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153 > Vitamins Pt 1 > Flashcards

Vitamins Pt 1 Flashcards

1
Q

Reasons why people take vitamins

A
  • Dietary insurance (most common)
    • For energy (mostly a placebo)
    • To prevent illness (other then AMD there is not much vitamins that do this)
    • Specific medical reasons (vitamins for eyes, deficiencies)
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2
Q

Is natural better then synthetic and are there any exceptions

A
  • You want to get your vitamins from your diet if you can
    • Exception is vitamin B12 (at 50 years of age go for synthetic as 1/5 people will have low stomach acid so it will be more bioavailable)
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3
Q

Are “natural” or synthetic vitamins better in pill form

A
  • The body can not tell the difference and the natural ones will just be more expensive
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4
Q

Situations ‘needing’ vitamins

A
  • Impoverished (don’t come into pharmacies)
    • Alcoholics (don’t come in)
    • Pregnancy/ lactation (know what they need)
    • Intense dieting (they wont listen to advice)
    • Deficiencies in iron, calcium, b12, d, folate, potassium but very unlikely
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5
Q

Will deficiencies be discovered by a pharmacist

A
  • Very unlikely
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6
Q

What do infants need

A
  • While breast fed automatically give 400 IU vit D
    • if formula fed you give none
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7
Q

With infant supplementation from Oct to April in northern areas (higher then Edmonton) what changes and why

A
  • Breast fed: give 800 IU Vit D daily
    • Formula-fed: 400 IU
    • There is less sunshine so need more vitamin D in the winter months
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8
Q

Best form of vitamin D for infants

A
  • D drops
    • There is 400IU in each drop
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9
Q

Do infants up to 6 months need iron

A
  • Usually have enough stores at birth
    • MD assessed not Pharm
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10
Q

For infants after 6 months do they need iron

A
  • No they don’t as baby foods are iron enriched (fortified)
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11
Q

When will an infant need iron

A
  • If an MD requests it
    • Sold behind the counter and don’t give unless a MD made the decision
    • Given 15 mg when deemed deficient
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12
Q

Are children vitamins good

A
  • They have a lot less vitamins and often no minerals, pick whichever one has the most types of vitamins/ minerals
    • Sometimes simply go with the character they like
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13
Q

What do young girls need to focus on

A
  • Calcium and iron intake
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14
Q

Why do teen girls need to increase calcium and iron intake

A
  • If they get a lot of calcium in early years then there risk of developing osteoporosis in there late years is minimized
    • Iron for monthly losses
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15
Q

Do we want 100% of our vitamins from supplements

A
  • No we don’t it is a marketing tactic
    • We want to get most of our vitamin// minerals from our diet and use vitamins to top up our needs
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16
Q

Why is there a difference in vitamins in seniors then adults

A
  • Declining smell/ taste = less appetite
    • Loneliness/ live alone= eat less
    • Health status= more chronic conditions and less dexterity
    • Changing needs= need less of some Bs, vit A, iron
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17
Q

Why do seniors need more calcium and vitamin D and IU/mgs

A
  • They intake less calories
    • Calcium: 31-50=-1000mg, 51-70=1200 mg, >70=1200 mg
    • Vitamin D: 31-50=600IU, 51-70=600IU, >70= 800 IU
    • These changes are not to much to worry about
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18
Q

What changes in regards to vitamin B12 when you get >50

A
  • Under 50 you need 2.4 ug (micrograms), but when you get over 50 it is recommended you take 2.4 ug of supplemented vit B12
    This is because you have a 1/5 chance of having lower stomach acid and the supplemented version is more accessible
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19
Q

RNI for vitamin B12 in seniors

A
  • 2.4 ug
    • Although you want it to be synthetic to allow it to be more accessible
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20
Q

Where do we get our vitamin D from

A
  • 10% from food and 90% from sunlight
    • It is a two step process in both
    • Getting vitamin D from the sun: sunlight hits cholesterol in the skin and then a 2 step process from liver to kidney
    • Getting vitamin D from food starts in gut and then transported to liver and then kidney
21
Q

Can I take all of my vitamin D for the week at 1 time

A
  • Yes you can
    • If you take 400 IU a day you can take 2800 IU
22
Q

Tolerable Upper daily limit for vitamin D

A
  • 4000 Iu for adults
    • Not where toxicity kicks in but rather where there should be 0 symptoms
23
Q

What form of vitamin D is used in all supplements

A

Vitamin D3

24
Q

Is cod liver oil a good source of vitamin D

A
  • No it isnt although has a lot of vitamin a
    • Has 2600 IU of vit A, 200 IU of vit D
25
Q

Is vitamin B12 toxic

A
  • Virtually non toxic
26
Q

Vitamin B12 RNI

A

RNI is 2.4ug

27
Q

What is pernicious anemia:

A

causes a lifelong vitamin B12 deficiency, they can take injections once a month but they can now take it oral instead

28
Q

Are tablets of 1000 ug of vitamin B12 safe

A
  • Yes as it is a water soluble drug so virtually non toxic
    • It is overkill but almost non toxic
      Is under the tongue (sublingual) b
29
Q

Is under the tongue (sublingual) better then oral

A
  • Not proven to be of any value
30
Q

What vitamin is almost automatic with pregnant women

A
  • Folic acid
31
Q

What is the best folic acid drug

A
  • Materna
    • It is a drug delivery system for folic acid and maybe iron
32
Q

4 big vitamin concerns for child bearing years (and amount taken)

A

Iron (18 mg), folate (400 ug), calcium (1000 mg), Vitamin D (600 IU)

33
Q

4 big vitamin concerns for pregnancy and amount

A
  • Iron (27mg),
    • Folate (400 ug supplement in addition to foods),
    • calcium (1000 mg, no change from child bearing years, unless <18 years of age then +300 mg which is an extra glass of milk),
    • vitamin D (600 IU, no change from child bearing years)
34
Q

How much iron does health canada state to have in a prenatal vitamin

A

16-20 mg

35
Q

What causes nausea within pregnancy vitamins

A
  • People believe it is the iron
    • B vitamins or the coating can be nauseating, although calcium and iron people believe this.
      Moring sickness happens and throwing in a pill of matterna can make this occur
      8. Is prescription prenatal vitamins better
36
Q

Is prescription prenatal vitamins better

A
  • It has more iron 35mg (this does not mean it is better)
    • Vitd, calcium
    • Has 1.1 mg of folate (you only need 0.4 mg of folate and anything over 1 needs a prescription)
    • This is a not better then the shelf rather is made to be Rx so it could get paid by insurance if prescribed
37
Q

Spina Bifida and what causes it

A
  • During 3rd and 4th week of fetal development
    • Defect in the spine
    • It occurs when folate is low within the mother
38
Q

what % of pregnacys are unplanned and why is it recommended for all women of child baring years take a multivitamin

A

50% of pregnancy’s are unplanned and this is why mulit-vitamins are recommended to all women of child bearing years (so they have folate in there system in case of accident)

39
Q

How long should you take folate and iron supplements before during and after pregnancy

A
  • Pre conception: folic acid for 3 months (doesn’t always happen)
    • Pregnancy: duration for both folic acid and iron
    • Post delivery: 6 weeks for folic acid
40
Q

What is the effect on tolerability of prenatal multivitamins in pregnancy due to iron content

A
  • Study done which tested low elemental iron (35mg) to high elemental iron (60mg)
    • Mean adherence in both groups was about half
    • Conclusion: iron content was not a major determinant of adherence to prenatal vitamins (the size of vitamin B could be the issue)
41
Q

What is better natural or supplement for calcium

A
  • Natural (eg. Milk) is better but if this doesn’t work should take a supp
42
Q

How much should calcium should females take (4-8, 9-13, 14-18, 19-50, 51+)

A
  • 4-8: 1000mg
    • 9-13: 1300 mg
    • 14-18: 1300 mg
    • 19-50: 1000 mg
    • 51+: 1200 mg
43
Q

Side effects of calcium and how much do you need to take to see side effects

A
  • Need to take up to 2500mg per day to start seeing them
    • Constipation is a side effect
44
Q

How to take a calcium supplement

A
  • Give with food, acid in the stomach helps with absorption
45
Q

How much calcium to give in one serving

A
  • Max amount per serving is 500mg: the gut can only handle 500 mg at a time so anything more then this it will just go through The body and not be used
46
Q

Common calcium products

A
  • Carbonate (40% elemental)
    • Caltrate
    • Citracal (20%)
    • Most money and not better (fancy words for lactate of gluconate): coral, chelated, natural source, dolomite
47
Q

different calcium salts and amount of element in each

A
  • Carbonate: 43%
    • Lactate: 13%
    • Gluconate: 9%
    • Citracal: 20%
48
Q

What is the benefit of citracal calcium

A
  • Is it believed to aid with lower stomach acid as it is more accessible calcium
    • For PPI users (less stomach acid), elderly (less stomach acid), taking without food
    • Could legit just take carbonate with food

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