Vitamin Supplementation

Question 1

inadequate vitamin intake populations

Answer 1

impoverished, elderly, anorexics, fad diets, parenteral nutrition

Question 2

what are the 13 vitamins

Answer 2

thiamine, riboflavin, naicin, biotin, pantothenic acid, B6, B12, folate
ascorbic acid (Vit C)
A, D, E, K

Question 3

what are the water sol B vitamins for energy release

Answer 3

thiamine, riboflavin, niacin, biotin, pantothenic acid

Question 4

what are the water soluble B vitamins for hematopoiesis

Answer 4

B6, B12, folate

Question 5

what are the fat soluble vitamins

Answer 5

A D E K

Question 6

thiamine (aka \_\_\_?\_\_\_)
moa
requirements increased when\_\_\_\_\_\_\_
max abs
deficiency in \_\_\_\_\_\_\_ causes \_\_\_\_\_\_\_

Answer 6

Vitamin B1!
coenzyme in multiple rxns
requirements increased with high carbohydrate consumption and in metabolic rate (athlete)
max absorption is 8-15mg/d
deficiency in alcoholics causes neurologic sequelae, Wernicke’s Encephalopathy, Korsakoff’s psychosis

Question 7

RIbofalvin (aka \_\_\_?\_\_\_)
moa
inc requirements \_\_\_\_\_\_
AE
deficiency is common or rare?

Answer 7

Vitamin B2!

role in numerous respiratory (oxidative) systems
inc requirements with metabolic stress and physical activity

AE: bright yellow urine!
deficiency is RARE

Question 8

Niacin (aka ___?___)
moa
deficiency state term, sx and tx

Answer 8

Vitamin B-3!
made of nicotinic acid + nicotinamide
deficiency state = Pellagra w sx of the three Ds
Dermatitis
Diarrhea
Dementia
tx = aggressively high doses

Question 9

Pyridoxine (aka ___?___)
moa
DDI

Answer 9

Vitamin B-6
coenzyme
DDI: levodopa, phenobarbital, phenytoin

Question 10

Cyanocobalamin, Hydroxycobalamin
use/moa
storage
dose
DDI
deficiency causes

Answer 10

coenzyme for cell growth and replication
100mcg IM q month
DDI w metformin, PPIs and HrRAs
deficient in >50 yo, macrocytic anemia, irreversible nervous system damage

Question 11

folic acid (aka \_\_?\_\_)
moa/use
important in \_\_\_\_\_, what dose?
deficiency with which meds

Answer 11

Vitamin B9
DNA synthesis and hematopoiesis
important in pregnant patients, 0.6mg/day
reduced by MTX, TMP, POC, phenytoin

Question 12

should you supplement with B12 or folic acid first

Answer 12

B-12 bc folic acid masks decreased B12 which can lead to irreversible nervous system damage

Question 13

Ascorbic acid (Vitamin C)
moa
increased requirements in:
deficiency =

Answer 13

cofactor for electron transfer in enzymes, collagen synthesis, wound healing
inc requirements: smokers need 100mg/d
burn patients need 1-2g/
500mg/d x 7-10d to enhance wound healing perioperatively
deficiency = scurvy

Question 14

Vitamin A
moa
requires _________ to be absorbed
deficiency leads to

Answer 14

retinal fxn, growth and diff of epithelial tissues, bone growth, immune function
requires bile salts, pancreatic lipase and dietary fate to be abs
deficiency –> blindness

Question 15

what dose of vitamin A is considered teratogenic

Answer 15

> 25,000 IU/day

Question 16

Vitamin E
moa
significance?

Answer 16

antioxidant, enhances vitamin A absorption

no nutritional significance

Question 17

Vitamin D
deficiency prone groups
fxn
preferred forms

Answer 17

age, skin color, geography, sun exposure
fxns as steroid hormone
ergocalciferol (D2) and cholecalciferol (D3) preferred

Question 18

potential benefits of vitamin D

Answer 18

CVD, DM< respiratory diseases, eye disease, infectious disease, neurologic disease, cancer

Question 19

_____ IU will inc blood concentrations of calcidiol by _____ ng/mL

Answer 19

100IU –> 1ng/mL

Question 20

who are at inc risk of falls with vitamin D supplementation

Answer 20

elderly

Question 21

higher dose regimen AE

Answer 21

falls in elderly

URI

Question 22

which vitamins should not be used in the primary or secondary prevention of CVD

Answer 22

E, C, beta carotene, B6, B12

Question 23

folic acid and pregnancy

Answer 23

folic acid should be used in childbearing years to prevent neural tube defects

Question 24

which vitamins are required for post op of all bariatric surgery types

Answer 24

D, B1, B12, thiamine

Question 25

folic acid and bariatric surgery

Answer 25

only in RYGB and BPDDS

Question 26

what are AREDS formulas used for

Answer 26

to prevent macular degeneration

Question 27

AREDS formula for non-smokers

Answer 27

500mg Vit C
400 IU Vit E
80mg Zinc
2mg copper
15mg Beta-carotene

Question 28

AREDS2 formula for current or past smokers

Answer 28

500mg Vit C
400 IU Vit E
80mg Zinc
2mg copper
10mg lutein
2mg zeaxanthin

Question 29

if a patient is on a PPI, which supplements should they receive?

Answer 29

B12, Ca, Mg

Question 30

if a patient is on Metformin, which supplements should they receive?

Answer 30

B12

Question 31

smokers have increased mortality with which vitamin

Answer 31

Vitamin A