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Pharm Exam 5 > XVII Nutritional and Complimentary Medicine (Chapters 67 & 69) > Flashcards

XVII Nutritional and Complimentary Medicine (Chapters 67 & 69) Flashcards

1
Q

2 Classifications of Vitamins

A

Fat Soluble Vitamins

Water Soluble Vitamins

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2
Q

What are the Fat Soluble Vitamins (4)

A

A
D
E
K

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3
Q

Water Soluble Vitamins (2)

A

C

B family

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4
Q

Which type of vitamin (fat soluble or water soluble) is stored in massive amounts and has a risk for toxicity?

A

Fat Soluble

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5
Q

Which type of vitamin (fat soluble or water-soluble) undergo minimal storage in the body and must be frequently ingested to replenish supply?

A

Water soluble

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6
Q

Indications for use of multivitamin supplementation (3)?

A

Malabsorption disorders
Those who have had weight loss surgery
Restrictive Diets (vegans)

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7
Q

Which vitamins have solid evidence for benefit of use (3)?

A

B12 (all people over 50)
Folic Acid (all women of childbearing age)
Vitamin D plus Calcium (postmenopausal women and those at risk for fracture)

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8
Q

What are substances present in food that can significantly decrease cellular and tissue injury caused by highly reactive forms of oxygen and nitrogen (free radicals)?

A

Antioxidants

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9
Q

Risks of specific antioxidants (4)?

A

B-Carotene in high doses associated with increased lung cancer in those who smoke

Vitamin E in high doses associated with increased prostate cancer and stroke

High doses, in general, can cause nutritional deficiency and other harms

Significant drug interactions

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10
Q

Indication for Vitamin A?

A

Prevention or correction of vitamin A deficiency

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11
Q

Dietary sources of Vitamin A (4)?

A

Dairy
Meat
Fish Oil
Fish

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12
Q

Results of Vitamin A Deficiency(3)?

A

Night vision blindness (first indicator)
Xerophthalmia (dry and thick conjunctiva)
keratomalacia (degeneration of cornea w/keratiniztion of corneal epithelium)

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13
Q

Vitamin A Toxicity causes what (3)?

A

Birth Defects (HIGHLY teratogenic)

Liver damage

Bone Related disorders (infants/children bulging in the skull where bone has not formed, increase risk of hip fracture)

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14
Q

Vitamin E indication for use?

A

Delay progression of age-related macular degeneration

Protecting blood cells from hemolysis (benefit to premature infants w/hemolytic anemia associated with Vitamin E deficiency).

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15
Q

Vitamin E dietary sources(5)?

A 
Vegetable Oils
Nuts
Wheat germ
Whole grains 
Mustard greens
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16
Q

People at risk for Vitamin E Deficiency(2)?

A

Those with inborn deficiency of a-TTP

Those with fat malabsorption syndromes & can’t absorb fat-soluble vitamins

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17
Q

Signs of Vitamin E Deficiency (4)?

A

Ataxia
Sensory neuropathy
Areflesia
Muscle hypertrophy

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18
Q

Vitamin E Deficiency causes what(4)?

A

Increase risk for Hemorrhagic Stroke (inhibition of platelet aggregation)

Increase risk for cancer or poor cancer outcome

Blunted benefit of exercise on insulin sensitivity

Increased death, especially in older people

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19
Q

Vitamin K Indications for use(2)?

A

Synthesis of prothrombin and clotting factors needed for blood coagulation

Recommended for ALL newborns immediately after birth r/t Vitamin K synthesized by intestinal bacteria (underdeveloped intestines for several days)

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20
Q

Vitamin K main sources?

A

Dietary (unspecified)

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21
Q

Vitamin K Deficiency causes what?

A

Bleeding tendencies

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22
Q

Typical causes of Vitamin K Deficiency?

A

Obstructive jaundice
Malabsorption syndromes
Ulcerative colitis

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23
Q

Vitamin K Toxicity causes what?

A

Hyperbilirubinemia
Hemolytic anemia
Jaundice in newborns

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24
Q

What is another name for Vitamin A?

A

Retinol

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25
Q

What is another name for Vitamin B?

A

Riboflavin

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26
Q

Vitamin B indications for use

A

Prevention and correction of Riboflavin deficiency

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27
Q

Dietary Sources of Vitamin B?

A 
Milk
Yogurt
Cheese
Bread
Fortified Cereals
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28
Q

Signs of Vitamin B Toxicity

A

None—devoid of any in humans

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29
Q

Vitamin B1 (Thiamine) Indications for use?

A

Treatment and prevention of thiamine deficiency

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30
Q

Vitamin B1 dietary sources(6)?

A 
Whole-grain products
Bread
Cereal
Tuna
Salmon
Anchovies
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31
Q

Vitamin B1 Deficiency occurs in what patient population?

A

Chronic Alcohol Consumers

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32
Q

Vitamin B6 (Pyridoxine) Indications for use?

A

Prevention and treatment of all states of vitamin B6 Deficiency

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33
Q

Dietary sources for Vitamin B6?

A 
Cereal
Meat
Fish
Poultry
Organ meats
34
Q

Causes of Vitamin B6 Deficiency?

A 
Poor diet (often r/t alcoholism)
Isoniazid therapy for TB
35
Q

Signs and Symptoms of Vitamin B6 Toxicity?

A

EXTREMELY LARGE DOSES:

Neurological injury to include ataxia and numbness of the feet and hands

36
Q

Vitamin B12 (Cyanocobalamin)Indications for use?

A

Treat deficiency due to all causes

Prevent deficiency in patients with increased Vitamin B12 requirements

37
Q

Dietary Sources of Vitamin B12(6)?

A 
Meat
Fish
Poultry
Eggs
Milk
Animal products
38
Q

What results from Vitamin B12(2)?

A

Megaloblastic anemia

Macrocytic anemia

39
Q

Vitamin B9 (Folic Acid) Indications for use(2)?

A

Prevent neural tube deficiency in developing fetus

Treatment of Megaloblastic anemia

40
Q

Dietary sources of Vitamin B9(6)?

A 
Beef
Liver
Spinach
Black Eyed Peas
Asparagus
Green leafy Veggies
41
Q

Results of Vitamin B9 Deficiency?

A

During pregnancy can impair the development of the central nervous system resulting in neural tube defects

42
Q

Results of Vitamin B9 Toxicity(2)?

A

Possible acceleration of pre-cancerous lesions

Increase in prostate cancer in older men

43
Q

St. John’s Wort drug interactions?

A

Induce CYP34A (accelerates metabolism of many drugs, decreasing therapeutic effect)

44
Q

Which supplements suppress aggregation when taken with anticoagulants (3)?

A

Ginko Biloba
Feverfew
Garlic

45
Q

Adverse effect of Ma Huang (Ephedra)

A

Rases BP

Stimulates CNS

46
Q

Black Cohosh Indications for use?

A

Menopause
Hot flashes
Vaginal Dryness

**DO NOT USE if hot flashes are related to Tamoxifen or other SERMs

47
Q

When should you NOT use Black Cohosh for hot flashes?

A

DO NOT USE if hot flashes are related to Tamoxifen or other SERMs

48
Q

Adverse Effects of Black Cohosh?

A

Liver Inflammation (leading to liver failure)

49
Q

Black Cohosh Durg Interactions(2)?

A

Hypertensives (potentiate hypotensive effects)

Insulin and other diabetic drugs (potentiate hypoglycemic effects)

50
Q

Coenzyme Q-10 Indications for use(2)?

A

Heart Failure

Muscle injury caused by statins

51
Q

Adverse Reactions of Coenzyme Q-10?

A

GI Upset

52
Q

Coenzyme Q-10 Contraindications?

A

Pregnancy

Breastfeeding

53
Q

Drug interactions with Coenzyme Q-10?

A

Warfarin

54
Q

Cranberry Juice Indications for use?

A

Prevention of UTI

Decreases urine odor in patients with incontinence

55
Q

What age group is Cranberry Juice effective for preventing recurrent UTI?

A

Older women

Women in teens and 20’s

56
Q

Adverse Reactions of Cranberry Juice(2)?

A 
Dose Dependent (more than 1L/day)
Increases risk for GI upset and kidney stone formation
57
Q

Cranberry Juice Drug Interactions?

A

Warfarin

58
Q

Indications for use of oral Echinacea(3)?

A

Stimulates immune function
Suppresses inflammation
Treats viral infections

59
Q

Indications for use of topical Echinacea(4)?

A

Treatment of burns
Eczema
Psoriasis
HSV

60
Q

What supplement has shown some effectiveness in preventing the common cold?

A

Echinacea

61
Q

Adverse Effects of Echinacea?

A

Allergic response (ragweed family)

62
Q

Contraindications of Echinacea?

A

Autoimmune Diseases such as LE, RA, TB, and HIV

63
Q

Echinacea Drug Interactions?

A

Immunosuppressant drugs and drug therapies for TB, CA, and HIV (oppose effects)

64
Q

Flaxseed Indications for use?

A

Constipation
Dyslipidemia
Provides a vegetarian source of Omega-3s

65
Q

How does flaxseed relieve constipation?

A

It works as a bulk-forming laxative

66
Q

Adverse Effects of Flaxseed?

A

GI Issues

67
Q

Flaxseed Drug Interactions?

A

Can decrease absorption of conventional

medications (take 1-2 hours after meds)

68
Q

Garlic Indications for Use(2)?

A

Reduce triglycerides and LDL

69
Q

Garlic has shown effectiveness in treating/preventing what 3 disease processes?

A

Hypertension (lowers BP)
Decreases rate of atherosclerosis development
May have a role in cancer prevention

70
Q

Garlic Drug interactions?

A

SIGNIFICANT anti-platelet effects, especially when combined with ASA, warfarin, and heparin

Can reduce levels of cyclosporine (immunosuppressant and saquinavir (HIV med)

71
Q

Indication for use of Ginkgo Biloba?

A

Improve memory (effectiveness unknown)

72
Q

Adverse effects of Ginkgo Biloba (seeds)?

A

can cause seizure and death

73
Q

Ginkgo Biloba drug interactions?

A

Suppresses Coagulation

Promotion of seizures

74
Q

Glucosamine and Chondroitin Indication for use?

A

Treatment of osteoarthritis–but American College of RA advised providers NOT to use for OA

75
Q

Adverse effects of Glucosamine and Chondroitin?

A

Gi Upset

76
Q

Glucosamine and Chondroitin have cross sensitivity with what food allergy?

A

shellfish (produced from the exoskeleton of shrimp)

77
Q

Glucosamine and Chondroitin drug interactions?

A

ASA, warfarin, Heparin (risk for increased bleeding)

78
Q

St. John’s Wort Indications for use?

A

Mild to moderate depression

79
Q

St. John’s Wort effectiveness?

A

Superior to placebo, equal to TCA

80
Q

St. John’s Wort Adverse Effects?

A

Allergic reactions (esp in those allergic to ragweed, daisies)

81
Q

St. John’s Wort Drug Interactions?

A

CYP Inducer (accelerates metabolism of several drugs, decreasing therapeutic effect)

Accelerates Elimination of:
Digoxin
CCB
Steroid hormones
Protease inhibitors
Certain anticancer drugs
Causes Serotonin Syndrome when combined with:
MAOI
SSRI
TCA
Duloxetine
Effexor

Pharm Exam 5 (5 decks)

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