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the patient > Vitamins, Minerals and Trace Elements > Flashcards

Vitamins, Minerals and Trace Elements Flashcards

1
Q

What are the basics of a healthy diet?

A 
Carbohydrate (simple and complex)
Fat 
Protein 
Dairy 
Vitamins
Minerals and trace elements
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2
Q

What role do vitamins and minerals play in the body?

A

They play a key role as co-factors or co-enzymes in most metabolic reactions
They also have an antioxidant effect in their role as free radical scavengers

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3
Q

How much vitamins and minerals are required?

A

Only required in small quantities

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4
Q

What are vitamins?

A

‘Vital amines’, complex organic substances

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5
Q

Why do we need vitamins in our diets?

A

The body does not make sufficient quantities and so we must obtain them from food or supplements

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6
Q

How is vitamin D made?

A

By exposure to sunlight (synthesised in the skin via cholesterol by sunlight), problematic for those who may be housebound

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7
Q

Where do we get vitamin B12 from?

A

Animal products, problematic for vegans

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8
Q

Which are the water soluble vitamins?

A

Vitamin C, B1, B2, B3, B5, B6, B7, B9, B12

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9
Q

Which are the fat soluble (stored) vitamins?

A

Vit A, D, E, K

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10
Q

What are water soluble vitamins like (in terms of structure)?

A

Tend to have polar structures with alcohols and esters

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11
Q

What are fat soluble vitamins like (in terms of structure)?

A

Tend to be lipophilic with long fatty acid chains

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12
Q

Where are most water soluble vitamins absorbed?

A

Small intestine (duodenum)

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13
Q

Where are most fat soluble vitamins absorbed?

A

By bile in the large intestine

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14
Q

What can reduce levels of fat soluble vitamins?

A

Levels of fat soluble vitamins are reduced if fat absorption is reduced e.g. by lack of pancreatic enzymes/low fat diet

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15
Q

How is vitamin B12 absorbed?

A

By intrinsic factor (IL) in the ileum

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16
Q

What produces vitamin K in the body?

A

GI flora from original plant sources

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17
Q

Why are vitamin K levels important to consider?

A

Interaction with warfarin/INR, antibiotics

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18
Q

Where do we get vitamin D from?

A

Dietary but also synthesised (sunlight)

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19
Q

Which vitamins are stored in the body?

A

Fat soluble

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20
Q

Which units are used to describe vitamins?

A

Milligrams or micrograms

Vitamin A, D and E are also quoted in International Units (IU)

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21
Q

Are vitamins sources of energy?

A

No, they simply take part in the body’s metabolic processes and act as antioxidants

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22
Q

Which external factors affect vitamins?

A 
Heat
Light 
Oxygen 
Enzymes 
Minerals
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23
Q

How are vitamins lost from foods?

A

Poor storage and preparation methods

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24
Q

What is the effect of a vitamin A deficiency?

A

Poor night vision

25
Q

What is the effect of a vitamin B1 deficiency?

A

Wenikes encephalopathy

26
Q

What is the effect of a vitamin B7 deficiency?

A

Hair loss, anaemia

27
Q

What is the effect of a vitamin B9 deficiency?

A

Megaloblastic anaemias, neural tube defects

28
Q

What is the effect of a vitamin B12 deficiency?

A

Pernicious anaemia, peripheral neuropathy

29
Q

What is the effect of a vitamin C deficiency?

A

Painful joints, scurvy

30
Q

What is the effect of a vitamin D deficiency?

A

Rickets, osteoporosis

31
Q

What is the effect of a vitamin K deficiency?

A

Abnormal clotting

32
Q

Which vitamin is important in pregnancy and why?

A

General principles of good nutrition apply in pregnancy, but particularly folic acid
Folic acid is important in the prevention of neural tube defects (including spina bidifda)

33
Q

Which doses of folic acid are given in pregnancy?

A

No previous history of NTD - 400mcg OD until 12th week of pregnancy
Previous history, epilepsy or taking anti epileptics increased to 5mg OD

34
Q

Which foods should be avoided in pregnancy and why?

A

Fish (shark, swordfish, marlin, tuna, as high mercury contents which can have neuro effects)
Raw shell fish (food poisoning)
Soft cheeses (Listeria)
Mayo and raw/undercooked eggs (Salmonella)
Liver and pate (Vit A teratogenic and listeria)
Restrict caffeine (miscarriage and low birth weight)
Alcohol

35
Q

What are some examples of minerals?

A 
Electrolytes 
Calcium 
Magnesium
Phosphorus 
Sodium 
Potassium
36
Q

What are some examples of trace elements?

A 
Iron
Zinc
Iodine
Fluoride
Selenium
Copper
37
Q

What are minerals and trace elements?

A

Inorganic substances

38
Q

How much minerals and trace elements are needed?

A

Minerals are needed in large amounts (particularly sodium and potassium)
Trace elements are needed in smaller quantities

39
Q

What are minerals and trace elements needed for?

A 
Formation of bones and teeth 
Essential constituents of body fluids and tissues
Components of enzyme systems 
Nerve function
Blood constituents
40
Q

What are sources of minerals and trace elements?

A

Food, supplements, water

No one food provides everything, need a balanced diet

41
Q

What affects the absorption of minerals and trace elements?

A

Presence of other minerals/vitamins either at high or low levels
Components found in food
Amount of mineral already in body

42
Q

What can a potassium and magnesium deficiency cause?

A

Cardiac arrhythmias

43
Q

What can a calcium and magnesium deficiency cause?

A

Osteoporosis, muscle cramps, tetany

44
Q

What can a zinc deficiency cause?

A

Hair loss and poor wound healing

45
Q

What can an iron deficiency cause?

A

Anaemia

46
Q

What is Copper-Wilson’s disease?

A

A rare genetic disorder that causes copper poisoning in the body

47
Q

What does RDA stand for?

A

Recommended dietary amount

48
Q

What does RDI stand for?

A

Recommended dietary intake

49
Q

What does RNI stand for?

A

Reference nutrient intake

50
Q

What does SUL stand for?

A

Safe upper level
Made for only 8 vitamins and minerals
Guidance issued for 22 others

51
Q

What is fortification?

A

Addition of nutrients to appropriate food vehicles

52
Q

What are some examples of fortification?

A

Vitamin D fortified margarine
B vitamins and iron in cereals
Calcium, iron, thiamine and niacin in white and brown flour
Fluoride in drinking water

53
Q

What are supplements?

A

Contain nutrients and other ingredients

People believe they will have a beneficial effect on health, but results are often anecdotal/misinterpretations

54
Q

Give one example of a claim from a supplement.

A

Vitamin C boosts the immune system

55
Q

Who uses supplements?

A

Over 40% of men and women regularly use supplements in the UK
Mostly used by the ‘worried well’ i.e. do not need them

56
Q

Who may actually need supplements?

A

People living in places with little sunshine (e.g. Manchester) - vitamin D deficient
Older people - calcium and vitamin D deficient, especially those who are housebound
Vegetarians/vegans - B12 and folic acid
Pregnant women - folic acid and possibly iron if anaemic
Babies and pre school children - vitamins A and D
Alcoholics (poor diet and poor GI absorption) - vitamin B1 (Wenikes and Korsikoffs psychosis)
People with vitamin/mineral deficiency (e.g. coeliac, UC/Crohns, lack of IF)
CKD - activated vitamin D and calcium
People taking antiepileptics drugs - vitamin D deficient

57
Q

What are some of the problems associated with supplements?

A

Toxicity/accumulation, especially with iron
Complacency and bad diet
Legal status means there is practically no control over them
Not viewed as a medicine so difficult for us to offer advice

58
Q

Give 3 examples of drug/supplement interactions.

A

Methotrexate and folic acid
Iron and vitamin C
Tetracyclines and metal salts

59
Q

What is our role as pharmacists?

A

Give advice on healthy diet
Identify patients who may benefit from supplements
Be aware of the common symptoms of deficiency
Be able to recommend appropriate supplements

the patient (17 decks)

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