April 2021—Review of Injectable Vitamins and Trace Elements in Adult Parenteral Nutrition 1. What trace element is not currently recommended to be included in MTE products for use in PN? A. Manganese B. Zinc C. Iron D. Copper 2. Which of the following is a commercially available MTE product in the United States that adheres to the ASPEN recommendations? A. Multitrace-5 B. Tralement C. Addamel N\ D. No such product exists
6. Factor leading to ASPEN recommending an MTE commercial product be made without chromium: A. Multiple cases of symptomatic toxicity while on PN B. High levels of chromium contaminating other PN components C. High levels of carcinogenic versions of chromium in PN D. Chromium is not necessary for functions within the body
7. Parkinsonian-like tremor is a sign of neurotoxicity due to _____ toxicity: A. Thiamine B. Manganese 3. A 56-year-old female is admitted with abdominal C. Zinc pain secondary to necrotizing pancreatitis and started D. Copper on PN. She reports eating little to nothing for over a week and is determined to be at risk for refeeding 8. The recommended dose of selenium was ____ to syndrome. Which of the following should be adminis- _____ mcg by ASPEN in 2012 tered to prevent complications from refeeding? A. Increased; 20-60 A. Cyanocobalamin B. Increased; 60-100 B. Thiamine C. Decreased; 20-60 C. Ascorbic acid D. Decreased; 60-100 D. Vitamin E 9. Why are parenteral water-soluble vitamin doses in 4. Which of the following commercially available mul- PN higher than oral RDA doses? tivitamin product(s) are currently on the market that A. Increased urinary excretion adhere(s) to the ASPEN dose recommendation? B. Patients at increased risk of deficiency or malnuA. M.V.I Adult trition B. M.V.I-12 C. Decreased bioavailability C. Infuvite D. a and b D. a and c 10. Concerns have been raised about the daily dose 5. Which of the following is not recommended during adequacy in MVIs of what fat-soluble vitamin? a national shortage of adult MVI or MTE products? A. Vitamin A A. Assess the indication for PN B. Vitamin D B. Administer oral supplements if able or tolerated C. Vitamin E C. Compound PN with appropriately dosed individ- D. Vitamin K ual injectable components D. Use pediatric formulations
|34| Kentucky Pharmacists Association | March/April 2021
