CAMs Flashcards
FAT soluble vitamins
ADEK
Stored in adipose tissue
Can be TOXIC or OD
Water soluble vitamins
not stored
excreted in urine
Vit A
vision, bone growth, reproduction, immune function, cell division
deficiency = night blindness, DEC immune function
teratogenic in HIGH doses
lower levels in chronic ETOH or malabsorption syndromes
Vit D
sunlight
critical to bone health (growth and remodeling)
required to absorb Ca from digestive tract
deficiency = brittle bones, misshaping of bones
oral corticosteroids INC risk of deficiency
TOXICITY = hyperCa or hyperphosphatemia
Vit E
anti-oxidant
boosts immune system, vasodilates, prevents clotting
HIGH doses INC risk of bleeding
Vit K
component blood clotting
synthesized by intestinal bacteria
given to newborns within first 2wks of life
warfarin interferes w/ vit K
INR >10 w/ no bleeding = give oral Vit K
INR HIGH w/ bleeding = give IV Vit K
Thiamine B1
critical for many body functions
Deficiency in alcoholics
SEVERE deficiency = wernicke’s encephalopathy (thiamine 500mg Tid IV x2 days; 500mg IV or IM daily x5days, then 100mg PO daily until no longer at risk)
Riboflavin B2
essential component of 2 major enzymes
ultraviolet and visible light deactivate riboflavin
Deficiency (rare): vegetarian athletes, pregnant/lactating women, infants, vegans
USES: migraine HA, CA prevention/tx
Niacin B3
cell metabolism; making/repairing DNA
lower VLDL, LDL, TG
INC HDL
benefit those not on a statin
Deficiency: pellagra
AE: flushing, raises serum BG, indigestion
Pyridoxine B6
protein and RBC metabolism
glucose regulation
deficiency: microcytic anemia, dermatitis w/ mouth sores, cracked lips, depression/confusion, weakened immune function
Meds cause deficiency: Anti-TB, anti-epileptics, theophylline
USES: for N/V during pregnancy
Folic Acid B9
tissue growth and function; production RBCs and DNA
Deficiency: INC demand (pregnancy/lactation), meds, malabsorption, ETOH, dialysis, liver disease
recommended for women of child-bearing age
Deficiency: macrocytic-normochromic anemia, neural tube defects
Cyanocobalamin B12
RBC formation, neuro function, DNA formation/regulation
role in synthesis of fatty acids and energy production
Deficiency: megaloblastic anemia, fatigue, loss of appetite, neurological change
body store in liver
supplementation: nasal sprays, injectable, oral
Ascorbic acid Vit C
biosynthesis of collagen = tissue repair
involved in protein metabolism
deficiency: scurvy
AE: osmotic effect in bowels = GI distress, N/V/D
Common cold: help prevent
St. John’s Wort
tx mild depression
USES:
DEC depression sx
DEC menopausal sx
topical: INC wound healing
AE: photosensitivity, INC BP
Interactions: MANY
do NOT take w/ meds that affect serotonin
Kava
member of pepper family
USE: anxiety (small effect)
linked to SEVERE liver disease
FDA WARNING: Liver damage
Saw Palmetto
USE: BPH, chronic pelvic pain, DEC libido, migraines, hair loss
Few interactions
Few AEs
Garlic
lipid lowering and antithrombotic properties
most effective 1 clove/day of fresh garlic
may cause: dizziness, irritation of mouth and esophagus, halitosis, body odor
may INC serum levels of ETOH
Ginkgo Biloba
USE: dementia, eye problems, intermittent claudication
AE: HA, stomach upset, allergy
INC risk of bleeding
May interact w/ meds
Eating raw or roasted seeds POISONOUS
Echinacea
boost immune system
USE: common cold, other infections
may DEC risk of catching cold
AE: GI, allergic reactions
few drug interactions
Ginseng
USE: improve general well-being; physical stamina, concentration, stimulate immune system
AE: HA, sleep problems, digestive problems
Asian ginseng: affect BG and BP
might interact w/ warfarin
Feverfew
USE: tx fever, migraine prophylaxis, menstruation, asthma, tinnitus
No AEs reported
AVOID PREGNANCY = affects uterine contractions
Valerian
USE: sleeping aid
FDA: safer than synthetic drugs
Benefits: fall asleep faster, better sleep quality, no “hangover”
Recommend using 2-3 wks, then 2-3wks off before restarting to avoid withdrawal
Ginger
USE: Nausea, motion sickness, pregnancy, CINV, RA and OA
AE: mild abd discomfort, heartburn, diarrhea, flatus
AVOID w/ GB disease
may interact w/ anticoagulants
AVOID ASA, NSAIDs
Turmeric
antioxidant
USE: chronic pain and inflammation
arthritis: inflammation relief
pain relief, DEC post-MI on bypass patients, DEC skin irritation post-breast CA radiation
liver protectant, DEC risk pancreatic, prostate CA, multiple myeloma
AE: stimulate secretion of gastric acid, blood thinning, stimulate uterine contractions
Flaxseed
USE: constipation, diabetes, cholesterol, CA
seeds contain omega-3 fatty acids
AVOID PREGNANCY
preliminary studies: ovarian CA, CVD, DM, asthma, inflammation
Cinnamon
USE: GI problems, loss of appetite, DM
NO improvement in DM, HTN
AVOID large amounts in liver disease
current studies: alzheimer’s, HIV protection, MS, wound infection
Capsaicin
chili pepper
USE: creams/lotions for muscle/joint pain
AE: erythema, pain at application site
Black Cohosh
member buttercup family
USE: menopausal sx, heart palpitations, tinnitus, vertigo, sleep disturbances, nervousness, irritability
CAUTION: LIVER DAMAGE
Milk Thistle
USE: liver disorders (hepatitis, cirrhosis), gallbladder
CAUTION allergy to ragweed, chrysanthemum, marigold, daisy
DM-2 use CAUTION - may lower BG
Glucasamine-Chondroitin
structural component cartilage
USE: OA, mainly hip and knee
NOT helpful for pain
may interact w/ warfarin
long-term use: kidney damage
may affect BG
CoEnzyme Q-10
found in heart, liver, kidneys, pancreas
may DEC risk heart damage from chemo
may DEC risk heart surgery complications
possible effect in migraine prophylaxis
NOT helpful in Parkinson’s
Interact w/ warfarin and insulin
Aloe Vera
USE: gel-burns, frostbite, psoriasis, cold sores; oral - bowel disease, fever; latex - constipation
AE (oral): abd cramps, diarrhea, may DEC drug absorption/effectiveness
may lower BG, careful in DM
Melatonin
natural hormone in sleep; RISES in evening, FALLS in morning
USE: prevent jet lag, sleep disturbances r/t shift work, delayed sleep phase disorder, insomnia
may worsen mood in dementia
SE: drowsiness, HA, dizziness, nausea
may affect biological clock
Probiotics
HERBAL Use for APRN
Pregnancy:
>multiple herbs dangerous during pregnancy
>AVOID: causes contractions
>contraindicated in LACTATION
General:
>NOT risk free
>discuss w/ patients
>be aware of potential interactions
>NOT regulated by FDA
