Chapter 80: Dietary Supplements, Natural & Complementary Medicine Flashcards
DSHEA requires the manufacturer to ensure that their products are ___ before they are marketed
safe
Drugs must be proven to be ___ & ___ before they can be sold
safe & effective
Adverse events from supplements can be reported to
The FDA’s Safety Reporting Portal
Supplements cannot claim
to treat, cure or mitigate (lessen) a condition
What are the 4 areas of concern with supplements
Drug interactions, increased bleeding risk, or cause hepatotoxicity or cardiotoxicity
Folic acid 600 mcg DFE = ___ mcg of folic acid daily
360 (the RDA for women in child-bering years)
St. John’s Wort should be avoided with which classes of drugs
MAOi, SSRIs and SNRIs (it is serotonergic)
St. John’s Wort causes ____ & requires counseling on ___ and avoidance
Photosensitivity
Sun protection
Which supplements can increase bleeding risk
- Remember the 5 G’s: ginger, gingko, garlic, ginseng & glucosamine
- Fish oils (at higher doses)
- Vitamin E
- Dong quai
- Willow Bark (a salicylate)
Which supplements can be hepatotoxic
- black cohosh (used for menopausal symptoms)
- Kava (used for stress/anxiety)
Which supplements can be cardiototoxic
- Ephedra (removed from market) - bitter orange (synephrine) replaced ephedra in many products (these drugs are stimulants)
- Yohimbe (used to increase libido & for ED) - increases BP, HR, risk of seizures
Which supplements can be used for anxiety
- Valerian
- Passionflower
- Kava
- St. John’s Wort
Which supplement can be used for ADHD
omega-3 fatty acids
Which supplement can be used for Cold sores
L-lysine
Which supplements can be used for colds and flu
- Echinacea
- Zinc
- Vitamin C
Which supplements can be used for dementia/memory
- Ginkgo
- Vitamin E
Which supplements can be used for depression
- St. John’s Wort
- SAMe
- Valerian
- 5-HTP
Which supplements can be used for diabetes
- Alpha lipoic acid
- Chromium
- Cassia cinnamon
Which supplements can be used for dyslipidemia
- Red yeast rice
- Omega-3 FA
Which supplements can be used for dyspepsia
- Calcium
- Magnesium
Which supplements can be used for energy/weight loss
- Bitter orange
- Caffeine
- Guarana, green tea powder
Which supplements can be used for erectile dysfunction
- Ginseng
- L-arginine
- Yohimbe
Which supplements can be used for HF/heart health
- Coenzyme Q10
- Hawthorn
- Omega-3 FA
Which supplements can be used for HTN
- Omega-3 FA
- L-arginine
- Coenzyme Q10
- Garlic
Which supplements can be used for GI health
- Fibers
- chamomile
- Probiotics
Which supplements can be used for inflammation
- Omega-3 FA
- Flax seeds/oil
- Turmeric
Which supplements can be used for insomnia/sleep
- Melatonin for sleep (taken QHS)/jetlag (0.5-2 mg taken pre-flight & higher doses like 5 mg taken post-flight)
- Valerian
- Chamomile
Which supplement can be used for liver disease
Milk thistle
Which supplements can be used for menopause
- Black cohosh
- Dong quai
- Evening primrose oil
- Soy, red clover
Which supplements can be used for migraine, ppx
- Feverfew
- Butterbur
- Magnesium
- Riboflavin
Which supplements can be used for motion sickness
- Ginger
- Peppermint
Which supplements can be used for osteoarthritis
- Glucosamine
- Chondroitin
- SAMe
- Turmeric
Which supplements can be used for osteoporosis
- Calcium
- Vitamin D
- Soy
Which supplements can be used for prostate health
- Saw palmetto
- Lycopene
Which supplement can be used for skin conditions like acne, dandruff, and fungal infections
Tea tree oil
Which supplement can be used for UTI
Cranberry
5-HTP safety concern
serotonergic
Bitter orange safety issue
Stimulant (synephrine component)
Black cohosh safety issue
May be hepatotoxic
Caffeine safety issue
Increases BP and HR
Dong quai safety issue
Bleeding risk
Hawthorn safety issue
Positive inotrope; avoid concurrent use with digoxin (additive effect)
Kava safety issue
Avoid d/t hepatotoxicity
Omega-3 FA safety issue
Increases bleeding risk with high doses
Probiotics safety issue
Safety concern with use of live bacteria in immunocompromised states
Red yeast rice contains a natural form of ____
lovastatin
SAMe safety issue
serotonergic
Valerian safety issue
Sedation
Vitamin C safety concern
nephrolithiasis
Vitamin E alternative name
alpha-tocopherol
Vitamin E safety issue
bleeding risk, CVD risk
Thiamine deficiency can cause
Wernicke’s encephalopathy
Symptoms of Wernicke’s encephalopathy
mental confusion, ataxia, tremor and vision changes
As the symptoms of Wernicke’s encephalopathy fade, which syndrome tends to develop
Korsakoff syndrome (permanent neurologic damage)
Which vitamin are most alcoholics deficient in
B1 (thiamine)
Anticonvulsants can contribute to which vitamin deficiency
Calcium
Exclusively breast fed infants need how many IU of vitamin D daily
400 IU
All women of childbearing age should obtain ___ mcg/daily of folic acid
400
During pregnancy, folate requirements increase to ___ mcg/day
600
How long before pregnancy should folate be started
at least 1 month before
Prescription prenantal vitamins usually contain ____ mcg of folate
1000 mcg or 1 mg
Too much vitamin E can cause
CVD risk
Breastfed babies need __ mg/kg/day of iron from 4-6 months old and until consuming iron-rich foods
1
When should Poly-Vi-Sol Vitamin drops be used
if both vitamin D and iron are needed
Amphotericin B depletes which vitamin(s)
Mg, K
Isoniazid depletes which vitamin(s)
B6
Loop diuretics deplete which vitamin(s)
K
Metformin depletes which vitamin(s)
B12
MTX depletes which vitamin(s)
Folate
Orlistat depletes which vitamin(s)
Beta-carotene, fat-soluble vitamins
PPIs deplete which vitamin(s)
Mg
Recommended supplement(s) for alcoholism
Vitamin B1
Supplement for Goiter
iodine
Recommended supplement(s) for microcytic anemia
Ferrous sulfate
Recommended supplement(s) for macrocytic anemia
B12 and/or folate
Recommended supplement(s) in pregnancy
Folate, Ca, Vitamin D, pyridoxine
Recommended supplement(s) for osteopenia/osteoporosis
Ca, Vit D
Recommended supplement(s) for CKD
Vitamin D
