CAM Vitamins Flashcards
Ginseng is known as a ______ and that means _______?
Known as an adaptogen meaning it is a general tonic for well being.
What is ginsengs active ingredient and MOA? What is its structure similar to?
- Active ingredient ginsenoside
- Alters carbohydrate metabolism
- May effect insulin release in the body
- Steroid hormones
What drug interactions does ginseng have?
Anticoagulants and antiplatelet agents.
Ginsengs adverse effects?
Insomnia, excitability, anxiety,
Increased heart rate
Fenugreek is used for?
Lowering blood sugar in patients with diabetes
What is fenugreeks MOA?
The fenugreek seeds contain 50% dietary fiber
-This is linked to delayed gastric emptying and therefore slowing the influx of blood sugar
Fenugreek may have additive affects eith what drugs?
- Anticoagulants/antiplatelets
- any drugs that lower blood sugar
What is cinnamons MOA?
WHat is it used for?
- Cinnamon may increase insulin action and insulin sensitivity
It is used in type 2 diabetes
1 gm = how much cinnamon
1/2 tsp
Creatine may be effective for?
Brief high intensity exercise
Adults older than? seem to not benefit from creatine
older than 60
Creatine is synthesized where and is also in what foods?
liver, kidneys, pancreas
also in meats and fish
What is Creatines MOA?
- Causes increased muscle stores in creatine phosphate.
- Reduced ATP degeneration
- Enhanced oxygen uptake
- increased glycogen storage
Who is more likely to respond to creatine?
vegetarians
What are some adverse rxns of creatine?
- Muscle cramping
- Nausea
- Diarrhea
- Weight gain
Creatine contraindications?
- Diuretic use
- dehydration
- impaired kidney function
- Interactis with ephedra and caffeine
- Nephrotoxic drugs
Creatine is safe for how many days?
10 days
DHEA is used in?
- Increased strength, energy muscle mass
- Weight loss
- Improve sexual performance
DHEA levels decrease with age and peak during?
Mid-20s
DHEA is known as a weak _____ and is the precursor to what sex hormones?
weak androgen and is a precursor to estrogens and testosterone
DHEA adverse effects occur when some takes more than?
200 mg daily
DHEA Contraindications include?
Pregnancy and breastfeeding
DHEA interacts with?
Hormonal or hormonal blocking agents
DHEA should be avoided if hx of what hormone sensitive cancers?
- Breast
- Cervical
- Endometrial
- Prostate
Ephedra is used for?
Weight loss and enhanced athletic performance
Ephedra is unsafe when used_____ and can cause what?
orally and can cause
- HTN
- MI
- Seizure
- Stroke
- All can occur with short term use in lower dose
Ephedra contains what?
- Ephedrine
- Psuedoephedrine
- PPA
Ephedra is a ______ stimulant and is causes what?
Vasoconstriction and cardiac stimulations
What are some adverse rxns of ephedra?
- Dizziness
- Anxiety
- Insomnia
- HA
- increased BP
- Tachycardia
- chest tightness
- dry mouth
Glucosamine and Chondrotin are used for? And MOA
Osteoarthritis
It may prevent cartilage degradation
may stimulate growth of new cartilage
May have anti-inflam and analgesic effects
Glucosamine and Chondrotin increase affects of what?
warfarin
It is important to tell patients that Glucosamine and Chondrotins onset of action? While they are waiting for releif what else could they use?
Is delayed and may take 6-8 wks
NSAIDS
Glucosamine in combination with ______ shows beneficial effects
Chondrotin
Studies show that combination Glucosamine and Chondrotin show benefits in ______ arthritis
Moderate to severe
MSM is used for?
Osteo and rheumatoid arthritis
joint inflammation
Chronis pain
MSM interactions
No known
MOA of MSM?
Unknown
Maybe antiinflam properties
Might inhibit joint degeneration
What is the active component of garlic?
Allicin
Garlic can be used to?
Lower cholesterol
and Lower High Blood pressure
What type of garlic is prefered for lowering cholesterol?
The fresh herb
Adverse rxns of garlic that are does related?
- Breath and BO
- GI discomfort
- Platelet dysfunction
What are garlics herbal interactions?
- Fish oils
- Feverfew
- Ginkgo
- Ginger
- Ginseng
- Any ones with antiplatelet effects
Garlic drug interactions?
- Antiplatelet and blood thinners
- Stop garlic 2 weeks prior to surgery
- May induce P450 3A4 (CCB, chemotherapy, antifungals, losartan)
- Lowers the levels of these drugs
Red Yeast RIce is used to?
MOA?
It is chemically identical to?
Adverse Rxns?
Lower cholesterol is effective
- Contains monacolins primarily monacolin Kthis is chemically identical to lovastatin
- Inhibits HMG CoA reductase
Same adverse rxns as statins
- Abd discomfort
- May increase liver function tests
What are Red Yeast RIces drug interactions?
HMG-reductase inhibitors
P450 inhibitors like theophylline, cisapride, ketoconazole, itraconazole, fluconazole- these drugs increases levels of RYR
Herbal interactions of Red Yeast RIce?
Contraindications?
- Grapefruit juice increase levels of Red Yeast RIce
- Liver dysfunction and pregnancy
What form of Coenzyme Q-10 is the recommended one?
Common uses?
Levels of Coenzyme Q-10 can be lowered by?
Improve what is diabetes?
- Ubiquinol
- Treats CHF
- lowered by statins
- Improve blood sugar control
The benefits of Coenzyme Q-10 are attributed to?
- Antioxidant activity
- Generation of ATP
Coenzyme Q-10 decreases if the effects of?
Protective effects?
Warfarin
- HMG reductase inhibitor
- RYR
Fish oil is used for?
- Lower elavated TG
- Reduced risk of death from heart disease
- RA
- Cancer, asthma, depression
FIsh oil MOA?
- Anti-inflammatory effects
- Decreased platelet aggregation
- Vasodilation
Dosing of Fish oil for High TG?
heart disease?
- 2-4 gm daily (EPA +DHA)
- 1 gram daily
Adverse effects of fish oil?
- Loose stool farting
- Nausea
- Heart burn
Herbal interactions of fish oil?
4 Gs and an F
Drug?
- Garlic, ginkgo, ginseng, ginger, Feverfew
- Anticoagulatants/platelets
How are adverse effects of fish oil minnimized
Take with food and taper dose slowly like up by 1 tab every week
Krill oil and Fish oil are pretty similar but
Krill oil has fewer adverse effects probably related to lower doses
Policosanol used for?
High cholesterol
Intermittent claidication
MOA of Policosanol for high cholesterol?
- Decrease hepatic synthesis and increase LDL degradation
- Overall decrease in TG and LDL increase in HDL
Policosanol NO INTERACTIONS or ADVERSSE
Stanols and sterols are used to?
MOA?
- Used to lower cholesterol reduces LDL
- Cholesterol is main animal sterol
- reduces cholesterol absosrption
Stanols and sterols with reduce cholesterol in?
No interactions some indegestion problems
2-3weeks
Unabsorbable and tasteless
Flaxseed is used for?
Elevated cholesterol
Constipation
Diabetes
Fiber from flaxseed is located in?
What is ALA it is contained in Flaxseed
Adverse effects?
seed coat
is a plant based OMega 3
- Bloating
- Fart
- ABD pain
- Diarrhea
Flaxseed drug interactions
- Can decrease platelets aggregation
- Antiplat substances and drugs
What is black Cohosh used for?
Hormone replacement therapy to manage menopausal symptoms
- Things such as Hot flashes
- Night Sweats
- Vaginal dryness
- UNKNOW MOA
When should Black Cohosh not be used?
History of:
- Breast Cancer
- Any other hormone sensitive cancers (endometrial, ovarian)
Are black cohosh adverse reactions likely?
WHat are they?
What are some drug interactions?
Not frequent
- Stomach upset
- HA
- Weight gain
- spotting or bleeding
DRug:
- HRT and contraceptives
If taking Black Cohosh what should you monitor?
Monitor Liver function
When are effects seen with black cohosh?
Seen with 4-12 weeks
Evening Primrose Oil is used for?
MOA?
- Menopause symptoms
- PMS
- Mastaligia
MOA: Oil rish in GLA, omega 6 fatty acids
Evening Primrose is well tolerated what are its herbal and drug interactions?
Platelet active herbals
Platelet active drugs
St. Johns Wort is used for?
- Depression (main use)
- Hot flashes
- PMS
What are the adverse Rxns of St. Johns Wort?
- Photosensitivity
- Restlessness
- Dizzy
- Delayed hypersensitivity
Interactions for St. Johns Wort?
Herbs:
- Digitalis
Drugs:
- INDUCER OF P450 ENZYMES POTENT
- 5-HT 1 agonist
- SSRIs
St. Johns Wort is not for?
Acute treatment results not seen for several weeks
IF you want to stop taking St. Johns Wort what do you do?
There can be withdrawal symptoms and it should not be stopped abruptly.
SO many interactions
What is Feverfew used for?
How do you take it?
WHat is it not for?
Onset?
- Headaches and Migraines prevention
- Must be taken continuously to have effect
- Not for acute migraine treatment
- Onset of benefit is about 4-8 weeks
Adverse effect of Feverfew?
GI shit
mouth ulcerations
Tongue irritation
What syndrome can you get if you stop feverfew abruptly?
Post feverfew syndrome
What are the interactions with Feverfew?
Herb:
- Anticagulant/antiplatelet potential
Drugs: same and NSAIDS
should stop before surgery
What is Ginkgo used for?
Alzheimers
Dementia
Has been used for 6 years
GINKGO interactions?
Anticoagulant
drug same
Consuming ginkgo can cause ______ thats why you dont give someone ginkgo even if their _______ is controls
seizure
epilepsy
Echinacea is used for?
- Immune stimulant to reduce symptoms of colds and URIs
- COLDs
Echinacea MOA?
Stimulates the immune response
activity of lymphocytes increased
Echinacea drug interactions?
Immunosuppressive therapy
Melatonin doesnt have a _____ effect like some other sleeping aids
hangover
When do you take Melatonin for insomnia?
30 minutes before bed
