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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker
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Chapter 60: Vitamins, Minerals, and Complementary/Alternative Medications

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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker | Registered Nurse (RN) School Study Aid

Chapter 60: Vitamins, Minerals, and Complementary/Alternative Medications
24 Picmonics to Learn | 38 mins
Vitamin D Deficiency
Signs & Symptoms
Rickets in children
Bending bones
Rachitic rosary
Breast milk has decreased vitamin D
Osteomalacia in adults
Tetany from Hypocalcemia
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2 mins
Vitamin A (Retinol)
Mechanism
Maintains Mucous Membranes
Eyes and Skin
Indications
Dietary Deficiency
Skin Disorders
Side Effects
Hepatosplenomegaly
Jaundice
Increased ICP
Vomiting
Considerations
Teratogen
Animal Food Products
Dark Green and Orange Fruits/Vegetables
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2 mins
Cobalamin (Vitamin B12)
Mechanism
Vitamin B12
Indications
Vitamin Deficiency
Pernicious Anemia
Side Effects
Hypokalemia
Arthralgia
Dizziness
Considerations
IM Injection for Pernicious Anemia
Never Give IV
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2 mins
Vitamin K1 (Phytonadione)
Mechanism
Synthesizes Clotting Factors II, VII, IX, X
Indications
Hypoprothrombinemia
Newborn Prophylaxis
Bleeding from Warfarin Overdose
Side Effects
Shock
Kernicterus
Cardiac Arrest
Considerations
Bile Salts required for Intestinal Absorption
Increased Risks with IV Administration
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2 mins
Ergocalciferol (Vitamin D2)
Mechanism
Vitamin D2
Indications
Hypoparathyroidism
Rickets
Hypophosphatemia
Side Effects
Fatigue
Constipation
Hypercalcemia
Kidney Stones
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2 mins
Vitamin C (Ascorbic Acid)
Mechanism
Antioxidant
Collagen Formation
Steroid Synthesis
Indications
Dietary Deficiency
Scurvy
Side Effects
GI Distress
Considerations
Citrus Fruits
May Improve Healing
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2 mins
Vitamin B6 (Pyridoxine)
Mechanism
Amino Acid and Protein Metabolism
Heme Synthesis
Neurotransmitters
Indications
Adjunct to Isoniazid
Dietary Deficiency
Premenstrual Syndrome (PMS)
Side Effects
Ataxia
Peripheral Neuropathy
Contraindications
Levodopa
Considerations
Cereals and Meats
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3 mins
Vitamin B1 (Thiamine)
Mechanism
Carbohydrate Metabolism
Indications
Dietary Deficiency
Beriberi
Wernicke-Korsakoff
Considerations
Alcoholics Highest Risk
Give Before Glucose
Give IM or IV
Enriched Whole Grains
Pork
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2 mins
Vitamin E (Alpha-tocopherol)
Mechanism
Antioxidant
Indications
Fat Malabsorption Syndrome
Alpha-TTP Deficiency
Side Effects
Bleeding
Considerations
Increased Risk Hemorrhagic Stroke
Limit Doses < 200 IU per Day
Nuts and Whole Grains
Vegetable Oils
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2 mins
Cholecalciferol (Vitamin D3)
Mechanism
Vitamin D3
Indications
Dietary Supplement
Vitamin D Deficiency
Side Effects
Fatigue
Constipation
Hypercalcemia
Kidney Stones
Considerations
More Effective Than Ergocalciferol
Hypervitaminosis D
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2 mins
Vitamin B3 - Niacin (Nicotinic Acid)
Mechanism
Decreases Triglycerides
Decreases LDL
Increases HDL
Indications
Dyslipidemia
Pellagra
Diarrhea
Dermatitis
Dementia
Side Effects
Flushing
GI Distress
Hepatotoxicity
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2 mins
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
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59 secs
Calcium (Ca2+) Lab Value
8.5 to 10.5 mg/dL
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26 secs
Magnesium Sulfate
Mechanism
Muscle Relaxant
Indications
Preterm Labor Contractions
Preeclampsia
Side Effects
Warm Feeling
Hypotension
Decreased Deep Tendon Reflexes (DTRS)
Decreased Respiratory Rate
Decreased Urine Output
Paralytic Ileus
Antidote
Calcium Gluconate
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2 mins
Phosphate (PO43-) Lab Value
2.5 to 4.5 mg/dL
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29 secs
Potassium (K+) Lab Value
3.5 to 5.0 mEq/L
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20 secs
Chloride (Cl-) Lab Value
95-105 mEq/L
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28 secs
Sodium (Na+) Lab Value
135-145 mEq/L
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24 secs
Osteoporosis Interventions
Increased Calcium Intake
Vitamin D Supplements
Bisphosphonates
Raloxifene
Denosumab
Calcitonin
Teriparatide
Bone Densitometry (DEXA) Scan
Weight Bearing Exercises
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2 mins
Magnesium (Mg2+) Lab Value
1.5 to 2.5 mEq/L
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28 secs
Hypomagnesemia
Assessment
Confusion
Increased Deep Tendon Reflexes (DTRs)
Neuromuscular Irritability
Seizures
Muscle Cramps
Tremors
Insomnia
Tachycardia
Interventions
Magnesium Sulfate
Foods High in Magnesium
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1 min
Hypermagnesemia
Assessment
Flushing
Lethargy
Muscle Weakness
Decreased Deep Tendon Reflexes (DTRs)
Decreased Respirations
Bradycardia
Hypotension
Interventions
Dialysis
IV Calcium Gluconate
Diuretics
Avoid Antacids and Laxatives containing Mg2+
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2 mins
Hypocalcemia
Muscle Spasms
Assessment
< 8.5 mg/dL Ca2+
Decreased Bone Density
Tetany
Chvostek's Sign
Trousseau's Sign
Increased DTR
ECG Changes
QT Prolongation
Considerations
Oral and IV Replacement of Ca2+
Seizure Precautions
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2 mins
Hypercalcemia
Assessment
> 10.5 mg/dL Ca2+
Pathologic Fractures
Lethargy
Hypercoagulation
Constipation
ECG Changes
QT Shortening
Interventions
No Calcium Intake
Chelating Drugs
Calcitonin
Bisphosphonates
Loop Diuretics instead of Thiazide Diuretics
Considerations
Increased Risk for Renal Calculi
Increase Fluids
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3 mins

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