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Drew 923 > 4_5Probiotics > Flashcards

4_5Probiotics Flashcards

1
Q

Define probiotic?

A

live microorganism that confers a health benefit to the host when given in adequate amounts

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2
Q

Define prebiotic.

A

nondigestable food ingredients to stimulate growth of limited colon bacteria

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3
Q

What are prebiotic substances?

A

oligofructose, inulin, galactooligosaccharides, lactulose

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4
Q

Define synbiotic

A

product containing probiotics and prebiotics

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5
Q

Define postbiotic

A

metabolic byproduct of a probiotic that influences biological host function

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6
Q

Who defined all the probiotic terms?

A

FAO/WHO joint working group in Ontario. No legal authorities.

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7
Q

What does probiotic technically mean, and when was the term first used?

A

“for life” in the 1960s

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8
Q

What percentage of the human microbiota are in the GI?

A

70%

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9
Q

Density of bacteria in the stomach?

A

10^3 CFU/g contents

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10
Q

Density of bacteria in the small intestine?

A

10^6 - 10^7

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11
Q

Density of bacteria in large intestine?

A

10^11

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12
Q

What are the functions of probiotics?

A

1) compete for binding sites and nutrients; 2) bacteriocidal; 3) immunomodulatory; 4) strengthen intestinal barrier; 5) enhance GI function

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13
Q

How are probiotics bacteriocidal?

A

secrete acid (lactic, acetic, propionic, organics); secrete bacteriocins and H2O2

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14
Q

How are probiotics immunomodulatory?

A

1) increase phagocytic activity; 2) stimulate IgA production; 3) stimulate cytokine production

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15
Q

How do probiotics strengthen the intestinal barrier?

A

1) stabilize TGs; 2) decrease permeability; 3) increase mucin production

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16
Q

How do probiotics enhance GI function?

A

1) aid digestion, 2) synthesize vitamins, 3) increase absorption, 4) detox carcinogens

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17
Q

Why is probiotic evidence not comparable/standard?

A

1) method of delivery varies; 2) strain and dose-specific effects; 3) varied length of treatment, age of patient, combos, post-biotics

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18
Q

Culturelle

A

LGG (lactobacillus rhamnosus GG)

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19
Q

Florastor

A

Saccharomyces boulardii

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20
Q

DanActive

A

Lactobacillus casei DN 114 001

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21
Q

Align

A

Bifidobacterium infantis

22
Q

What are the common probiotic organisms?

A

1) LGG; 2) Bifidobacterium; 3) E. coli Nissle; 4) Strep thermophiles; 5) Enterococus faecalisa and faeciuma; 6) Saccharomyces boulardii; 7) bacillus cereus

23
Q

effects of LGG

A

decreased duration of acute diarrhea in kids

24
Q

How do probiotic strains differ?

A

1) ability to withstand acid; 2) ability to colonize GI

25
Q

What probiotic for acute diarrhea?

A

LGG, S. boulardii

26
Q

What probiotic for Abx-associated diarrhea?

A

LGG, S. boulardii

27
Q

What probiotic for C. dif diarrhea?

A

Lactobacillus, S. boulardii, L. casei

28
Q

What probiotic for traveler’s diarrhea?

A

S. boulardii

29
Q

What probiotic for IBS?

A

B. infantis

30
Q

What probiotic for IBD?

A

UC VSL #3

31
Q

What probiotic for Crohn’s?

A

none

32
Q

What probiotic for atopic dermatitis?

A

L. fermentum, LGG, B. lactis

33
Q

What probioti for H. pylori?

A

can only treat symptoms

34
Q

What probiotic for lactose intolerance?

A

yogurt - has fermented milk proteins and enzymes

35
Q

What probiotic for vaginitis/candidiasis?

A

Lactobacilli

36
Q

What probiotic for weight loss?

A

Lactobacillus gasseri, Candians showed LGG + prebiotic 30 mins before breakfast and dinner for 12 weeks

37
Q

What probiotic for periodontitis?

A

L. reuteri (Periobalance lozenge BID)

38
Q

What probiotic to decrease LDL?

A

L. reuteri (NCIMB 30242)

39
Q

How may probiotics affect CNS disorders?

A

may produce neurochemicals

40
Q

Other probiotic effects in children?

A

may stimulate IgA (probiotic formulas not recommended by AAP, however)

41
Q

What are the ADRs of probiotics?

A

mild/transient gas and bloating; rare, severe eosinophilic syndrome; rare eosinophilic esophagitis

42
Q

What are the symptoms of eosinophilic syndrome?

A

sudden malaise, arm/leg weakness, numbness

43
Q

How is eosinophilic syndrome treated?

A

IV corticosteroids and months of immunosuppression

44
Q

What are the effects of eosinophilic syndrome?

A

permanent motor and sensory deficits

45
Q

What is eosinophilic esophagitis?

A

hives and itching due to allergens

46
Q

Where should probiotic use be cautioned/avoided?

A

1) immunosuppressed; 2) short-bowel syndrome; 3) central venous catheters; 4) pregnant/breastfeeding; 5) infants;kids; 6) elderly

47
Q

What are probiotic interactions?

A

Abx - space 2 hours

48
Q

How do supplements differ from food?

A

food must be safe for all ages in any amount with a cumulative effect; supplement can specify dose/age/duration

49
Q

What components are included in best-practice product labeling?

A

1) scientific name; 2) best-by date; 3) dose based on evidence; 4) safety; 5) storage; 6) contact info

50
Q

How should an appropriate probiotic be chosen for a specific use?

A

1) use same genus/species/strain and formulation as the study; 2) base dose on CFUs; 3) choose product with best-by date

51
Q

What are the two viability dates that can be provided on a label?

A

1) CFUs at time of manufacture; 2) best-by date

52
Q

How can probiotics be marketed as a drug?

A

file NDA with the microbiologic characterization through CBER (biologic regulation)

Drew 923 (28 decks)

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