Vitamin D ISM

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Vitamin D ISM
2011-05-20 23:24:14
Vitamin ISM Therapeutics Exam8

Vitamin D ISM Dr. Koski Therapeutics Exam8
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  1. What are the 3 main sources of vitamin D for humans?
    • diet
    • dietary supplements
    • sunlight
  2. Which form of vitamin D is available by Rx?
  3. What is the vitamin D metabolite that is monitored and used to determine a pt's vitamin D status?
    25-hydroxyvitamin D
  4. What is the level of 25-hydroxyvitamin D that most experts define as vitamin D deficiency?
    Less than 20 ng/ml
  5. List OTC strengths of Vitamin D3
    400, 800, 1000, 2000 IU
  6. How much vitamin D is usually found in multivitamins?
    400 IU
  7. What are other names for vitamin D2, D3, and rocaltrol?
    • D2 = Ergocalciferol
    • D3 = Cholecalciferol
    • Rocaltrol = Calcitriol
  8. When a multivitamin product label say the product contains Vitamin D, which form of vitamin D is usually contained in the product?
  9. List the prescription vitamin D products and strengths
    • Vitamin D2 50,000 IU/capsule
    • Vitamin D2 8,000 IU/ml liquid (Drisdol)
  10. Name a symptom of Vitamin D deficiency
    muscle weakness
  11. List some diseases Vitamin D deficiency has been linked to
    • cancer
    • T1DM
    • Crohn's Disease
    • MS
    • HTN
    • CHF
    • schizophrenia
    • depression
    • osteoporosis
    • osteomalacia
    • rickets
  12. List 3 natural food sources of vitamin D
    • Fish (tuna, sardines, salmon)
    • Egg yolk
    • Mushrooms
  13. list 3 foods that are usually fortified with Vitamin D
    Milk, OJ, yogurt, butter, margarine, cheese, breakfast cereal, infant formula
  14. List 5 scenarios that can cause Vitamin D deficiency
    • breastfeeding
    • use of sunscreen
    • skin grafts
    • liver failure
    • chronic kidney disease
  15. List medications that cause Vitamin D deficiency
    • anticonvulsants
    • glucocorticoids
    • HAART
    • antirejection meds
  16. What is the usual treatment dose of Vitamin D2 for vitamin D deficiency for an adult? For an 8 yo child?
    • 50,000 IU weekly for 8 weeks
    • same for 8 y.o.
  17. What is the usual maintenance dose of Vitamin D to prevent deficiency in adults? For an 8 y.o. child?
    • Adult - D2 50,000 IU Q 2-4 weeks or D3 800-1000 IU daily, sensible sun exposure
    • Child - D3 400-1,000 IU daily
  18. How much vitamin D3 should lactating women ingest to ensure adequate levels for themselves and the breastfed infant?
    D3 1000-2000 IU/day; 4000 IU qd is safe for up to 5 months
  19. Is a tanning bed effective at elevating vitamin D levels?
  20. What is the goal 25-hydroxyvitamin D level for pts with chronic kidney disease and how often should it be monitored?
    • 30 ng/ml
    • annually
  21. How much sun exposure is "sensible sun exposure" to maintain adequate vitamin D levels?
    5-30 minutes between 10 a.m. and 3 p.m. twice a week (depending on time of day, latitude, and skin pigmentation)
  22. What level of 25-hydroxyvitamin D is considered to be toxic?
    > 150 ng/ml