11 - Supplements Flashcards

1
Q

Definition(s) of a dietary supplement

A
  • A product (excluding tobacco) intended to supplement the diet with ingredients of vitamins, minerals, amino acids, herbs or other botanicals
  • A substance to increase the total dietary intake
  • A concentrate, metabolite, constituent, extract, or combination of any ingredients
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2
Q

Dietary supplements must be in what form(s)?

A

Must be in the form of a capsule, powder, or softgel

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3
Q

Are dietary supplements considered a drug or food?

A

Neither - it is it’s own category

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4
Q

When are supplements required?

A

When they’re deficient in a vitamin (ex. people take Vitamin D in winter)

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5
Q

How do taking dietary supplements affect people?

A
  • Improve quality of life
  • Improve self-esteem
  • Promote a healthy life style
  • Alternative treatment/medicine
  • Active role in self health management
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6
Q

List some ingredients in dietary supplements

A
  • Vitamins
  • Minerals
  • Amino acids
  • Other natural chemicals from (plants, animals, extracted or semi-synthetic)
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7
Q

Infusion

A

pouring hot water over an herb (ex. tea)

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8
Q

Decoction

A

boiling of herb (softens plant material ex. root or bark)

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9
Q

Water-based processes will only be used for ______ agents

A

hydrophillic

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10
Q

For lipophilic agents, _____ has been used (hydroalcoholic extracts)

A

alcohol

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11
Q

Describe herbs

A
  • from natural plants
  • raw or processed ingredients
  • for daily intake
  • better health benefits
  • in the form of medicines
  • specially labelled
  • available as supplements
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12
Q

What is included under “Natural Health Products” (NHPs) ?

A
  • Vitamins & Minerals
  • Herbal remedies
  • Homeopathic medicines
  • Traditional medicines
  • Probiotics
  • Other products (amino acids, fatty acids, etc.)
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13
Q

NHPs are ____

A

OTC

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14
Q

What are some dilemmas with NHPs/supplements?

A
  • Food or medicine?
  • Are they necessary?
  • Are they safe?
  • Can they be used with Rx meds?
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15
Q

What are some pros about NHPs/supplements?

A
  • OTC availability
  • Wide range of indications
  • Use without consultation
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16
Q

What is a functional food?

A

A food that can potentially provide benefits

  • Food with health benefits
  • Foods for daily intake
  • In the form of foods
  • Labeled as foods
  • Available as foods
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17
Q

What is the difference between a functional food and a nutraceutical?

A

A functional food is similar to a conventional food (i think it’s like how an orange can provide you with vitamin C)

A nutraceutical is isolated from a food and sold in dosage forms (so like a vitamin C tablet?)

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18
Q

Describe functional foods & nutraceuticals

A

Food components that provide demonstrated physiological benefits or reduce risk of chronic diseases, above and beyond their basic nutritional functions

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19
Q

Define “Alternative medicine” and list some examples

A

All other approaches and techniques that were not taught in “traditional” medical schools and residencies, but are practiced for healthcare improvement or disease treatment

Examples:

  • hypnosis
  • meditation
  • chiropractice/massage
  • acupuncture
  • traditional medicine
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20
Q

What are some Use Concerns ?

A
  • boundary not well-defined, terminology, interchangeable
  • constant regulatory changes based on different situations and requirements
  • lack of post-marketing surveillance of safety, efficacy, adverse effects, etc.
  • inappropriate usage due to OTC status
  • interactions with conventional medications is possible, information is deficient
21
Q

Beta-carotene (vitamin A precursor):

Benefits?

A

44% reduction in the risk of precancerous colon tutors in subjects who neither drink nor smoke

22
Q

Beta-carotene (vitamin A precursor):

Signs of too much?

A
  • headache
  • hair loss
  • muscular stiffness
  • fatigue
  • liver damage
23
Q

Vitamin B:

Benefits?

A
  • B12 reduces depression

- B6/12 reduces risk of breast cancer and slows progression of Alzheimer’s disease

24
Q

Vitamin C/Vitamin E:

Benefits?

A

cut stroke risk by 70% and 20%

25
Vitamin D: | Benefits?
reduced incidence of precancerous growths in colon, reduced fractures in people over 65 years
26
Vitamin D: | Signs of too much?
- nausea - vomiting - diarrhea - excessive urination and thirst
27
Vitamin C: | Signs of too much?
- UTI | - kidney/bladder stones
28
Calcium: | Signs of too much?
- impaired absorption of iron and zinc | - calcium deposits in tissues
29
Folic Acid: | Signs of too much?
- loss of appetite - nausea - sleep disturbances
30
List some dosage forms that dietary supplements come in
- Tablets (regular or coated) - Chewable tablets - Capsules - Oral liquids - Gummies
31
What are some important things to look at when buying supplements?
- Important elements: A, B groups, D, Cu, Zn, Mg, Fe, I, Se, Cr - % of recommended daily intake - Possible extra doses - Watch for marketing scams "natural", "super potency", "senior formula" (those words don't necessarily mean anything)
32
Generic or brand better?
Equal in quality - may have different excipients - brand is more expensive
33
Take supplements with ____ for better absorption
food
34
Not everyone needs a multivitamin/supplement. List some special populations that do need supplements and why
1) People over 65: they have lower absorption so may need supplements 2) Pregnant women or women who may become pregnant: for healthy babies/pregnancy 3) Vegetarians & people on special diets: To counteract diet imbalance 4) People with low-income: to supply extra nutrients in a diet which is lacking
35
____ administration is the only administration for supplements in Canada
Oral - some countries have parenteral administration of herbs but not Canada
36
Describe the formulation modification of dietary supplements
- Identification/separation of effective active ingredients - Elimination of unnecessary or less important components - Formulation of conventional solid dosage forms (tablets and capsules) - Improvement of bioavailability and bioequivalence
37
Adverse effects: | Ginseng
- hypertension - euphoria - nervousness - insomnia - skin eruption - edema - diarrhea
38
Adverse effects: | Ginkgo
- gastric distrubance - headache - dizziness
39
Adverse effects: | Valerian
- headache - excitability - insomnia - uneasiness - cardiac distrubance - ataxia - hypothermia
40
Adverse effects: | Saw palmetto
- nausea | - stomach upset
41
Long-term safety/toxicity data is _____
deficient/lacking
42
What is some information required for Licensed NHPs
- product name - product license holder - NPN (natural product number) or DIN-HM - product's medicinal ingredients - product's non-medicinal ingredients - product's dosage form - product's recommended use or purpose - relevant risk info
43
Is the labelling good on dietary supplements?
NO - HCPs are extremely important in providing info - There is lots of incorrect/misleading info on labels - Insufficient info on labels - NO universally-acepeed labelling systems - Info on drug-supplement interactions is limited and individual assessment for each combo is required
44
Describe a pharmacist's roles in Supplements: | Knowledge base
active ingredients, indications, dosage forms, recommended doses, potential side effects/interactions
45
Describe a pharmacist's roles in Supplements: | Product choice
brands, similarity, difference, preference
46
Describe a pharmacist's roles in Supplements: | Patient counselling
all kinds of questions related to patient's conditions, extremely important in use of supplements by patients and consumers
47
Describe a pharmacist's roles in Supplements: | Attitudes
positive, encouraging, unbiased
48
Describe a pharmacist's roles in Supplements: | Information collection
use of supplements and prescriptions, health conditions, physician's input
49
Describe a pharmacist's roles in Supplements: | Guidelines
discussion with physicians, no recommendation to patients with serious medical conditions, selection of quality brands, start with lower doses, follow-up with patients