Dietary Supplements Flashcards
why do supplements not need to provide proof of efficacy and safety to the FDA?
Because they are considered food supplements that are used for health maintenance.
What are the 3 types of Echinacea people use today?
Botanical Substances: Echinacea Purpurea, E. pallida, and E. angustifolia
What does Echinacea help with?
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
- Anti-inflammatiry Effect
- inhibit cyclooxygenase,
- Antibacterial, Anti-fungal, Antiviral, Antioxidant
-Herpes simplex virus, S.
pyogenase, H. influenza, L.
pneumophilia
Echinacea side effects?
Flue-like symptoms from intravenous use.
Rahses in Pediatric patients.
GI upset
Orally: unpleasant taste and GI upset.
Drug interactions with Echinacea?
No drug interactions
BUT avoid if taking immunosuppressant , if have autoimmune disorders or TB. Also don’t take if you are immunodeficient.
Another name for Garlic?
Allium Sativum
Supposed usage of Garlic?
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
- Endocrine Effect
A. Glucose homeostasis:
-hypoglycemic effects - Antimicrobial Effect
- gram+ and gram- and fungi (C. albicans), Protozoa (Entamoeba histolytica) and certain viruses.
- Attack thiol-containing enzymes needed by microbes - Antieoplastic effect:
- inhibit procarcinogens of stomach, colon, breast, esophageal, lung
Adverse affects with the use of Garlic?
Nausea (6%)
Hypotension (1.3%)
Allergy (1.1%)
Bleeding (rare)
Breath and body order incidence (20-40%)
Drug interactions associated with the use of Garlic?
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)
Adverse effects or drug interactions with Garlic?
Hypotension (1.3%)
Allergy (1.1%)
Bleeding (rare)
May reduce the bioavailablity of saquinavir (antiviral protease inhibitor)
Supposed use for Ginko Biloba?
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
Adverse effects or drug interactions for Ginko biloba?
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.
Common names of Ginseng?
Panax ginsing
Panax quinquefolium
Eleutherococcus senticosus *
mostly seen in USA
Pfaffia paniculataSupposed uses of Ginseng?
- Modulates immune function
- CNS effect: increase in Norep, Epi, and Dopamine.
- Anti-inflammatory
- Antioxidant
- Analgesia
- Vaso-regulatory effects
(vasodilation via increase in NO) - Cardioprotective (against hypertrophy/remodeling)
- Glucose homeostasis
- Anticancer properties
Adverse effects of Ginseng?
Vaginal bleeding and Mastalgia (breast pain)
Insomnia
Nervousness
Hypertension (HIGH doses)
Drug interactions with Ginseng?
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
What is the another name of milk thistle?
Silybum Marianum
What are the supposed uses of Milk thistle?
- Limits hepatic injury
- Anti-inflammatory property: inhibits lipoxygenase and reduces leukocyte migration, inhibits TNF-alpha and mediates activation of NF-kappaB
- Chemotherapeutic effects
- inducer of lactation
What are the adverse effects to using Milk Thistle? Drug interactions?
Laxative effect in high doses
Gastrointestinal upset, dermatologic, headaches.
What are drug interactions with Milk Thistle?
No drug-drug interactions known at this time
What is another name of St. John’s Wort?
Hypericum Performatum
What are the supposed uses of St. John’s Wort?
Anti-depressive action
-MAO and -B inhibitors
Antiviral
Anticarcinogenic
What are some adverse effects of St. John’s Wort?
Photosensitization
Hypomania
Mania
autonomic arousal
Drug interactions with St. John’s wort?
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
