone that is important in the maturation and function of female sex organs?
Estrogen
132
What are the 3 metabolic effects of Estrogen?
Increases bone mass
Improves cholesterol levels
Causes blood coagulation
133
What are the AE of estrogen
Cancers of the female repro system
cardiac events due to clotting
134
What are the uses of estrogen?
Menopause
Female hypogonadism
Female acne
135
What are the 4 routes for estrogen administration?
PO
Transdermal
Vaginal
IV
136
What are the two selective estrogen receptor modulators?
Tamoxifen and Raloxifene
137
What is the hormone that is used in menopause, uterine bleeding, amenorrhea, infertility, endometrial carcinoma, and hyperplasia?
Progestin
138
What are the AE of Progestin?
Tetrogenic
Breast cancer and tenderness
Gynecological issues and bloating
Depression
139
What is the most common symptoms of Menopause
Hot flashes and night sweats
140
What are the benefits of estrogen therapy in treatment of menopause?
Helps with the annoying symptoms
141
What are the risks of estrogen therapy in treatment of menopause?
Endometrial cancer
Breast cancer
Cardiac events
Gallbladder disease
142
What are the benefits of Progestin therapy in the treatment for Menopause?
Reduces estrogen induced irregular bleeding and endometrial carcinoma
143
What are the risks of progestin therapy in the treatment for menopause?
Bloating, weight gain, unpredictable uterine bleeding at first.
144
The use of unopposed estrogen is only to be used in they have had a ____________
Hysterectomy (other wise they need progestin as well)
145
What is the PO progesterone tablet
Aygestin
146
If a patient has a high risk of VTE, you should use a non oral route of hormones at the _________ dose possible
LOWEST
147
If a patient has a high risk of breast cancer, you should use a _________________ treatment in menopause
NONHORMONAL
148
If a patient has a high risk of CVD, you should use a _________ treatment for menopause
NON HORMONAL
149
If a patient has a moderate risk of CVD, you should use __________ estrogen with appropriate use of progesterone
TRANSDERMAL
150
What are the three considerations for birth control selection?
Efficacy
Safety
Person preferences
151
What are the two main types of OCs?
Combination OC -estrogen and progestin
Progestin only OC
152
What are the 3 MOAs of OCs
1. Suppress Ovulation
2. Thickening of cervical mucous
3. Alters the endometrial lining to prevent implantation of a fertilized egg
153
What are the possible AE of Combined OCs
Thromboembolic disorders
Cancers
Tetragenic
154
What are the benefits of OC use?
Suppressed dysmenorrhea
Endometriosis
Acne
Hirsutism
Less ovarian cysts and PID
155
What are the COC methods
Oral
Patch
Vaginal ring
156
What are the methods of Progestin only OCs?
PO
Injection
Implant
Intrauterine
157
What are the contraindications for combination oral contraceptives?
Smoker for over 35 years
Risk for PE and DVT
Migraines with aura
clotting risk
CVD and breast cancer.
158
What are COC AE?
N/V
Acne
Breakthrough bleeding
ACHES- clotting
159
What is the MOA of progestin only contraceptives
Thickens cervical mucous
160
What is the important consideration regarding taking the POC
Must take the dose at the same time every day
161
If the POC is taken 3 hours late, they need to use __________
backup contraception for 48 hours
162
What are the AE for progestin only contraceptives?
Changing in bleeding patterns
breast tenderness
163
What are the possible AE of the DEPOT Provera injection
Weight gain
Mood issues
Long term fertility issues
Decrease in BMD if given over 5 years
164
What are the possible AE of the DEPOT Provera injection
Weight gain
Mood issues
Long term fertility issues
Decrease in BMD if given over 5 years
- need to take Ca and Vitamin D
165
What is the intrauterine progestin progestin only contraceptives?
Mirena (left in uterus for 5 years)
166
What is the progestin implant in the arm?
Nexplanon
167
How long is nexplanon left in the arm?
3 years
168
What is the chemical surfactant that kills sperm by destroying the cell membrane?
Spermicides
169
What is the nonhormonal contraceptive that changes sperm motility and maintains vaginal pH?
Vaginal gel
