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🄼💊Chemotherapy/AntiViral/Botanicals > Botanicals & Dietary Supplement > Flashcards

Botanicals & Dietary Supplement Flashcards

1
Q

Aloe Vera Indication (3)

A

Wound Healing

Laxative - some clinical evidence

Osteoarthritis

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2
Q

Aloe Vera SE

A

Stomach Cramps (PO)

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3
Q

Bitter Orange Indication (3)

A

Nausea

Constipation

Wt. Loss

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4
Q

Bitter Orange SE (3)

A

INC HR

INC BP

[Stroke / MI (especially with caffeine)]

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5
Q

[Bitter Orange] DDI (2)

A

* Inhibits Intestinal CYP3A4

*[Interacts with MAOI since it contains tyramine metabolites]

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6
Q

Black Cohosh Indication

A

“Use Black Cohosh to help a painful Black Coochie”

Menopausal Sx

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7
Q

Black Cohosh SE

A

Worsens Breast CA (estrogenic)

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8
Q

Is there Clinical Evidence for Black Cohosh?

A

+/-

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9
Q

[Cranberry Juice] Indication

A

UTI

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10
Q

Is there Clinical Evidence for [Cranberry Juice]?

A

+/-

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11
Q

Echinacea DDI

A

Inhibits 3A4

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12
Q

Echinacea SE

A

Ech(i)nacea… (i) for immune booster

Exacerbates Autoimmune Dz

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13
Q

Echinacea Indication (2)

A

Ech(i)nacea… (i) for immune booster

Cold vs. Flu (immune Booster)

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14
Q

Ephedra Indication (4)

A
  1. Colds
  2. Fever
  3. Flu
  4. Wt. Loss
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15
Q

Ephedra DDI

A

Has Additive Effects with stimulants

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16
Q

Ephedra SE

A

INC risk for CVD / stroke / death

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17
Q

Is there Clinical Evidence for Feverfew?

A

+/-

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18
Q

Feverfew Indication (2)

A

Feverfew reduces Fever with only a few HA left afterwards

  1. Fever
  2. [HA / Migraine]
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19
Q

Feverfew DDI (3)

A

Inhibits CYP

1A2

2C9

2C19

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20
Q

Feverfew SE

A

Withdrawal Syndrome with chronic use = Rebound HA & Joint Pain

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21
Q

Feverfew Contraindication

A

Pregnancy (causes early contractions)

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22
Q

Garlic Indication (2)

A
  1. Hypercholesterolemia
  2. HTN

+/- Clinical Evidence

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23
Q

Garlic DDI (5)

A

Anticoagulants + [DEC SINO]

  1. Anticoagulants
  2. DEC Isoniazid
  3. DEC Saquinavir
  4. DEC NNRTI
  5. DEC OCP
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24
Q

Garlic SE

A

Bleeding Risk

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25
Q

Ginger Indication

A

GI upset (Morning Sickness / Nausea)

+/- Clinical Evidence

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26
Q

Ginger DDI

A

Anticoagulants

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27
Q

Ginger SE

A

Bleeding Risk

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28
Q

Ginkgo Indication (5)

A
  1. Memory Loss
  2. HA
  3. Fatigue
  4. Tinnitus
  5. Sexual Dysfunction
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29
Q

Ginkgo DDI

A

Anticoagulants

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30
Q

Ginkgo SE (3)

A

Bleeding Risk

Pregnancy Safety concerns

Seizures (uncooked Ginkgo)

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31
Q

Ginseng Indication (3)

A

HEP drank Gin to Sing

  1. Performance Enhancer (Mental / Physical / Immune)
  2. Erectile Dysfunction
  3. Hyperglycemia

+/- Clinical Evidence

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32
Q

Ginseng DDI (2)

A
  1. INC Effects of Insulin/Sulfonylurea
  2. Blocks Anticoagulants
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33
Q

Ginseng SE (2)

A

Babies and Preggos Hate to hear HepSing!

Birth Defects

Pregnancy Safety Concern

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34
Q

Ginseng Contraindication

A

Pregnancy (estrogenic)

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35
Q

Hawthorn Indication (3)

A
  1. Heart Dz CHF - clinical evidence
  2. HTN
  3. Heart Pain (Angina)
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36
Q

Hawthorn DDI (3)

A
  • Digoxin
  • Nitrates
  • BP meds
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37
Q

Is there Clinical Evidence for Hawthorn?

A

YES, ONLY FOR MILD CHF

38
Q

[Horse Chestnut] SE (2)

A

[Raw seed = poisonous Esculin toxin]

Exacerbates Renal Dz

39
Q

[Horse Chestnut] Indication (3)

A
  1. [Chronic Venous Insufficiency]
  2. Varicose Veins
  3. Hemorrhoids
40
Q

[Horse Chestnut] DDI

A

Anticoagulants

41
Q

Is there Clinical Evidence for [Horse Chestnut]?

A

YES

42
Q

Kava Indication (4)

A

“Her name was Kava AAID”

  1. Insomnia
  2. Anxiety
  3. Depression
  4. ADHD
43
Q

Is there Clinical Evidence for Kava?

A

YES

44
Q

Kava DDI (2)

A
  • Additive with sedatives
  • INC APAP toxicity
45
Q

Kava SE (2)

A

Liver Damage (SERIOUS)

Muscle Spasm

46
Q

[Milk Thistle] Indication (3)

A
  1. Liver Protection (Jaundice/Cirrhosis)
  2. Hypercholesterolemia
  3. DM
47
Q

[Milk Thistle] DDI

A

Inhibits UGT

48
Q

[Saw Palmetto] Indication

A

BPH

49
Q

Is there Clinical Evidence for [Saw Palmetto]?

A

+/-

50
Q

[Saw Palmetto] DDI (4)

A
  • Inhibits*
  • UGT
  • 3A4
  • 2D6
  • 2C9
51
Q

[St. John’s Wort] Indication (6)

A

St. John Prays tht Demons May Wane

  1. Depression/Anxiety
  2. Sleep DO/Chronic Fatigue
  3. Palpitations
  4. Wound Healing
  5. Migraine
52
Q

Is there Clinical Evidence for [St. John’s Wort]?

A

YES

53
Q

[St. John’s Wort] DDI (5)

A
  • Antidepressants
  • INC Expression of 3A4/SC19 –> DEC HOCS
  • DEC OCP
  • DEC Cyclosporin
  • DEC Statin
  • DEC HIV PTI
54
Q

[St. John’s Wort] SE (4)

A

PMS & T

  1. Photosensitization
  2. Serotonin Syndrome (with SSRI/MAOI/TCA)
  3. Mania (in Bipolar/Depressed/Psychotic)
  4. Teratogenic
55
Q

Valerian Indication (3)

A

“Grab Valerie if ur SAD”

  1. Sleep DO
  2. Anxiety
  3. Depression
56
Q

Is there Clinical Evidence for Valerian?

A

+/-

57
Q

Valerian DDI

A

Additive Effects on Sedatives (Benzo / Barbituates / Kava)

58
Q

Valerian SE

A

Drowsiness

59
Q

Yohimbe Indication (4)

A

WASE

Sexual Dysfunction

Erectile Dysfunction

Athletic Performance

Wt. Loss

60
Q

Yohimbe DDI

A

INC SE of MAOIs

61
Q

Yohimbe SE (4)

A
  • INC BP
  • INC HR
  • INC Anxiety –> Insomnia
  • Renal Failure
62
Q

List the ingredients typically found in Dietary Supplements (4)

A

Vitamins

Minerals

Herb Botanicals

Amino Acids

63
Q

What was the stipulation made by the 1994 Health Act that restricted FDA regulation on Dietary Supplement

A

Dietary Supplement Manufactureres can not make any claims stating their products treat, prevent, or cure

Supplements are not Drugs

64
Q

What type of evidence does Dietary Supplements have to provide due to the 1994 Health act

A

NOT required to prove Efficacy and Safety of product, but only have to provide substantiated claims by adequate evidence (yet this evidence has no standard of proof)

FDA can only prove that supplements (after 1994) are unsafe/ineffective. anything before 1994 is automatically safe

65
Q

List & Describe the 3 Claims [Dietary Supplements and Herbal Meds] are allowed to make

A
  1. Nutrient Claim = Certain amount of a nutrient in the product
  2. Health Claim (must be pre-approved by FDA first and evidence based w/ scientific agreement) = DS can DEC risk of obtaining a Dz or health condition
  3. [Structure-Function Claim] (MOST DS & HERBALS USE THIS CLAIM)= “Antioxidants help maintain cell integrity” or “Echinea supports the body’s immune system”. Can’t imply it’ll affect a Dz or condition
66
Q

What is the Product Label that must be contained on all [Dietary Supplements & Herbals]

A

“This product has not been evaluated by FDA. This product is not intended to diagnose, treat, cure or prevent any dz”

67
Q

Are [Dietary Supplement and Herbal] Manufacturers responsible for reporting SE?

A

YES! Serious SE must be reported to FDA AND [Good Manufacturing Practices] must be maintained

68
Q

Descibe how Common Vitamin A Deficiency is

A

Uncommon

69
Q

Describe Supplementation for Vitamin A Deficiency

A

Not Recommended

70
Q

Vitamin A Toxicity causes what? (5)

A

AAAA, ur a PINTH!

  1. Tertogenic
  2. Hypervitaminosis A
  3. Nausea/Vision: Acute
  4. INC ICP: Chronic
  5. Painful Joints & Coma
71
Q

Descibe how Common Vitamin D Deficiency is (2)

A

Overt Deficiency is rare = Osteomalacia/Rickets

Sublinical is common in some populations

72
Q

Who should receive Vitamin D Supplementation (5)

A
  1. Older
  2. Institutionalized Adults
  3. Limited Sunlight pts (Dark skinned pts)
  4. Obese pts
  5. GI DO pts
73
Q

Vitamin D Toxicity causes what? (4)

A
  1. Hypercalcemia
  2. Vascular Tissue Calcification
  3. [Damage to Heart / Blood vessel / Kidney]
  4. [NV, weight loss]
74
Q

Descibe how Common Vitamin E Deficiency is

A

Uncommon

75
Q

Describe Supplementation for Vitamin E Deficiency

A

Not Recommended

76
Q

Vitamin E Toxicity causes what? (2)

A

Mortality

Bleeding (when with anticoagulants)

77
Q

Descibe how Common Vitamin K Deficiency is

A

Rare although common in Newborns!

78
Q

Who should receive Vitamin K Supplementation

A

All newborns are given [IM Vitamin K] to prevent [Hemorrhagic Dz of Newborn]

79
Q

Vitamin K Toxicity causes what?

A

Rare

Don’t worry about it

80
Q

Vitamin C Toxicity causes what? (2)

A

Too much C causes [Gee-I issues] & [Kid-Ney Stones]

GI Issues & Kidney stones

81
Q

Descibe how Common Vitamin B1 Deficiency is

A

Rare in developed world but may –> BeriBeri

82
Q

Who receives Vitamin B1 Supplementation? What’s the PGN?

A

Chronic Alcoholics: [Wernicke Korsakoff Syndrome]

20% Fatal if untreated

83
Q

Descibe how Common Vitamin B12 Deficiency is

A

Kinda Common actually

84
Q

Who should receive Vitamin B12 Supplementation (5)

A

12 Grassleaves to VAPE!

  • Elderly (poor absorption)
  • [Vegans / Vegetarians]
  • Alcoholics
  • GI Malabsorption DO
  • Pernicious Anemia
85
Q

Descibe how Common Folate Deficiency is

A

Uncommon

86
Q

Who should receive Folate Supplementation

A

Women of childbearing age

(prevents Neural tube defects)

87
Q

Melatonin Indications (2)

Are these Clinical evidenced?

A
  2. Cognitive Impairment: NO EVIDENCE
88
Q

Melatonin Contraindications (2)

A

Anti-Epileptic

Warfarin

89
Q

[Glucosamine Chondroitin] Indication

Is this Clinical evidenced?

A

Osteoarthritis: NO EVIDENCE

90
Q

Fish Oil Indications (5)

Are these Clinical evidenced?

A

ALL IS EVIDENCED

DECREASES….

CVD

CHD death

Sudden CArdiac Death

HR

BP

91
Q

[Co-Enzyme Q10] Indications (5)

Are these Clinical evidenced?

A

“CHAD Married the Q (fraternity) life”

  1. CHF
  2. Angina
  3. HTN
  4. DM
  5. Migraine

+/- evidence: only for rare genetics

🄼💊Chemotherapy/AntiViral/Botanicals (4 decks)

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