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PHAR 153 > Vitamins > Flashcards

Vitamins Flashcards

1
Q

Do vitamin/mineral needs differ between people?

A

Yes, age is the most important factor that effects vitamin/mineral needs. sex also has an effect

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2
Q

Are natural sources of vitamins and minerals better?

A

Yes, we should promote good diets and vitamins/mineral supplements are secondary. People that really need them, don’t look for them

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3
Q

Why do people take vitamins/minerals?

A

Dietary insurance

For energy (B vitamin supplement effect is 100% pyschological)

To prevent illness (diet is king, supplements won’t ward off cancer or heart disease)

Specific medical reasons (eye vitamins for preventing AMD progression)

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4
Q

Why are B12 vitamins for seniors important?

A

Some people after aging over 50 will have issues with getting B12 from their diet (protein-cleaving issues), so supplements might be needed to help people get B12

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5
Q

Who really needs vitamins?

A

Impoverished groups
alcohol addicts
pregancy/lactation
obese
elderly

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6
Q

What supplements are given to infants automatically in Canada?

A

In Southern Canada
If breast-fed : 400IU
If formula fed: 0IU

If you live in northern areas?
If breast-fed: 800 IU
If formula-fed: 400 IU

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7
Q

Do babies need iron supplements?

A

This the realm of pediatricians. They might recommend a prescribed iron supplement if situation is exceptionally bad

Kids don’t need any iron supplements until 6 months

Iron-enriched baby food is available after 6 months

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8
Q

Do kids really need supplements?

A

Good food is king, but if parents want to cover all of their bases, go ahead and give vitamins

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9
Q

What are the Vitamin D requirements for people by age?

A

Infant (0-12 months): 400 IU, toxicity is 1000-1500 IU

Children and Adults (1-70 years): 600 IU, toxicity is 2500-4000 IU

70+: 800 IU , toxicity is 4000 IU

Vitamin D toxicity is the most concerning and possible out of the fat soluble vitamins

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10
Q

What is the utility of children’s multivitamins?

A

They are so low in dose, that they are effectively sub-therapeutic

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10
Q

What is the utility of children’s multivitamins?

A

They are so low in dose, that they are effectively sub-therapeutic. The selection of what vitamin/minerals included is also arbitary.

Something is better than nothing, just go with favourite character on box

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11
Q

What vitamins do teenagers need?

A

Young girls need to focus on calcium(osteoporosis risk reduction) and iron (loss due to menstruation)

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12
Q

Is it a serious issue if you give someone supplements not for their age group?

A

Not really, getting something is better than nothing

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13
Q

Are 100% complete multivitamins particularly better than other multivitamins?

A

Not really, they might be overkill. We only need multivitamins to top our levels up

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14
Q

How much vitamin D should people take?

A

600 IU a day (7000 IU once per week is also fine and does not pose toxicity concerns)

Toxicity starts after 4000IU per day and everyday. it can happen, so be careful

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15
Q

What is the best source of vitamin D?

A

90% of vitamin D production can be attributed to sunlight

10% of Vitamin D comes from food supplementation

We need to balance concerns between sun exposure causing skin damage and sun exposure promoting the production of Vitamin D

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16
Q

What vitamins do seniors need?

A

1200mg of Calcium
600-800 IU of Vitamin D
2.4 micrograms of Vitamin B12

Declining smell and taste = lower appetite(consuming less vitamins and minerals)

Live alone = eat less

Need less…
B vitamins because lower metabolism
Vitamin A
Iron

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17
Q

What supplements do people with pernicious anaemia take to help with their condition?

A

High dose Vitamin B12 (1000 micrograms and above)

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18
Q

Are the advantages sublingual B12 clinically relevant?

A

No, speed of absorption doesn’t really matter

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19
Q

What vitamins do pregnant women need?

A

Pregnant women are automatically given Materna (folic acid delivery system)

Iron: 27mg
Folate: 400 micrograms
Calcium: 1000mg
Vitamin D: 600 IU

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19
Q

What vitamins do young women need?

A

Pregnant women are automatically given Materna (folic acid delivery system)

Child-bearing age
Iron: 18mg
Folate: 400 micrograms
Calcium 1000mg
Vitamin D: 600mg

Pregnant woman needs
Iron: 27mg
Folate: 400 micrograms + what you were taking before
Calcium: 1000mg
Vitamin D: 600 IU

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20
Q

Why do pregnant women not like taking Materna?

A

People erroneously blame iron or calcium for nausea, but it is mostly from B12.

If meat-eating women does not want to take Materna, thats fine. We are more concerned about vegetarian mothers

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21
Q

Do pregnant women need specifically pregnancy-labelled multivitamins?

A

No, but ensure that there is a good amount of iron, folate, Vitamin D, and calcium

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22
Q

Why do pregnant and young women take folate?

A

It is taken to prevent spinal developmental issues in the fetus. Because 50% of pregnancies are unplanned, women of child-bearing age should take some type of folate. Women need to take at least 400 micrograms of folate.

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23
Q

Does iron content affect multivitamin adherence?

A

No, it is unfairly blamed. tablet size might play a bigger role in adherence

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24
Q

How much calcium should women take daily according to their age?

A

4-8 years old: 1000mg
9-13 years old: 1300mg
14-18 years old: 1300mg
19-50 years old: 1000mg
51+ years old; 1200mg

Side effects only start after 2500mg per day (and even at this dose, side effects are barely perceptible. constipation is the biggest concern)

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25
Q

What is the maximum dosing for calcium in one serving?

A

500mg. The body simply excretes the excess. This means you need to take calcium multiple times in a day to reach RNI (hence BID dosing)

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26
Q

What are some common sources of calcium available in a pharmacy?

A

Calcium carbonate (40% elemental)
Ca lactate (13%)
Ca gluconate (9%)

Citracal (20%) - used for people on protein pump inhibitors

Rolaids/Tums has 200 - 400 mg

27
Q

How to improve bone health and density?

A

Load bearing activities (lifting weights) and Calcium supplements. This especially a concern for women

28
Q

Do Calcium-Magnesium supplements help with leg cramps?

A

Although the media and doctors may reccomend these products for leg cramps, there isn’t clear evidence in support

29
Q

Do calcium and magnesium oppose side effects?

A

Yes in theory, but the doses are too low in supplements

30
Q

Does excess B vitamins help with energy?

A

Most people are not B vitamin deficient, and excesses do not give extra energy?

31
Q

What are the best sources of iron?

A

Heme (meats), but non-heme (plants) sources are fine, but that iron is less accessible

32
Q

What is the women’s RNI for Iron?

A

15-18 mg for females

33
Q

Are iron supplements easily accessible at pharmacies?

A

No, they are behind the counter and usually the pharmacist will have to ensure that the patient will use them properly

34
Q

Should we take iron supplements without food?

A

You can, but you will have a metallic after taste

35
Q

What are some common iron supplements?

A

The only difference between these options is how fast we need iron levels to increase.

Ferrous fumarate (33% elemental)
Ferrous sulfate (20%)
Ferrous gluconate (12%)

If doctor of patient does not mention a preference, ferrous sulfate is a good starting point. Use further questioning to change mind of stay with ferrous sulfate.

36
Q

What is the absorption of iron during iron deficiency?

A

20% of iron that passes through the GI tract is absorbed. Only 10% is absorbed if you have a normal amount of iron

37
Q

How long after iron supplementation does iron defiencieny anemia start to go away?

A

2-3 weeks

38
Q

What are the side effects of iron?

A

All of these side effects are dose dependent

Constipation - 12%
Dyspepsia - 7%
Nausea - 6%

These numbers go up with higher doses

39
Q

Is iron best absorbed quickly or slowly?

A

Iron is best absorbed quickly, this is why slow release iron tabs are less efficacious

40
Q

What percentage of poisoning deaths in children are caused by iron?

A

1/3 = 33%

41
Q

What is the iron RNI for child-bearing and pregnant women?

A

RNI for women = 18mg
pregnant women = 27mg (dose found in Materna)

42
Q

Can vitamin/mineral supplements stave off chronic disease?

A

No value in…
reducing mortality
any type of cancer
almost any type of cardiovascular disease

Diet is more important

43
Q

What was niacin used for?

A

Poor man’s statin (cholesterol management)

High amounts needed, niacin causes prickling feeling

Not used very commonly for this indication and by the general public

44
Q

Can vitamin and mineral supplements prevent cancer?

A

No, lifestyle choices and diet are more important (smoking and red meat consumption)

45
Q

Do B vitamins reduce stress?

A

B vitamin supplements have no real effect on energy, mostly psychological (placebo)

46
Q

What is the RNI for Thiamine (Vitamin B1)?

A

1mg, excess is simply excreted

47
Q

Can eye vitamins prevent the progression of AMD?

A

Vitamins that have the AREDS2 formulation can delay progression from Intermediate to Advanced AMD in 1/4 cases

This is the only vitamin that we cannot get the same benefit from dietary changes

48
Q

What is the RNI for Magnesium?

A

320 - 420 mg

used mostly for heart health, leg cramps, bone health, anti-constipation

49
Q

What dose of magnesium will cause diarrhea?

A

800mg to 1g of magnesium will definitely cause diarrhea

50
Q

What is the RNI for potassium?

A

4700mg

51
Q

Why are potassium levels tracked diligently?

A

hypo/Hyperkalemia can have negative effects on heart health

52
Q

Can meal replacement drinks provide all of the vitamins and minerals you need?

A

Yes, they are 100% nutrition.

53
Q

Do all Ensure products provide 100% nutrition?

A

No, some products do not contain everything you need

54
Q

What is the RNI for Vitamin C in males and females?

A

Males: 90mg
Females: 75mg

55
Q

Does Vitamin C help with colds?

A

There is no physiologic effect, but we cannot change the minds of the public

56
Q

Does Vitamin E oil have particularly significant effects on scar healing?

A

It is like any other oil

57
Q

What is the RNI for Vitamin E?

A

15mg or 22.4 IU

58
Q

What is the role of Vitamin K in the body?

A

Vitamin K plays a key role in helping the blood clot, preventing excessive bleeding. UNlike many other vitamins, vitamin K is not typically used as dietary supplements

Vitamin K1 is the main form found in supplements

59
Q

What is the RNI for Vitamin K?

A

100micrograms

60
Q

Why is Vitamin K1 the preferred type of Vitamin K in supplements?

A

K1 is generally the preferred form because it has less concern for toxicity and works faster, but some of the bone work claim K2 is better for that indication.

61
Q

How do fat soluble vitamins and mineral oils interact?

A

Mineral oils are rarely used, but Vitamins ADEK can leach into the mineral oil and is excreted without full absorption. This effect is almost negligible

62
Q

How does Vitamin E and anticoagulants (Warfarin)?

A

Need to get to 1000 IU before seeing anticoagulation, but hard to get to this level. Not possible if taking multivitamins

63
Q

How do Iron and Calcium interact with tetracyclines?

A

Tetracyclines may interact with the divalent charges on Fe and Ca. The tetracyclines are less effective, but not by a lot

64
Q

What is the interaction between calcium and corticosteroids?

A

Calcium can improve the risk of loosing bone mass following long-term corticosteroid use.

65
Q

What is the interaction between vitamin A and retinoids?

A

Retinoids were used topically for acne, but some kid took a bunch orally. Vitamin A is a retinoid, so there is a risk for overdose if both are taken orally

66
Q

Are vitamin-drug interactions for the most part clinically insignificant?

A

Yes, but we should still be cautious about potential adverse effects when doses are high

PHAR 153 (20 decks)

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