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Spring Pharm Block 4 > Vitamins and Minerals > Flashcards

Vitamins and Minerals Flashcards

1
Q

Differentiate vitamins obtained through the diet from vitamins obtained through a supplement.

A

The body does not differentiate one from the other. The only difference is the dietary form likely has additional nutrients.

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2
Q

What determines whether or not a patient should take a vitamin supplement?

A

Individual choice based on how balanced their diet is

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3
Q

What is the primary use of vitamins and minerals in our body?

A

Used as cofactors in metabolism

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4
Q

In what type of vitamins do we worry about toxicity?

A

Fat soluble - A, D, E, K

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5
Q

Describe Nephrocaps and state what type of patients should take them.

A

Multivitamin fortified with higher concentration of water soluble vitamins. Taken by patients on dialysis because dialysis removes a lot of water soluble vitamins.

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6
Q

What substances are pre-natal vitamins fortified with?

A

Folate and iron

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7
Q

What is the name for vitamin A and its analogues?

A

Retinol / retinoids

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8
Q

Describe the functions of vitamin A in the body.

A

Skin development
Formation of retinal photochemicals
Enhance immune function
Protective effect against certain cancers

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9
Q

What are the indications for prescription vitamin A supplementation?

A

Psoriasis, acne (most common), some leukemias

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10
Q

What are the AEs of taking vitamin A supplements?

A

Teratogenicity, GI upset, hyperglycemia, hyperlipidemia, dry/chafed skin, elevated LFTs

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11
Q

What are the signs and symptoms of vitamin A toxicity?

A

Headache, N/V, drowsiness, pain in long bones

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12
Q

List and name the B vitamins discussed in class and describe what they are primarily known for.

A

B1: Thiamine - deficiency in chronic alcoholics
B3: Niacin - increase HDL
B6: Pyridoxine - supplemented in patients taking isoniazid for TB
B9: Folate - deficiency causes anemia
B12: Cyanocobalamin - deficiency causes pernicious anemia

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13
Q

Describe the mechanism by which B12 is absorbed in the stomach

A

B12 is known as extrinsic factor. To be absorbed you need intrinsic factor absorbed by the stomach.

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14
Q

Other than anemia, what else can result from long term B12 deficiency?

A

Neurological and psychiatric symptoms, ex = depression

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15
Q

What drug can mask signs and symptoms of B12 deficiency/pernicious anemia?

A

Folate –> can return CBC values to normal but still result in further neuronal destruction and misdiagnosis. Pernicious anemia requires replacement of B12.

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16
Q

How may B12 be administered?

A

PO or by injection

17
Q

What is the name for vitamin C?

A

Ascorbic Acid

18
Q

What is the indication a person is getting too much vitamin C?

A

Urine turns yellow

19
Q

What is the name of the condition caused by vitamin C deficiency?

A

Scurvy - petechial hemorrhages, hematomas, gum bleeding, anemia

20
Q

What processes in the body requires vitamin C?

A

Collagen production and reduction/neutralization of free radicals

21
Q

What supplement is often co-formulated with vitamin C and why?

A

Iron because vitamin C is acidic and iron requires acid for absorption.

22
Q

What condition should cause caution in recommending supplementation with vitamin C and why?

A

Kidney stones –> acidification of the urine may promote stone formation

23
Q

What condition results from vitamin D deficiency?

A

Rickets –> softening of the bones

24
Q

What is the name of vitamin E and what are its uses in the body?

A

Tocopherol –> reduction/neutralization of free radicals and some anti-coagulant properties

25
Q

What are the signs and symptoms of vitamin E toxicity?

A

GI distress and bleeding disorders

26
Q

What are the vitamin K dependent pro-coagulant and anti-coagulant clotting factors?

A

Pro-coagulant: II, VII, IX, and X

Anti-coagulant: Proteins C and S

27
Q

What medications may hinder the absorption of vitamin K in the colon?

A

Drugs that block fat absorption –> orlistat for ex.

28
Q

What patients require folate supplementation and why?

A

Pregnant women –> fetus requires folate for neural tube formation

29
Q

What drugs interfere with folate processing and activation?

A

Bactrim interferes with folate in bacteria

Methotrexate interferes with folate in humans

30
Q

Deficiency of what vitamin can ultimately lead to folate deficiency anemia and why?

A

Vitamin C protects stores of tetrahydrofolic acid (active form of folate). Vitamin C deficiency can lead to depletion of active folate and ultimately folate deficiency anemia.

31
Q

Compare the dose of folate recommended for a pregnant person to that recommended for a non-pregnant person.

A

Typical Dose = 50-100 mcg

Pregnancy = 300-400 mcg

32
Q

What is the most significant AE of iron supplementation and how is it mitigated?

A

GI upset –> take with food

33
Q

Why is iron necessary in the body?

A

Required in formation of hemoglobin

34
Q

How is iron stored and transported in the body?

A

Storage: ferritin
Transport: transferrin

35
Q

By what routes can iron supplementation be administered?

A

PO or parenterally (IV, etc.) –> several different formulations

36
Q

In what two conditions is iron supplementation required?

A

Pregnancy and anyone taking erythropoietin

37
Q

With what medications might iron interact and why?

A

All heavy metals chelate –> space from fluoroquinolones and tetracyclines

38
Q

What patients most commonly overdose on iron and why?

A

Young children because iron tablets look like M&Ms

39
Q

What is the antidote for iron toxicity and how do you measure its effect?

A

Deferoxamine –> turns urine pink. When urine returns to normal all iron has been detoxified.

Spring Pharm Block 4 (17 decks)

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