Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Pharm II - Week 9
Vitamins and Supplements
| Question | Answer |
|---|---|
| True or false: research evidence regarding vitamins and supplements generally study single substances | True |
| __% of US adults take at least 1 vitamin supplement | 50 |
| True or false: CDC recommends people take multivitamins to avoid vitamin deficits | False. CDC states not to waste money on multivitamins UNLESS you're in a deficit already |
| What is RDA? | Recommended Daily Allowance, which meets needs of 97% of the population |
| RDA is standard for everyone | False. Different for sex, age, pregnancy, lactation, and pts. with certain diseases |
| AI is what? Is it useful? | Average Intake: estimate of average for all; not useful |
| TUL stands for what? Is it useful? | Tolerable upper limit (NOT recommended!); useful |
| Which vitamins are fat-soluble? Water soluble? | Fat soluble: ADEK Water soluble: CB |
| Which type of vitamin needs frequent intake? Why? | Water soluble because if you take too much you simply pee it out. Need regular amounts since not stored in the body |
| Which type of vitamin would you be concerned regarding toxicity? | Fat soluble, since vitamins can be stored in body and accumulate to toxic levels |
| True or false: multivitamins are mostly discouraged now. Rather encouraged to take 100% RDA or less | True |
| Efficacy is well established for 3 vitamins. What are they and which populations would require them? | 1) Vit B12 for vegans. May need shots. 2) Vit D. For heart/mental health pt. 3) Folic acid for childbearing/pre-pregnant women |
| Vitamin A (known as _____) is required for which functions? | Retinol. Required for: 1) vision/low light, 2) sperm production, 3) embryo organogenesis, 4) immunity, 5) growth, 6) skin/mucous membrane integrity |
| Where is vitamin A stored? | Liver |
| Vitamin A deficiency manifests in: (list 3) | 1) Night blindness, 2) Corneal degeneration, 3) skin lesions |
| Vitamin A toxicity manifests in: (list 3) | 1) High birth defects, teratogenic in large doses, 2) liver damage, 3) increased fractures |
| What is the relationship between Vit A and Vit D? | Toxic amounts of Vit A blocks the use of Vit D and can increase risk of fracture |
| True or false: vit A is protective against cancers and heart disease | False |
| Who would be most likely to be vit A deficient? | Anorexics, malnourished indiv., alcoholics, people with fat malabsorption issues |
| True or false: Vit D2 and D3 produce almost the same effects | True |
| Which vit D is produced in response to sunlight? Which one in plants and foods? | D3; D2 in food |
| Where is vit D stored and activated? | Liver |
| What are the effects of vit D? | Regulate calcium and phosphorous by increasing their absorption in intestine and mobilizing Ca from bone into bloodstream |
| True or false: with the exception of fish and dairy, there is very little D3 found in foods | True |
| True or false: nowadays infants are supplemented with Vit D and recommendations for D have doubled for children | True |
| D deficiency may be involved into ____ diseases | Autoimmune |
| D toxicity includes: | N/V, weakness, fatigue, nocturia, polyuria, proteinuria. Severe toxicity: Ca depletion |
| ____ is a preparation of D given to pts. with ____ | Calcitriol; chronic kidney dialysis |
| Vit E is found in _____ | Oils, nuts, wheat germ, some greens |
| True or false: it is well known vit E is an antioxidant, which protects heart health and reduces cancer risk | False. E poorly understood |
| Evidence suggests topical vit E ____ wound healing | doesn't improve |
| With topical E there is a high incidence of _____ | Contact dermatitis |
| E deficiency results in: (list 3) | Ataxia, neuropathy, poor reflexes |
| E toxicity results in: | Increased bleeding due to suppression of coagulation. Reversal drug: vit K |
| Vit K's function: | Needed to make prothrombin and clotting factors |
| Where is K made? What does it require? Who is given K? | Intestine; normal flora; newborns given K IM |
| K is given as ______ IM and can _____ bilirubin levels | Phytonadione (Aquamephyton); elevates |
| When K taken PO, what is needed for absorption? | Bile salts |
| K deficiency can be d/t: | Bleeding/hemorrhage, conditions that decrease bile salts |
| K reverses effect of ____ and _____ | Warfarin/Coumadin and Vit E toxicity |
| What are antioxidants? | Things that remove products of metabolism that can cause tissue injury (free radicals). Thought to POSSIBLY prevent chronic diseases/cancer |
| Evidence so far does NOT support high levels of the following antioxidants (list 4): | Vit C&E, selenium, carotenoids |
| Vit C (aka ____) has many functions. List 6 | Ascorbic Acid. 1) cellular energy, 2) needed to make adrenal steroids, 3) needed for conversions of many substances in body (e.g., folic acid), 4) needed to make collagen to bind cells together, 5) helps iron absorb, 6) antioxidant |
| C deficiency manifests in: (list 4) | Scurvy, bad bone/teeth, bleeding gums, bruising |
| C toxicity results in: | N/V/D, cramping, mucous membrane irritation |
| True or false: based on current research, vit C decreases severity of colds but the number of colds | True |
| Vit C is found in: | Colorful, acidic foods |
| Vit B1 is _____. Needed for these functions (3): | Thiamine. Needed for carb metabolism, neurologic and cardiac health |
| Vit B1/Thiamine deficiency results in: | Beriberi, CHF, arrhythmias, neuropathies |
| B1/Thiamine def. is most common in ______ and is known as this syndrome: | alcoholics; Wernicke-Korsakoff syndrome |
| CNS effects of thiamine/vit B1 deficiency: | Ataxia, agitation, memory issues. May be irreversible |
| If someone has Wernicke-Korsakoff syndrome or displays s/sx of thiamine deficiency, priority action is: | To give thiamine IV stat |
| Vit B2 is known as _____ and has these functions: | Riboflavin. Affects enzyme processes, skin/mucous membrane integrity, corneal integrity. |
| Riboflavin/B2 may potentially help with ____ in high doses | Migraines |
| Vit B3 is known as _______ and is a _____ nutrient | Niacin/Nicotinic acid. Typical nutrient |
| Indication for B3/niacin to be given as med: | To lower cholesterol |
| B3/niacin def. results in: (list 8) | 1) pellagra, 2) poor skin integrity, 3) GI pain, 4) diarrhea, 5) sores, 6) memory loss, 7) anxiety, 8) dementia |
| True or false: vit B3/niacin deficiency causes CNS dysfunction that is irreversible | False. All def. side effects are reversible |
| High dose of niacin/B3 causes the following: (list 4) | Vasodilation, FLUSHING, dizziness, nausea |
| B6 is known as ______ and has what role? | Pyridoxine. B6 is an enzyme in metabolism of amino acids/proteins |
| B6/Pyridoxine def. is caused by: | 1) poor diet, 2) alcoholism, 3) use of isoniazid/TB drugs |
| Pyridoxine is given with TB drugs to prevent _______ | Peripheral neuropathy |
| B6/Pyridoxine def. signs include: | Anemia, depression |
| B6/Pyridoxine interferes with _____ and is contraindicated with it | Levodopa/Parkinson's drug |
| B9 is known as _____ and is needed to make ___ | Folic acid; DNA |
| Folate deficiency can result in: | Anemia, neuro deficits, birth defects (incomplete neural tube closure) |
| True or false: all grain products in US are enriched with folic acid | True |
| Women __ age who plan to be pregnant should take folic acid supplements | >35 |
| B9/Folic may help prevent _____ cancer | Colon |
| True or false: oral birth control pills do not affect folic acid levels | False. Can decrease them. This is why important to supplement folic acid in childbearing women |
| B12 is _______ and found mostly in ___ foods | Cyanocobalamin; animal |
| True or false: cyanocobalamin can be found in certain yeast products | True |
| True or false: like most vitamins, B12/Cyanocobalamin cannot be measured | False. Can draw blood level to determine |
| Who needs B12/cyanocobalamin levels drawn? | Vegans, pregnant women (need B12 for RBC production), anemics. IM inj may be necessary |
| Calcium is given in these routes. | PO/IV |
| RN considerations for Ca IV: | Acute situations; give slowly; pt. on cardiac monitor d/t risk of dysrhythmias |
| Ca is regulated by three things: | 1) absorption from intestine (1/3), 2) renal excretion, 3) resorption/deposition Ca into bone |
| Ca processes are controlled by: | Parathryoid hormone (increase absorption), vitamin D (increase absorption), calcitonin (decrease blood Ca) |
| Ca absorption is DECREASED in these types of foods: | Spinach, rhubarb, chard, beets, whole grains, bran decrease Ca absorption |
| Ca comes in different types: | Acetate, carbonate, citrate, gluconate, lactate, phosphate |
| Best bioavailability: | Tums and Os-Cal (Os-Cal slightly higher) <-- known as carbonate |
| Calcium salts are taken __ and have DDI with these drugs: | PO; thiazide diuretics (decrease excretions), GC (decrease absorption), Ca (decrease thyroid absorption) |
| Calcium and thyroid hormone should be given _____ | Several hours apart (4 hrs) |
| Weeds and flowers are used by ____ Americans, ___ regulated, ____ researched, and _____ marketed | 40%, not well regulated, poorly researched, and highly marketed |
| ___% pts. do not disclose use of CAM | 70% |
| DSHA (Dietary Supplements Health and Education Act 1994) states three important things about CAM: | 1) most CAM products exempted from FDA regulation, 2) products do not have to prove safety and efficacy, 3) assumed safe unless proved harmful in court |
| True or false: for CAM labels do not have to accurately list ingredients | True |
| Some CAM products have been found to contain very dangerous substances: (3 examples) | Mercury, lead, arsenic |
| Current Good Manufacturing Practices 2007 requires no contamination and accurate labeling information. What issues exist regarding this Practice act? | Largely voluntary, spotty oversight, usually in response to report of injury regarding CAM |
| Private Quality Certification is what? | USP approval that are enforceable by FDA. Tests label matches that is inside, NOT safety/efficacy! |
| WHO surveyed 141 member states and found only __ have a national policy regulating CAM/herbal | 36% |
| A RN should be concerned about the following if a pt. is taking St. John's Wort: | 1) increased potential for serotonin crisis if taking SSRI/SNRI, 2) sun sensitivity, 3) liver enzyme inducer |
| Nursing consideration re: Ma huang/ephedra/ephedrine: | ANS/CNS stimulant: neuro/cardio effects |
| Kava is an alternative to _____ and can cause this AE: | Benzodiazepines; hepatotoxicity |
| Comfrey is given in these routes and has this AE: | Topical/soothing, PO. Hepatotoxicity |
| The following decrease platelet aggregation: | Garlic, ginko biloba, feverfew |
| Obesity: # for overweight, obese, morbidly obese | >25 overweight, >30 obese, >40 morbidly obese |
| Obesity is regarded as ____ than smoking/drinking/poverty | Worse |
| Who should be treated in terms of BMI/waist circumference? | BMI>25 + 2 risk factors, BMI>30, WC>40'' (M), WC>35''(F) |
| ___ type of weight loss is safer and more likely to be kept off | Slow (10% over 6 mo, 1 lb/wk) |
| When should drug therapy begin for an obese pt.? | Only after failing diet and activity for 6 mo has failed. Should be part of an OVERALL approach to lose wt. |
| Wt. loss with drugs usually is __ lbs on average | 4-22 |
| Mechanism of actions for obesity drugs: (list 3) | 1) suppress appetite, 2) reduce absorption of nutrients, 3) increase metabolic rate (sympathomimetics, not usu Px) |
| Appetite suppressant prototype name (the one D/Ced), AE, contraindication | Sibutramine/Meridia. AE: may elevate BP, contraindicated in hypertensive pts., pts. on antidepressants/sympathomimetics |
| List two other appetite suppressants (drugs already studied): | Fluoxetine/Prozac, Bupropion/Wellbutrin. With Prozac lose wt. then regain. Wellbutrin small loss. (3-5%) |
| Fenfluamine and phentermine are ______ that were withdrawn d/t _______ | Appetite suppressants; withdrawn d/t damage to heart valves |
| Orlistat is also known as ___ or ____ | Xenical, Alli |
| How does Orlistat work? How much weight is usually lost? | Decrease fat absorption by 30% by inhibiting lipase. Diet should have no more than 30% fat. Mean loss after 2 yrs = 19 lbs |
| AE of Orlistat: (list 5) | Oily spotting, flatulence, fecal urgency, fatty stools, fecal incontinence |
| Orlistat works similarly to Antabuse in that... | Behavioral deterrent (stop eating oily/fatty foods) |
| Orlistat ___ absorption of ___ vitamins | Reduces; ADEK |
| What should be taken before and after Orlistat? | Multivitamin (2 hrs before/after) |
| True or false: for most drugs, unknown how Orlistat would affect them | True |
| List various sugar substitutes. | Saccharine, Aspartame (not for PKU pts), sucralose, sorbitol, xylitol |
| Sorbitol and xylitol have the following SE: | Sugar free candy that can increase blood glucose |
| FDA states sugar substitutes are ___ and that claims of brain cancer/diabetes are _____ | Very safe; unproven |
| Sugar substitutes intended for ___ intake, not ___ | Occasional; NOT primary intake! |
| Sugar substitutes may be useful for diabetics but for non-diabetics, calorie-wise a tsp of sugar contains __ cal vs. honey's 22 cal | 16 |
Created by:
choel
Popular Pharmacology sets