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153 > Vitamins Pt2 > Flashcards

Vitamins Pt2 Flashcards

1
Q

What are tonics

A
  • Old school remedys for seniors
    • More phycological then anything
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2
Q

Two types of iron

A
  • Heme: meats and is the best
    • Non heme: plants,
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3
Q

RNI of iron and best way to reach this

A
  • 15-18 mg for females (15 for teens, 18 for adults)
    • best way to get this is through dietary measures if possible
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4
Q

Do we hand out iron tablets (high iron supplements)

A
  • No we don’t
    • Try to increase it through dietary measures but if not possible use lab results
    • Don’t prescribe them only dispense them
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5
Q

Different salts iron is available in

A
  • Ferrous fumarate: 33% iron (blue)
    • Ferrous sulfate: 20% iron (red)
    • Ferrous gluconate: 12% iron (green)
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6
Q

What % of dietary iron (heme) is absorbed

A
  • 10-15% is absorbed by the body from diet
    • When in an iron deficiency about 20%
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7
Q

Why are some people told to take iron supplements with orange juice

A
  • Vitamin C causes a little better absorption of iron
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8
Q

why do some iron supp say less/ no side effects

A

A lot of iron supplements have very little iron as only 10-20% is absorbed, also say less side effects but this usually just means less iron

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9
Q

Absorption Interactions with iron (food, vit C, protein/calcium/antacids, coffee/tea)

A
  • Increase: vit C
    • Decrease: food (May have less then 50% of what you thought you had, but it is better to have it tolerable with food and not have any side effects), protein/calcium/antacids, coffee/ tea
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10
Q

How long does it take for an iron deficiency to be under control

A

2-3 weeks, however prescription usually 3 months

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11
Q

Tolerable Upper limit of iron

A

45 mg

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12
Q

Side effects of iron

A
  • Dyspepsia (heart burn)
    • Nausea vomiting
    • Constipation
    • Dark stools (can be via unabsorbed iron and is harmless in this state)
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13
Q

Do slow release formulations help?

A
  • Iron is best absorbed quickly in the gut
    • With a slow release product many of these may not be freed and may not even be available and goes through
    • Slow release iron is more expensive and lower absorption
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14
Q

If there is discoloration in the stool what do we do

A
  • Most likely just the iron colour
    • We cant tell if it is this or an actual bleed
    • Needs to be checked out by a MD
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15
Q

Is iron safe with kids?

A
  • No it is not safe around kids as it can kill
    Pediatric toxicity
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16
Q

what vitamin has pediatric toxicity

A

iron, can cause death in kids

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17
Q

Why do most people take vitamins

A
  • Just in case 75% of people
    • No value in reducing mortality, cancer, or almost any type of cardiovascular disease
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18
Q

What are niacin used for

A
  • Was used for cholesterol at the prescription level but now has less value now and has
    barely any value at the OTC
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19
Q

Flushing vs no flushing niacin

A

non flushing niacin means that it is deemed ineffective as the amide makes it useless (niacin/ nicotinic acid have some effect, niacinamide/ nicotinamide have no effect)

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20
Q

Cancer with vitamins

A
  • Antioxidants: When there is a mix of all antioxidants it is way better then just one at a time
    • Foods vs supplements: supp not helpful
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21
Q

Stress/ fatigue/ energy with vitamins

A
  • B vitamins are critical just as proteins carbs… but it does not drive us to have less stress/ fatigue and more energy if you arent deficient
22
Q

Depression and anxiety with vitamins

A
  • If you are deficient has some evidence for thiamine
    • Thiamine’s(B1) RNA is 1 mg but the supplements come in at much higher then this
23
Q

AMD

A
  • Age related macular degeneration: the flooding of blood and is basically high cholesterol in the eye (get fat deposits)
    • Once you get it you cant reverse it (starts in the middle of the eye)
24
Q

Dry vs wet types of eye vitamins

A
  • Dry: 90%: for high cholesterol
    • Wet type: 10%, vascular type and get into your high
25
Q

What are AREDS

A
  • Age related eye disease studies
    • Potentially delays progression of 1 in 4 cases that have intermediate AMD
    • This level of agents cant be met by diet alone
    • The only evidence based eye drops for AMD
    • Must say AREDS or AREDS 2 on the package
26
Q

RNI of magnesium

A
  • 320-420 mg
27
Q
  1. What is magnesium most likely used for
A
  • Heart health
    • Leg cramps
    • Bone health
    • Depression
    • Anti-constipation
28
Q

Where do we want to get magnesium from

A
  • Get majority with diet and then top up from supplements
29
Q

UL of diarrhea and side effects of magnesium

A
  • Tolerable upper limit it 350 mg
    • At 500 mg can cause diarrhea
    • Cant say no side effects but need a lot of mg to cause diarrhea
30
Q

Potassium

A

Important aspect of DASH diet (For hypertension and lifts potassium levels up and seems to help heart health)

31
Q

RNI of potassium

A
  • 4700 mg
    • A banana has 470 mg
32
Q

What does high levels of supplemented potassium do in relation to BP

A
  • 2300 mg of supp lowered BP by 3 points
    • Not to mess around in the OTC world rather prescription
33
Q

What can we expect If a person starts taking multi-vitamin, calcium, iron, AMD product

A
  • Not going to feel different unless they are maybe iron deficient
    Preventative more
34
Q

How long will I be on iron, calcium, AMD product

A
  • Iron: about 3 months if iron deficient
    • Calcium: for life
    • AMD product: lifelong
35
Q

Enteral products

A
  • Complete nutrition has all the carbs, fats, proteins vitamins and minerals to keep you sustained as possible
    • If worried about vitamins you can take them to this as this gives them everything
      -Boost, ensure
36
Q

Why would a person take an extra fat enteral product

A

The plus is more fats thrown in, can drink 50% less of liquid

37
Q

what are other uses for enteral products

A

Also used for tube feeding, nursing home, jaw wired shut

38
Q

Diabetic(glucerna) enteral product

A
  • Slower carb release
    • Marketed to diabetics
    • Only difference is the carbs are a bit more Complex in glucerna
      Gives less spike for diabetics
39
Q

kid vs adult enteral product

A

basically same thing with different labelling

40
Q

Vitamin C

A

Essential vitamin

41
Q

Vitamin C Needed for 19+

A
  • Male: 90 mg
    • Female: 75 mg
    • Need very little amount while Most tablets are at about 500 mg
42
Q

Vitamin E

A
  • Mostly used for scar prevention
    - May help
    Vaseline works just as good
43
Q

Needed vitamin E: 14+

A
  • Males: 15 mg (22.4 IU)
    • Females: 15 mg
    • However most products have 400 IU
44
Q

Vitamin K

A
  • Generally not a self medication scenario (it affects coagulation)
    • Low levels of vitamin K can raise the risk of uncontrolled bleedings but deficiencies are rare in adults
    • Clotting vitamin
      May have an influence on bone mineral density and osteoporosis
45
Q

RNI of vitamin K

A
  • Around 100 ug
46
Q

Types of vitamin K

A

a) K1: phylloquinone
- Dietary form, found in plants like green vegetables, low toxicity
b) K2: menaquinone
- Created in body by intestinal flora and found in fermented foods
c) K3: menadione
- Created in body by intestinal flora and found in fermented foods
-concern for toxicity

47
Q

which vitamin K is preferred usually

A

K1 usually preferred as lower concern for toxicity and works faster but some claim for K2 being better for boen

48
Q

Fat soluble vitamins and mineral oil interactions

A
  • Mineral oil is hard on gut, no constipation patient is taking mineral oil, fat soluble vitamins could leak into mineral oil taken out of body.
49
Q

Vitamin E and anticoagulation interactions

A
  • It is not linked to any cardiovascular value at 400IU
    • It could have an effect if you had upwards of 1000 IU
50
Q

Fe (not at multivitamin levels, TUL of iron is 45 mg)with antacids, coffee/tea/wine, tetracyclines, any drug with GI irritation potential, any drug with potential for constipation

A

a) Antacids
- PPIs can make less Acid and make iron Less absorbed
b) Coffee, tea, wine
- Could make it a little less Absorbed, not to worry about
c) Tetracyclines
- Big one (could be on for acne), Iron could make tetracycline less effective
d) Any drug with GI irritation potential, any drug with potential for constipation
- Unless your taking the TUL not an issue
Ibuprofen

51
Q

Calcium with tetracyclines, corticosteroids, chronic PPI use, any drug with potential for constipation

A

a) Corticosteroids
- Chronic steroids can leach Ca out of the bones
- Ca would be a good thing with chronic steroids
b) Potential for constipation
- Not going to cause (at 2500mg it could) but you only have about 200mg in a multivitamin
c) Vitamin A and retinoids (oral and topical) interactions
- Retinoids (vitamin a derivatives for acne), if have both then multiple sources of vit A
- No multivitamin will interact with retinoids, vit a will not help with acne orally
d) Potassium and diuretics interactions
- Can lose a bit of potassium with diuretics
- Multivitamin will not increase K levels (not enough in them)

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