Dietary Supplements Flashcards

1
Q

why do supplements not need to provide proof of efficacy and safety to the FDA?

A

Because they are considered food supplements that are used for health maintenance.

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2
Q

What are the 3 types of Echinacea people use today?

A

Botanical Substances: Echinacea Purpurea, E. pallida, and E. angustifolia

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3
Q

What does Echinacea help with?

A
1. Immune modulation
(boost immune system)
     -increased phagocytosis
     -increased circulating white 
      blood cells without 
      immunostimulation.
     -increase in interleukins 1,6, 10
     -Increase in TNF alpha
     -Cytokine activation
  1. Anti-inflammatiry Effect
    • inhibit cyclooxygenase,
  2. Antibacterial, Anti-fungal, Antiviral, Antioxidant
    -Herpes simplex virus, S.
    pyogenase, H. influenza, L.
    pneumophilia
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4
Q

Echinacea side effects?

A

Flue-like symptoms from intravenous use.
Rahses in Pediatric patients.
GI upset
Orally: unpleasant taste and GI upset.

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5
Q

Drug interactions with Echinacea?

A

No drug interactions

BUT avoid if taking immunosuppressant , if have autoimmune disorders or TB. Also don’t take if you are immunodeficient.

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6
Q

Another name for Garlic?

A

Allium Sativum

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7
Q

Supposed usage of Garlic?

A
1. cardiovascular effects:
   A. Cholesterol reduction
        -Limits HMG-CoA reductase 
         to reduce cholesterol
   B. blood vessel elasticity 
   C. BP
   D. Antioxidant effect
         - increase resistance to low-
           density lipoprotein 
           oxidation
  1. Endocrine Effect
    A. Glucose homeostasis:
    -hypoglycemic effects
  2. Antimicrobial Effect
    - gram+ and gram- and fungi (C. albicans), Protozoa (Entamoeba histolytica) and certain viruses.
    - Attack thiol-containing enzymes needed by microbes
  3. Antieoplastic effect:
    - inhibit procarcinogens of stomach, colon, breast, esophageal, lung
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8
Q

Adverse affects with the use of Garlic?

A

Nausea (6%)
Hypotension (1.3%)
Allergy (1.1%)
Bleeding (rare)

Breath and body order incidence (20-40%)

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9
Q

Drug interactions associated with the use of Garlic?

A

Because of Anti-platelet effects, people on anti-coagulants should be careful with the use of garlic– Warfin, Aspirin, Ibuprofin

Reduce bioavailability of saquinavir (antiviral protease inhibitor)

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10
Q

Adverse effects or drug interactions with Garlic?

A

Hypotension (1.3%)
Allergy (1.1%)
Bleeding (rare)

May reduce the bioavailablity of saquinavir (antiviral protease inhibitor)

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11
Q

Supposed use for Ginko Biloba?

A

Increased blood flow (promotes vasodilation)
reduces blood viscosity

Prevent peripheral artery disease

Blood Pressure (clinically insignificant)

Antioxidant- Radical-scavenging properties (may protect against ischemic injury)

CNS- increased adrenergic/muscarinic reporter
densities.

Slow progression of dementia

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12
Q

Adverse effects or drug interactions for Ginko biloba?

A

Comparable to placebos

May compound Anti-platelet therapy and work against anticoagulative therapy

Enhanced sedative effect with trazodone

Uncooked Ginko seeds are epileptogenic and may cause seizures.

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13
Q

Common names of Ginseng?

A
Panax ginsing
Panax quinquefolium
Eleutherococcus senticosus * 
      mostly seen in USA
Pfaffia paniculata
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14
Q

Supposed uses of Ginseng?

A
  1. Modulates immune function
  2. CNS effect: increase in Norep, Epi, and Dopamine.
  3. Anti-inflammatory
  4. Antioxidant
  5. Analgesia
  6. Vaso-regulatory effects
    (vasodilation via increase in NO)
  7. Cardioprotective (against hypertrophy/remodeling)
  8. Glucose homeostasis
  9. Anticancer properties
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15
Q

Adverse effects of Ginseng?

A

Vaginal bleeding and Mastalgia (breast pain)

Insomnia

Nervousness

Hypertension (HIGH doses)

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16
Q

Drug interactions with Ginseng?

A

Anti-depresive medication combined with ginseng may induce irritability, sleeplessness, and manic behavior.

Anti-platelet properties- don’t use with anti-coagulants (Warfin)

Do not use if on psychiatric, estrogenic, hypoglycemic medication

Do not use if have autoimmune disorder/ taking immunostimulants

17
Q

What is the another name of milk thistle?

A

Silybum Marianum

18
Q

What are the supposed uses of Milk thistle?

A
  1. Limits hepatic injury
  2. Anti-inflammatory property: inhibits lipoxygenase and reduces leukocyte migration, inhibits TNF-alpha and mediates activation of NF-kappaB
  3. Chemotherapeutic effects
  4. inducer of lactation
19
Q

What are the adverse effects to using Milk Thistle? Drug interactions?

A

Laxative effect in high doses

Gastrointestinal upset, dermatologic, headaches.

20
Q

What are drug interactions with Milk Thistle?

A

No drug-drug interactions known at this time

21
Q

What is another name of St. John’s Wort?

A

Hypericum Performatum

22
Q

What are the supposed uses of St. John’s Wort?

A

Anti-depressive action
-MAO and -B inhibitors
Antiviral
Anticarcinogenic

23
Q

What are some adverse effects of St. John’s Wort?

A

Photosensitization
Hypomania
Mania
autonomic arousal

24
Q

Drug interactions with St. John’s wort?

A

Increase drug clearance: stimulates CYP3A4, CYP2c9, CYP1A2.
- digoxin, birth control, cyclosporine, HIV protease and non nucleoside RTIs, warfarin, irinotecan, thopylline, and anticonvulsants
= sub-therapeutic levels

Antidepressive medication+ St. John’s Wort can lead to serotonin syndrome

25
Q

What is the supposed use of Saw Palmetto?

A

Prostate hyperplasia : inhibits 5-aromatase and prevents DHT from binding to Androgen receptors.

26
Q

What are the adverse effects of Saw Palmetto? Drug interactions?

A

Nausea, Headache, diarrhea, fatigue, headache, decreased labido, rhinitis

No drug-drug interactions

27
Q

Supposed use of coenzyme Q10? Other names of Co-enzyme Q10?

A

Reduced hypertension

Heart failure reduction
-improve ejection fraction

Ischemic heart disease reduction

Prevention of statin induced myopathy–
statins block HMG-CoA = Coenzyme Q10
synthesis. Low CoQ10 blocks steps in
muscle cell energy generation –>
Myopathy

other Names:
CoQ10
Ubiquinone

28
Q

Adverse affects of Coenzyme Q10?

Drug interactions?

A

GI problems (nausea, diarrhea, heartburn, anorexia) (<1%)

Irritability, dizziness, and headache

Maculopapular rash and thrombocytopenia RARE!!

Drug interactions:
Interactions with Warfarin (similar to vitamin k)

29
Q

What are the supposed uses of Glucosamine?

A

Treatment of osteoarthritis:
-production of new cartilage is exceeded by
the rate of degradation of existing cartilage.

30
Q

Adverse effects of Glucosamine?

Drug interactions of Glucosamine?

A

Mild GI symptoms (diarrhea/nausea)
Cross-allergy with people who are allergic to shellfish

Drug interaction:
Increased INR (international normalized ratio) in patients taking warfarin
     -increased risk for bruising and bleeding.
31
Q

Supposed uses of Melatonin?

A

(serotonin derivative)

Jet lag and insomnia treatment

Decrease female Reproductive function:
-partial inhibition of ovulation

Increase Male Reproductive Function:
-associated with enhanced sperm quality
and motility

32
Q

Adverse effects with the use of Melatonin?

A
  • decrease/increase BP
  • next day drowsiness
    - Fatigue, dizziness, headache, irritability
  • inhibit conception
33
Q

Drug interactions with Melatonin?

A

Antihypertensive medication

beta-androceptor agonists and antagonists

Drugs that alter CYP1A2 may increase melatonin’s effect.

May decrease effects of warfin.

Nifedpine, leading to increase blood pressure and heart rate