Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology II > Vitamins > Flashcards

Vitamins Flashcards

1
Q

Most likely not to eat balanced diet

A

Elderly
No money
Malabsorption syndrome
Alcoholics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Thiamine requirement increase in

A

1) pregnancy
2) Lactation
3) Chronic Alcoholism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

S/S of thiamine deficiency ( Mild)

Beriberi

A 
Loss of appetite
Skeletal muscle weakness
Tendency of peripheral edema 
Decreased systemic BP
Low body Temp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Korsakoff Syndrome ( Severe Thiamine deficiency S/S)

A

Common in Alcoholics
1- Peripheral polyneuritis ( weakness, numbness pain from nerve damage )plus Hyperesthesia( Increased sensitivity in any of your senses ) and Anesthesia of legs.
2- High output HF with extensive Peripheral edema
3- Flat or inverted T-Wave .

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

First signs of B2 deficiency

A

Pharyngitis and Angular stomatitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Later S/S of B2 Deficiency

A

Glossitis
Red denuded lips
Sebhorric Dermatitis of the face
Dermatitis of trunk and extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Oral-Ocular-Genital Syndrome ?

A

Classic sign of B2 deficiency: Angular Cheilitis , Photophobia, Scrotal Dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What signs can be prominent in B2 deficiency ?

A

Anemia and Peripheral Neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

S/S of Niacin deficiency

A 
Nausea 
Skin/Mouth lesions
Anemia
Headache 
Tiredness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chronic Niacin Deficiency =

A

Pellagra
Skin: Erythematous skin especially Sun, friction pressure exposed. Very red and swollen tongue
Main GI : Enteritis, Stomatitis , Diarrhea
Other GI: N/V and excessive salivary secretions
Motor and sensory Peripheral neuropathy like Thiamine def , and Dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tryptophan- deficient corn diet causes

A

Pellagra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who else has Pellagra other than Niacin deficient

A

Alcoholics and chronic GI disease ppl.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What medication can lead to Pellagra

A

Isoniazied by stopping nicotinic acid to be in NAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment for Pellagra severe vs less severe

A

IV niacin= severe
PO niacin= less severe
Tx response in 24 hrs !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Toxic Effect of Niacin

A 
Pruritus 
Headache 
Flushing
Hepatotoxicity 
Hyperglycemia 
Hyperurecemia 
Activation of PUD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the function of B6 ( Pyridoxine)

A

Conversion of 1) Tryptophan to Serotonin 2) Methionine to Cysteine

1) Amnio acid Metabolism
2) Neuronal Excitability
3) Heme synthesis
4) Decrease blood Homocysteine level
* *Homocysteine is :( amino acid found in blood /when high level can cause heart disease/found in meat/high homocysteine is a risk factor for Heart disease,.high when you are deficient in B6, B12, folate and renal disease )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

B6 deficiency ..Who?

A

Rare. May accompany other B vit. Deficiency
Elderly, alcoholic, malnourished
Renal disease and on HD/ Hepatic disease/Type 1 DM/ HIV/RA/

18
Q

B6 deficiency effects are

A

Seizures bc lowers seizure threshold
Peripheral neuritis - Carpal Tunnel Syndrome
Decreased Synthesis of GABA ( so not enough inhibitory =seizures )
B6 and B3 deficiency goes to together

19
Q

B6 Drug interactions

A

Isoniazied and Hydralazine = no pyridoxal kinase = no synthesis of B6= no GABA = seizures!! So give pyridoxine (b6) to decrease the chance for having seizures
B6 increased decarboxylation of levodopa at periphery = levodopa becomes dopamine at periphery = can’t cross BBB = now levodopa not effective for the Parkinsons patients
Oral contraceptive = less of pyridoxal phosphate level in blood= GABA can’t be synthesized = not enough inhibition = maybe seizures ???
Corticosteroids and anticonvulsants= interfere with metabolism of B6

20
Q

B12 is what kind of compound? And other names please ..

A

Cobalt containing compound

Names: Cyanocobalamine , Cobalamine , B12

21
Q

Storage depot of VitB12

A

Liver

22
Q

B12 MOA

A

1- when **hydrogen ion ** is in stomach = release of B12 released from protein then binds to glycoprotein intrinsic factor . The combine and Form a complex
2- that complex travels to the ileum , goes a specific receptor then enters endothelium
THATS ABSORPTION
3 after absorption B12 binds to B globulin, transcobalamine II for transport to tissue ( especially Liver ).

23
Q

Likely cause of VitB12 deficiency?

A

1-Have too little or no Hydrochloric acid in gastric secretion ( Acchlorydia ) and not having enough secretion of intrinsic factor ( remember b12 only released when hydrogen ions present plus that it binds to intrinsic factor to for a complex in order to enter ileum )
***not likely bc you eat to little VitB12, unless you are vegan :-)
2- Bacterial overgrowth = B12 can’t reach the ileum
3- cutting the ileum = B12 cannot be absorbed
4_ Nitrous Oxide = oxides the cobalt atom of B12= 2 enzymes now can’t be synthesized: a)methionine b) thymidalate.

24
Q

Lab value of B12 deficiency

A

Less than 200pg/ml

**PG/ml **

25
Q

All the ways you can Vit B12 deficiency

A

1- Lab level of <200pg/ml
2- Indirectly: measure gastric acid level
3-Shilling’s test : measure radioactivity in the urine after you gave PO b12 to see how much went the ileum
4- ** confirm the diagnosis **= reticulocytosis ( high new immature red blood because you have anemia) remember low B12=pernicious anemia.

26
Q

What are s/s of B12 deficiency ?

A

Hematopoietic = change in erythrocyte and really severe you get cytopenia ( low levels of more than 1 type of blood cells, not just erythrocytes) : Megaloblastic anemia ! Which folic acid can fix btw ..
and Nervous system s/s
1-Encephalopathy : myelopathy/peripheral and optic neuropathy
2- most obvious neuro s/s is from demyelination = Parethesia of hand and feet , decreased sensation of proprioception and vibration —unsteady gait, then decreased DTRs and in advanced state: decreased memory , confusion, esp. elderly

27
Q

Treatment of B12 def

A

Initially - B12 IM plus PO Folic acid.( Hct up in 10-20days !!) iron now low bc it’s making new Hgb. Platelet back to normal in days …This will fix the anemia but neuro symptoms only slowly goes back to normal and if they were there for 12-18months will not go back to normal ever.
But within 24 hrs of Tx pt has memory back and sense of well-being

28
Q

Folic Acid is absorbed in …

A

In the Jejunum ( which is in the small intestine ) and depends on enterohepatic recirculation

29
Q

Who most at risk for Folic acid deficiency

A

Alcoholics because of low food intake and bc of their bad enterohepatic recirculation

30
Q

Who else gets Folic acid deficiency?

A

Small intestine disease like - Sprue

31
Q

Metabolically active form of Folic acid is …

A

Tetrahydrofolate ( 4 =tetra/water= hydro/leaf=folate ) 4 water leaf need Vit B12 to exist !

32
Q

4 actions of Tetrahydrofolate

A

1) Homocysteine to Methionine ( amino acid antioxidant needed in metabolism)
2) Serine ( an a-amino acid needed in protein biosynthesis ) to Glycine
3) DNA synthesis
4) Purine Synthesis ( remember pure as gold in DNA synthesis ?)

33
Q

What drugs can decrease Folic acid/ Folic acid deficiency?

A

Methotrexate and Trimethoprim ( dihydrofolate reductase inhibitor)
Phenytoin - ( interferes with absorption and storage of folic acid )

34
Q

Folic acid most common s/s ? With a cavit

A

Megaloblastic ( pernicious) anemia ! Which you can’t distinguish from the pernicious anemia of Vit B12 deficiency !
Also this folic acid anemia is rapid : happens in weeks vs B12 anemia takes years to happen *

35
Q

How to confirm Folic acid deficiency?

A

Lab level < 4 ng/ml

ng/mL*

36
Q

What might go down after Folate/ Folic acid or VitB12 therapy?

A

Iron..

Because they busy fixing the anemia problem now that the is B12 or Folic acid

37
Q

What is Folate therapy?

A

Folic acid, Vitamin B12 and Vitamin B6

38
Q

What condition increased requirement of Folic acid ?

A

Pregnancy , hence the preventive administration of it

39
Q

Leucovorin

A

Metabolically active reduced folic acid

Give after methotrexate as rescue

40
Q

Fat soluble Vitamins absorption parallels

A

Fat absorption

Affected by Malabsorption Fat disease , ex: obstructive jaundice

Pharmacology II (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions