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DNT final1

final topics

QuestionAnswer
Flavonoids biochemistry Potent anti-oxidants. Reduce capillary fragility. Anti-histamine, anti-inflammatory, anti-cancer. Weak hormone like actions.
Flavonoid indication -Capillary fragility -Venous insufficiency -CVD (improve endothelial function and HDL levels) -Osteopenia
Flavonoid Dietary sources and dosage -Fruits, Vegetables, Tea, Red wine -Dosage varies
Flavonoid Interactions Grapefruit ones alter cytochrome p450 enzyme activity -Vegetarians/Vegans should choose beans w/ lower [Polyphenols] and [Phytic acid]which inhibit Iron absorption
Vitamin D Biochemistry Hormone for calcium homeostasis regulation.
Vitamin D Indications -Pvx/Tx of Osteoporosis, Osteomalacia, Rickets, Falls -Psoriasis -Cancer Pvx/Tx -Seasonal Mood D/o (enhance mood) -PCOS (normalize menstruation) -Respiratory infections
Vitamin D Testing + Deficiency vs Insufficiency -Serum testing: 25-OH vitamin D3 (calcidiol) and 1,25-OH vitamin D3 (calcitriol) -Deficiency=<10ng/ml, Insuffiency=<30ng/ml
Vitamin D Deficiency + Causes -Osteomalacia, Hypocalcemia, Rickets. Potential increased risk of autoimmunity, cardiovascular disease, and cancer Causes: Malabsorptive disorders (Crohn’s, Celiac Disease, Cystic Fibrosis, etc), hypothyroidism, poor sun exposure and certain drugs
Vitamin D Dietary Sources + Dosages -Sources=Fish/cod liver oil, eggs, fortified milk, Sun -Dosages: Maintenance=1000IU, Deficiency=4000IU
Vitamin D Interactions -Dilantin and ACE inhibitor and Bariatric surgery reduces D levels, -D lowers Atorvastatin
Vitamin D Toxicity >40,000IU, Kidney stone risk w/ calcium
Vitamin E Biochemistry -group of eight different tocopherols or tocotrienols that act as lipid soluble antioxidants. -Supplements mostly contain alpha-tocopherol form.
Vitamin E Indications -Pvx/Tx of CVD (Reduced MI w/ 400IU) -Venous thromboembolism -Intermittent claudication -Fibrocystic breast dz/PMS, Hot flashes, migraines, dysmenorrhea
Vitamin E Dietary sources + Dosage -Sources: Wheat germ oil, soy yogurt, sunflower seeds/oil, almonds/pecans/hazelnuts -Dosage: ~400-600IU, but <1000IU
Vitamin E Interactions -Reduced tardive dyskinesia by Phenothiazines -reduced cisplatin (chemotherapy)-induced neurotoxicity -ihibitory w/ iron -Inc Vit E need w/ PUFAs,
Vitamin K Biochemistry -Needed w/ blood clotting factors, and is cofactor for bone mineralization (osteocalcin, matrix Gla), synthesized in LI by bacteria
Vitamin K Indications -Tx of Blood clotting d/o, reverse coumadin overdose -Pvx/Tx of osteoporosis -Atherosclerosis (red. CAD)
Vitamin K Dietary Sources + Dosages -Sources: turnip greens, broccoli, dark/leafy veggies, beef liver, oats, cheese, green tea. -K2 synthesized in LI by bacteria -Dosage: 100-1000mcg/day
Vitamin K Interactions -contraindicated w/ Warfarin -food sources should be monitored during anti-coagulant therapies
Vitamin K Deficiency Hemorrhagic Dz of the newborn, Easy bleeding
Vitamin K Toxicity None reported, although adverse effects seen w/ precursor menadione and water soluble derivative menadiol (both no longer used)
Calcium Biochemistry Major extracellular cation. Main constituent of bone. In intestinal lumen, binds and precipitates bile acids.
Calcium Indications Osteoporosis, Leg cramps, Cancer Pvx, Preeclampsia pvx, HTN, Hypertriglyceridemia/cholesterolemia, Wt loss (fat oxidation), PMS
Calcium Dietary Sources + Dosages Dairy, fortified fruit juice, fortified soy, green leafy veggies (not spinach) -Dosage: supplementation 600-1200mg/day where diet provides 400-1000 mg/day.
Calcium Interactions Glucocorticoids deplete Ca, Inhibits Antibiotics, bisphonates, aluminium absorption, and thiazide diuretics may cause hypercalcemia
Calcium Testing Serum
Calcium Defieciency Rickets, osteoporosis, tetany (muscle pain, spasms, tingling/numbess in hands and feet
Calcium Toxicity Constipation, Hypochlorhydria, Hypercalcemia, Inc. MI
Magnesium Biochemistry important intracellular cation, necessary for proper function of muscle tissue and the nervous system and cofactor in a large number of enzymes.
Magnesium Indications Mitral Valve prolapse sxs, CVD (MI, CHF), Asthma, Mg Deficiency Sxs, Diabetes (improve insulin resistance), HTN (hypotensive), Osteoporosis,
Magnesium Dietary Sources/Dosages Sources:whole grains, nuts, legumes, dark green vegetables, fish, and meat. -Dosages:Supplemental 200-600mg/day, RDA range: 80-420mg/day
Magnesium Interactions Diuretics/Platinum/B agonists/laxatives (deplete),
Magnesium Toxicities Diarrhea and IV form (cautions: hypotension, bradycardia, or respiratory depression (avoid in those w/ recent heart attack)
Magnesium Deficiencies fatigue, depression, anxiety, irritability, insomnia, hyperventilation, muscle spasms and fasciculations, chest tightness, confusion, and memory loss.
Magnesium Testing Serum levels not predictive of stores (RBC and WBC forms better), 24 hr urine test best.
Potassium Biochemistry major intracellular cation. Imbalances in sodium / potassium ratios can cause serious trouble, including cardiac arrest.
Potassium Indications HTN (DASH diet), Renal stones (dec. recurrence), Diabetes (inc. glucose tolerance)
Potassium Dietary Sources/Dosages Sources: meat, avocado, apricot, banana, kiwi, spinach, tomato, lima bean, coconut water -Dosages: RDA: 3500mg/day FDA caps @ 99mg, liquid or effervescent preparation or extended release. In diet usually 50-100mEq~2000-4000mg. IV not recommended.
Potassium Interactions Thiazides and loop diuretics may deplete, ACE inhibitors inc. levels
Potassium Testing Serum tests sufficient
Potassium Toxicities Diarrhea, Gastric irritation/ulceration. CI: pts w/ renal failure or diabetes w/ K metabolism abnormalities,
Potassium Deficiencies seen in individuals with excessive fluid loss such as vomiting, diarrhea, sweating or medication. Sxs include muscle weakness, irritability, fatigue, heart disturbances, and confusion.
Zinc Biochemistry involved in over three hundred enzymes, is necessary for proper wound healing, normal immune function, reproduction and as direct viricidal effect.
Zinc Indications Skin conditions (Acne, Furuncles, Acroderm. enteropathica, Seborrheic dermatitis (pruritis, erythema, dandruff), warts), Infectious Dz (cold sxs, Pneumonia, herpes, OM), gastric ulcer, hepatic encephalopathy, macular degeneration, immune function, BPH.
Zinc Dietary Sources Oysters, crimini mushrooms, spinach, sea vegetables, basil, thyme, pumpkin seeds, yeast, beef, lamb, green leafy vegetables, whole grains, nuts, poultry and eggs.
Zinc Dosages/Testing RDA: 15mg/day, Supplemental: 15-90mg/day. no reliable test for subtle deficiency. Picolinate and Citrate forms more bioavailable and less risks than sulfate form.
Zinc Interactions Diuretics/NSAIDS/OC (deplete), Tetracycline/Fluoroquinine/Iron inhibited, Cu deficiency(30x:1Cu ratio best),
Zinc Toxicities GI upset. (taken intranasally->anosmia), CU deficiency
Zinc Deficiencies Taste test? Horizontal white spots on fingernails? impaired wound healing, dermatitis, rough skin, poor nail health, and increased infections
Copper Biochemistry involved in synthesis of collagen, regulation of cholesterol levels and in formation of bone, is a cofactor in one of the superoxide dismutase enzymes.
Copper Indications Deficiency, High cholesterol, arthritis (bracelet), Osteoporosis
Copper Dietary Sources/Dosages Sources: whole grains, nuts, legumes, vegetables, and meat. -Dosages: Recommended: 1.5-3mg/day, RDA: 900mcg (adults), 1000/1300 (pregnant/nursing)
Copper Interactions NSAIDS/penicillamine/AZT/ethambutol/Zn (deplete), prevents GI toxicity of aspirin
Copper Testing Serum ceruloplasmin good screening test better along w/ serum non-ceruloplasmin copper test.
Copper Toxicities nausea, vomiting, other GI distress. Liver cirrhosis, Psychiatric Dz.
Copper Deficiencies impaired glucose tolerance, hypercholesterolemia, hyperuricemia, cardiovascular disease, osteoporosis, emphysema, anemia, neutropenia, and impaired immune function
Created by: phdinh33