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Drew 923 > 4_3CAMTop10 > Flashcards

4_3CAMTop10 Flashcards

1
Q

How does glucosamine work its magic?

A

1) decreases chondrocyte breakdown; 2) decreases damage to cartilage matrix; 3) increases formation and repair of cartilage; 4) inhibit cytokine-stimulated production of inflammatory mediators

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2
Q

What are the uses of glucosamine?

A

1) mild-moderate knee OA (A); 2) general OA (B); 3) TMJ arthritis (PE); 4) RA - not as effective

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3
Q

What were the results of the GAIT trial?

A

glucosamine for knee OA: less effective if older, heavier, or chronic disease (worn-down cartilage and bone-on-bone)

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4
Q

What are the ADRs of glucosamine?

A

1) GI upset, 2) heartburn, 3) diarrhea; 4) may increase blood sugar as an amino sugar

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5
Q

Who is allergic to glucosamine?

A

those with shellfish allergy - use veggie-based product

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6
Q

What are sources of glucosamine?

A

1) marine exoskeletons; 2) in vivo glycoprotein produced by cartilage, synovial space

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7
Q

What are sources of chondroitin?

A

1) bovine/pork/shark cartilage; 2) a glycosaminoglycan in cartilage and CT

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8
Q

How does chondroitin work its magic?

A

1) inhibits synovial enzymes to decrease cartilage destruction; 2) increases H2O retention and elasticity in cartilage

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9
Q

What are the uses of chondroitin?

A

1) arthritis; 2) dry eye

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10
Q

What is methylsulfonylmethane (MSM)?

A

an odorless metabolite of DMSO occurring naturally in green plants

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11
Q

What is the normal dosage for glucosamine/chondroitin?

A

g/c 500/400 mg/day in 3 divided doses for 3 months; decrease when OA/RA is under control according to weight; do not increase after 3 months if no effect

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12
Q

How is chondroitin supplied?

A

as sulfate of HCl form; Mn may be included

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13
Q

What is the RDA of Managenese?

A

1.8-2.3 mg/day

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14
Q

What is the function of Mn in chondroitin?

A

aids in bone formation

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15
Q

How much Mn may be supplied in glucosamine/chondroitin products?

A

> 11 mg/day

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16
Q

What are the considerations for Mn in chondroitin?

A

not dangerous if

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17
Q

How is chondroitin used for cataract surgery?

A

a viscoelastic agent; also as a preservative medium for cornea transplantation

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18
Q

What did a 2011 study find regarding chondroitin use for OA?

A

800 mg QD for 3 months decreased hand pain and morning stiffness; but modest effect if used without glucosamine

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19
Q

What are the ADRs for chondroitin?

A

GI upset, nausea, diarrhea

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20
Q

What are chondroitin’s interactions?

A

anticoagulants (inc. INR at high doses)

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21
Q

What are the uses for methylsulfonylmethane?

A

1) OA, 2) maybe for allergic rhinitis, 3) absorption vehicle for topical preparations

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22
Q

What are the ADRs for methylsulfonylmethane?

A

garlic taste in mouth

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23
Q

What is the dosing regimen for melatonin?

A

2-3 mg Qday 30-60 min before bedtime; use x4 days after long flight

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24
Q

How is melatonin supplied?

A

1) pure form, 2) with valerian (sleep aid), 3) with B6 (Trp synthesis)

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25
Q

What are ADRs of melatonin?

A

drowsiness for 6h; vivid dreams but no hangover effect

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26
Q

What are the uses of melatonin?

A

distrubed sleep-wake cycles (autism, DM, schizophrenia, Alzheimers, Parkinsons, blindness)

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27
Q

What are the sources of melatonin?

A

1) synthesized from Trp in pineal gland; 2) supplements from synthetic or plant extracts

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28
Q

What are other names for CoQ-10?

A

1) idebenone; 2) mitoquinone; 3) ubiquinone

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29
Q

What are sources of CoQ-10?

A

1) dietary chicken, beef; 2) synthetic; 3) in vivo production of ubiquinol esp. in heart, liver, pancreas

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30
Q

What are the uses of CoQ10?

A

1) CVD, 2) T2DM, 3) migraine, 4) parkinsons, 5) statin myopathy, 6) anti-aging ingredient, 7) sun protection

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31
Q

What is the usual dose for CoQ-10?

A

100-200 mg/day

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32
Q

What is the CoQ-10 dose in parkinsons?

A

300-1200 mg/day

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33
Q

Why is CoQ-10 beneficial in statin myopathy?

A

(conflicting evidence). Statins decrease in vivo production of ubiquinol

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34
Q

How is CoQ-10 supplied?

A

in various dosage forms with variable F; can buy pure form; range of cost

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35
Q

What are ADRs of CoQ-10?

A

1) Gi upset, 2) nausea/vomiting, 3) rash, 4) HA, 5) anorexia; 6) heartburn

36
Q

What are CoQ-10’s interactions?

A

1) can decrease BP; 2) decrease warfarin effect

37
Q

What are counseling points for high doses of CoQ-10?

A

1) safe if

38
Q

What are other names for echinacea?

A

1) purple coneflower, 2) American coneflower, 3) black susan

39
Q

What are the sources of echinacea?

A

it’s a North American plant: 1) leaves of E. purpurea, 2) root of E. angustifolia

40
Q

How does Echinacea work its magic?

A

immune system modulator

41
Q

What are the uses of echinacea?

A

1) common cold, 2) vaginal yeast infection

42
Q

How is echinacea taken for cold?

A

as prophylaxis throughout the season or at first symptoms for 7-10 days

43
Q

How is echinacea taken for vaginal candidiasis?

A

as an adjuct to antifungal - can reduce recurrence

44
Q

How does echinacea affect a cold?

A

decrease symptoms 10-30% but not preventive

45
Q

What is the dosage of echinacea?

A

1) 900 mg dried extract, 2) 3-4 mL alcohol tincture at 5x concentration

46
Q

What substances may be combined with echinacea?

A

goldenseal and elderberry

47
Q

What is goldenseal?

A

a topical antibacterial

48
Q

What is elderberry?

A

an immunomodulator

49
Q

Who is allergic to echinacea?

A

those with allergic reaction to asteracaea/compositae family (ragweed, chrystanthemums, daisies, marigolds)

50
Q

What are echinacea’s interactions?

A

decrease effects of immunosuppressants; 1A2 and 3A4 inhibitor

51
Q

What are the ADRs of echinacea?

A

1) GI, 2) fever, 3) dizziness, 4) HA, 5) rash

52
Q

How long can echinacea be used?

A

safe if less than 12 weeks

53
Q

How does cranberry work its magic?

A

prevents bacterial adherence to bladder wall

54
Q

What is the dosage for cranberry?

A

300-400 mg BID or 8-16 oz pure juice QD

55
Q

At what dosage does cranberry have ADRs?

A

> 8-16 oz/day of juice

56
Q

What are the hi-dose ADRs of cranberry?

A

anticoagulant, decreased effect of alkaline drugs (antidepressants and pain meds)

57
Q

What are the active principles of garlic?

A

alliin and allicin

58
Q

What is allicin?

A

the active biological ingredient; sulfur containing AA derivative in garlic that has a significant odor

59
Q

What are the uses (PE) for garlic?

A

1) HTN, 2) atherosclerosis, 3) GI cancers - fresh garlic only; 4) tick bites; 5) tinea

60
Q

For what conditions does garlic have IE?

A

1) BPH; 2) colds; 3) corns; 4) pre-eclampsia; 5) prostate cancer; 6) warts

61
Q

What is the dosage of garlic?

A

3.6-5.4g allicin; 4g=1 clove of fresh; 8mg oil; 600-1200 mg extract - TID for HTN!

62
Q

What are the interactions of garlic?

A

1) may induce CYP450 system - inc. bleeding of anticoags; inc. metabolism of NNRTIs and Pis; 2) EC garlic may be more effective

63
Q

Who is allergic to garlic?

A

those with allergy to lily

64
Q

What are garlic’s ADRs?

A

odor, heartburn, GI upset

65
Q

What are the sources of ginseng?

A

roots of: 1) American (WI and Ontario); 2) Panax (Asian and Korean); 3) Siberian (Devil’s bush and Eleuthern)

66
Q

What is an adaptogen?

A

substance that increases resistance to stress

67
Q

What is a tonic?

A

substance that increases well-being and immune function

68
Q

What are the proposed benefits of ginseng?

A

1) adaptogen, tonic, energy; 2) T2DM for reduced post-prandial blood sugar; 3) cold/flu prevention

69
Q

What is the active component of ginseng?

A

ginsenoside

70
Q

What is the dose of ginseng?

A

100 mg extract BID; 1-2g powder Qday x 2-3 weeks

71
Q

How does ginsenoside content vary among ginseng sources?

A

Asian = 1.5%; American = 2%

72
Q

How is ginseng supplied?

A

powder and extract

73
Q

What information should be provided in a ginseng supplement?

A

1) type, 2) plant part, 3) amount, 4) dosage form

74
Q

What are ginseng’s interactions?

A

1) decreases warfarin effect, 2) stimulants, 3) hypoglycemics

75
Q

When is ginseng contraindicated?

A

1) pregnant/breastfeeding; 2) breast cancer; 3) insomnia

76
Q

What are other names for Ginkgo?

A

fossil tree, maidenhair tree, silver apricot

77
Q

How long does the ginkgo tree live?

A

1000 years

78
Q

What is the most commonly adulterated top-10 supplement and why?

A

ginkgo - hard to find

79
Q

What part of the ginkgo tree is used?

A

leaf extract (Chinese may use fruit)

80
Q

What components of ginkgo have a biological effect?

A

1) flavonol glycosides (antioxidant); 2) terpene lactones (vasodilators)

81
Q

How does ginkgo work its magic?

A

1) decreased platelet activation, 2) decreased amyloid effects; 3) increased endothelin; 4) increased prostacycling; 5) increased hippocampal excitability via GABA receptors

82
Q

What are the uses of ginkgo?

A

1) age-related memory impairment and cognitive function; 2) PVD; 3) dementia; 4) glaucoma; 5) diabetic retinopathy; 6) PMS; 7) Raynauds; 8) vertigo

83
Q

What is the dosage of ginkgo?

A

increased until 120-600 mg/day in divided doses

84
Q

What are the ADRs of ginkgo?

A

HA, N/V/D, allergic dermatitis; uncooked seeds/pulp = neurotoxic;

85
Q

What are the functions of ginkgo seeds?

A

need to be cooked! Antibacterial and antifungal

86
Q

What are the interactions of ginkgo?

A

1) anticoags - increased bleeding; 2) decreased effect of anti-epileptics; 3) variable effects on CYP450 system

Drew 923 (28 decks)

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