Flashcard Set Preview
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| 1 |
What is the RDA?
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The average daily intake to meet the nutrient requirements of 97% of all healthy individuals
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| 2 |
What are the fat soluble vitamins?
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Vitamins A, D, E, K
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| 3 |
What are the water soluble vitamins?
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Vitamin C and members of the vitamin B complex
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| 4 |
What are the important functions of Vitamin A (retinol)?
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Eye- adaptation to dim light
Embryogenesis,Spermatogenesis,Immunity,Growth
structural and...
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| 5 |
What occurs with Vitamin A deficiency?
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Night blindness
Xerophthalmia- a dry thickened condition of the conjunctiva
Blindness may...
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| 6 |
What occurs with Vit. A deficiency?
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Keratomalcia- degeneration of the cornea with keratinization of the corneal epithelium
...
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| 7 |
Vitamin A toxicity
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Teratogenic
Hypervitaminosis A
Vomiting, jaundice, hepatosplenomegaly, skin changes, hypomenorrhea...
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| 8 |
Vitamin A toxicity
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Do not exceed 7500 retinol equivalents per day
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| 9 |
Role of Vitamin D
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Role in regulation of calcium and phosphorus metabolism
Deficiencies now linked to cancer,...
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| 10 |
ROle of Vitamin D
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In children deficiency causes rickets
An adult deficiency causes osteomalacia
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| 11 |
Vitamin E
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Antioxidant
Helps to protect against peroxidation of lipids
Adverse effects
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| 12 |
Excessive amounts of Vitamin E
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Excessive vitamin E may increase the risk of bleeding
Can suppress coagulation increased prothrombin...
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| 13 |
Vitamin K
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synthesis prothrombin and three other clotting factors (VII, IX, X)
All of these vitamin...
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| 14 |
Vitamin K deficiency
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Bleeding disorders
Deficiencies in patients with decreased absorption (ex. malabsorption syndromes,...
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| 15 |
Vitamin K deficiency
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Deficiencies could be secondary to antibiotics
Normal infants are deficient in vitamin K
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| 16 |
Adverse Effects of Vitamin K
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Hypersensitivity reactions- prefer to give PO. give SQ, IM. Give IV if no alternative exists....
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| 17 |
Vitamin K Uses
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Vitamin K reverses hypoprothrombinemia and bleeding caused by excessive dosing with Warfarin
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| 18 |
Vitamin C (Antioxidant) deficiency
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Scurvy
Faulty bone and tooth development
Loosening of the teeth
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| 19 |
Vitamin C deficiency
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Gingivitis,Bleeding gums,Poor wound healing,Ecchymoses
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| 20 |
AE of Vitamin C
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Diarrhea,Nausea,Abdominal cramps,Kidney stones with excess
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| 21 |
Niacin (Nicotinic Acid)
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Used to lower cholesterol,Deficiencies,Pellagra “rough skin”,Dermatitis,GI tract,CNS
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| 22 |
NIacin AE
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Flushing, dizziness and nausea
Give aspirin prior to administration
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| 23 |
Riboflavin (Vitamin B2)
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Involved in numerous enzymatic reactions
Can be used in Migraine headaches
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| 24 |
Thiamine (Vitamin B1)
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Essential for carbohydrate metabolism
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| 25 |
Thiamine Deficiency
Wet Beriberi
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Sx: Fluid accumulation in legs and CV system
Palpitations, EKG changes, High output H
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| 26 |
Thiamine Deficiency
Dry Beriberi
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Sx: Neurological and motor deficits
Ataxia, foot drop, memory problems
Edema absent
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| 27 |
Thiamine Deficiency
Wernicke-Korsakoff syndrome
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Wernicke-Korsakoff syndrome
CNS and Neuro and Psych- diplopia, ataxia, severe inability to...
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| 28 |
Pyridoxine (Vitamin B6)
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Enzyme in the metabolism of amino acids and proteins
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| 29 |
Pyridoxine Deficiency
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Poor diet
Isoniazid- prevent conversion of B6 to active form, decreased levels of B6
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| 30 |
Pyridoxine Deficiency
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Sx: dermatitis, microcytic anemia, peripheral neuritis, convulsions and depression
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| 31 |
Folic Acid
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Fetal development
Colorectal cancer
Atherosclerosis
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| 32 |
Vitamin B12 deficiency
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Megaloblastic anemia
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| 33 |
Role of Calcium
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Skeletal,Nervous ,Muscular Cardiovascular System
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| 34 |
Calcium cont.
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98% of calcium in the bone,Osteoclast- resorb old bone, Osteoblast- deposit new bone
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| 35 |
Calcium Cont
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Absorption of calcium is:
Increased by PTH and Vitamin D
Decreased by glucorticoids
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| 36 |
Regulation of calcium levels:
PTH- released and elevates calcium by three mechanisms
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1.)Reabsorption from bone, 2.)Reabsorption of calcium that has been filtered by the glomerulus,...
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| 37 |
Regulation of calcium levels:
PTH- released and elevates calcium by three mechanisms
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3.)activates vitamin D
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| 38 |
Regulation of calcium levels:
Vitamin D- increases calcium levels by:
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Increasing reabsorption from bone
Decreasing calcium excretion by kidney
Increasing calcium...
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| 39 |
Calcitonin
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Produced by the thyroid gland to decrease levels of calcium
Opposite effects of PTH and vitamin...
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| 40 |
Signs of Hypercalcemia
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G. I. disturbances,Kidney damage
CNS effects- lethargy and depression
Treatment:
IV fluids,...
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| 41 |
Signs of Hypocalcemia
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Tetany,Convulsions,Spasm of muscles
Treatment:
IV calcium
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| 42 |
Disorders of HypoCa+
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Rickets:Disease of childhood
Insufficient vitamin D or limited light exposure
Osteomalacia:Adult...
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| 43 |
Disorders of HypoCa+:
Paget's Disease
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Common in people >40 yo old
Increased bone reabsorption and replacement of bone with abnormal...
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| 44 |
Calcium Salts
Ca+ Carb. contains the highest percentage of calcium.
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Drug interactions:
Avoid iron,Avoid prednisone, Avoid foods high in oxalic acid
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| 45 |
Calcium Salts:
Parenteral administration
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Calcium chloride
Calcium gluconate
Adverse effects
Cardiac arrest if administered to quickly
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| 46 |
Vitamin D
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Important regulator of calcium and phosphorus homostasis
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Vitamin D Toxicity
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Toxicity-associated with hypercalcemia
Weakness, fatigue, nausea, vomiting and constipation
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| 48 |
Vitamin D Toxicity Treatment
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Treatment:
D/C vitamin d,High fluid intake,Decrease calcium in diet
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| 49 |
Calcitonin Uses
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Inhibits the activity of osteoclast
Inhibits the tubular reabsorption of calcium thus increasing...
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| 50 |
Calcitonin Uses
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Osteoporosis and hypercalcemia
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| 51 |
Calcitonin A/E
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Nasally- dryness and irritation
IM- nausea, inflammatory reactions and flushing of the face...
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| 52 |
Biophosphonates
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Incorporate into the bone and inhibit bone resorption by decreasing the activity of osteoclasts
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| 53 |
Biophosphonates:
Fosamax
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Use: osteoporosis and Paget’s disease
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| 54 |
Fosamax A/E
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A/E:Esophagitis
Full glass of water,Empty stomach,Remain upright
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| 55 |
Biophosphonates
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Actonel: works basically in the same way as fosamax,Boniva- works same way as Fosamax- only...
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| 56 |
Raloxifene
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Selective estrogen receptor modulator
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| 57 |
Raloxifene Uses/ A/E
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Osteoporosis
A/E: Thrombosis,Pregnancy category X
Hot flashes
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| 58 |
Alternative Medicine
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Exempts vitamins, minerals and botanical products from FDA regulation
Avoids stringent FDA...
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| 59 |
Alternative Medicine
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Imposes no such requirement on dietary supplements,Manufactured and marketed w/o giving the...
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| 60 |
Packaging of Alternative Medicine
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Dietary supplements must not claim to diagnose, prevent or treat disease,Can claim to favorably...
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Packaging of ALternative Medicine
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May say: promote urinary health, helps maintain cardiovascular function, see book page 1172
Must...
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| 62 |
Packaging of Alternative medicine
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May not say: protect against cancer, reduced pain and stiffness of arthritis, lowers cholesterol
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| 63 |
Herbal and Vitamins are not regulated by FDA
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No uniformity in preparation,Potency and purity is unknown
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| 64 |
Herbal and Vitamins are not regulated by FDA
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Adverse interactions with conventional drugs
Even with standardization there may be unidentified...
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| 65 |
Herbal and Vitamins are not regulated by FDA
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Untested for safety and accuracy
Clinical information is lacking
Information on adverse reactions...
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| 66 |
Dangerous Interactions
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Ginko biloba, feverfew, and garlic suppress platelet aggregation (increased bleeding with warfarin,...
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| 67 |
Dangerous Interactions
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Ma huang (ephedra) contains ephedrine
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| 68 |
Dangerous Interactions
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St. John’s Wort activates cytochrome 450 and can increase metabolism, decreasing therapeutic...
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| 69 |
Dangerous Interactions
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St John’s Wort interferes with many other antidepressants/decongestants- can cause hypertensive...
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| 70 |
Herbals: most common alternative approach
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Use of plant derivatives to promote health and relieve symptoms of disease
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| 71 |
Herbals
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May be effective, harmful,deadly
Because of lack of regulation, it is difficult to determine...
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Herbals:Black Cohosh Uses
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MOA: Suppression the release of LH in the pituitary; one action is the mimicking of estrogen...
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Herbals:Black Cohosh Uses
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Acute symptoms of menopause
Hot flashes, vaginal dryness, palpitations, depression, moods,...
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| 74 |
Herbals: Black Cohosh Uses
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Do not take during pregnancy
Watch with use of conventional antihypertensives, oral hypoglycemic...
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| 75 |
Echinacea
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Oral: stimulates immune function
Suppresses inflammation, treats viral infections (flu and...
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| 76 |
Echinacea
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Topical: wound care, burns, eczema, psoriasis. Herpes Simplex.
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| 77 |
Echinacea
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Popular among consumers
Efficacy is questionable
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| 78 |
Echinacea S/E
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SE are rare: fever, n/v, allergic reaction
Avoid in patients with autoimmune diseases (e.g....
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| 79 |
FeverFew
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Prophylaxis and treatment of migraine (suppresses serotonin release from plts, and leukocytes)
Relieve...
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| 80 |
Feverfew
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treat upset stomach, suppresses inflammation
Topically: treats infection, relieve toothaches
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| 81 |
FeverFew S/E
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GI SE: flatulence, diarrhea, abd. pain, indigestion, n/v
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| 82 |
Fever Few S/E: Can increase bleeding risk in patients taking
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conventional anticoagulants (warfarin, heparin) or antiplatelets (ASA)
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| 83 |
Garlic
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Used for cardiovascular effects
Reduces triglyceride levels and LDL
Taken to treat HTN, suppress...
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| 84 |
Garlic
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inc.arterial elasticity, and dec. atherosclerotic plaque,Antibacterial/anticancer effects
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| 85 |
Garlic
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GI s/s: flatulence, n/v, diarrhea, burning in the mouth,Increased risk of bleeding with conventional...
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| 86 |
Garlic
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Garlic can increase insulin levels (potentiate medications to treat diabetes)
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| 87 |
Garlic
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Decreases levels of saquinavir (a protease inhibitor) to treat HIV
Effects on BP and cholesterol...
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| 88 |
GingerRoot
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Suppress n/v in motion sickness, morning sickness and cancer chemotherapy
? Use in URI’s
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| 89 |
GingerRoot
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Anti-inflammatory and analgesic properties (Rx arthritis & other chronic inflammatory problems)...
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| 90 |
GingerRoot
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SE are rare but in excessive doses may see cardiac dysrythmias and CNS depression
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| 91 |
GingerRoot
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Use with caution in pregnancy stimulate uterine contractions),Risk of bleeding with patients...
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| 92 |
GinkGo
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Improve thinking (inc. blood flow in the brain & scavenging free radicals; suppr. platelet...
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| 93 |
GinkGo
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Well tolerated but suppresses coagulation (watch with conventional antiplatelet & anticoagulant...
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| 94 |
GinkGo
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May promote seizure activity (avoid if history of seizure activity, or on meds that lower the...
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| 95 |
Goldenseal
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Treat bacterial, fungal & protozoal infections of respiratory, GI, GU systems and oral and...
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| 96 |
Goldenseal
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In high doses can cause n/v, diarrhea, CNS stimulation. Toxic doses: HTN, convulsions, respiratory...
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| 97 |
Goldenseal
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Often sold in combination with echinacea (protects against bacterial infections, while echinacea...
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| 98 |
Ephedra
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Active ingredient is ephedrine,Reduce appetite, enhance energy, overcome fatigue,Relieves symptoms...
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| 99 |
Ephedra
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Activates adrenergic receptors
Dangerous cardiovascular effects (deaths have been reported)...
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| 100 |
St. Johns Wort
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Relieves depression,Interacts with many drugs
Watch for dysrythmias with conventional antidepressants
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| 101 |
Saw Palmetto
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Relieves urinary symptoms connected to BPH
May exhibit an antiadronergic activity
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| 102 |
Saw Palmetto
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keep away from pregnant women…don’t even touch it!
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| 103 |
Saw Palmetto
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May cause false negative test results on PSA (should get a baseline before taking)
HA, GI...
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