Drug-Nutrient-Herb Interactions & Herbs Flashcards
Which of the following are 2 key metabolism modulators for drugs?
a. Cytochrome P-450/CYP3A4 enzyme in the intestinal cells and sodium-potassium pumps
b. Cytochrome P-450/CYP3A4 enzyme in the intestinal cells and pyruvate decarboxylase in the cytoplasm
c. Cytochrome P-450/CYP3A4 enzyme in the intestinal cells and superoxide dismutase
d. Cytochrome P-450/CYP3A4 enzyme in the intestinal cells and intestinal P-glycoprotein (P-gp)
d. Cytochrome P-450/CYP3A4 enzyme in the intestinal cells and intestinal P-glycoprotein (P-gp)
These two regulate bioavailability of most drugs in the enterocytes. intestinal P-glycoprotein (P-gp) is an efflux system that transports molecules to regulate the rate of substrates presented to CYB 3A4. Together, they form a coupled transport-metabolic system. Certain nutrients can disrupt this.
Individuals taking anti-convulsant medications may develop depleted reserves of: v b. thiamin and riboflavin c. folate and pantothenic acid d. pyridoxine and biotin
a. folate and vitamin D
Anti-neoplastic or anti-cancer agents most significantly affect nutritional status by:
a. damaging immune function
b. affecting the intestinal mucosa and reducing nutrient absorption
c. increasing nutrient excretion
d. causing abnormal metabolism
b. affecting the intestinal mucosa and reducing nutrient absorption
Some nutrition-related side effects of long-term use of Proton Pump Inhibitors (PPIs) include:
a. osteoporosis
b. SIBO
c. IBS
d. A and B only
e. all of the above
e. all of the above
A number of botanicals are contraindicated in liver conditions. Hepatotoxicity is associated with all of the following herbal supplements except:
a. ginkgo biloba
b. green tea extract
c. comfrey
d. valerian
a. ginkgo biloba
Hepatoxicity is a concern with green tea extract, comfrey, and valerian.
It may be wise to assess the status of the following in a client on long-term proton pump inhibitor (PPI) therapy:
a. folate
b. B12 and minerals
c. biotin
d. CoQ10
b. B12 and minerals
What are the effects of St. John’s Wort on drugs and on health conditions?
a. induces P-450 CYA 3A4 enzyme
b. decreases drug’s levels in the body
c. upregulates P-gp
d. can be used to support mild depression if the client is taking no other medications
e. all of the above
e. all of the above
Which of the following drugs have a “narrow therapeutic range”?
a. Levothyroxine (thyroid)
b. Warfarin (anti-coagulent, blood thinner)
c. Digoxin (heart drug)
d. Cyclosporine (organ transplant support)
e. Phenytoin & Carbamazepine (anti-convulsants)
f. All of the above
f. All of the above
“Narrow therapeutic range”: if amount of drug is even a little too high or low, can cause problems.
Use of a thiazide diuretic drug may produce a low plasma concentration of:
a. calcium
b. potassium
c. uric acid
d. phosphorous
b. potassium
An individual with ragweed allergy may not be able to tolerate:
a. lavender
b. gingko bilboa
c. chamomile
d. saw palmetto
c. chamomile
Some commonly used herbs that are part of the ragweed family and should be avoided with ragweed allergies are:
- chamomile -milk thistle
- wormwood -goldenseal
- echinacea
Methotextrate, a drug used to treat certain cancers, severe psoriasis, and rheumatoid arthritis, can deplete which of the following nutrients:
a. folate
b. Vitamin A
c. choline
d. none of the above
e. all of the above
e. all of the above
Which food product decreases the activity of the enzyme, CYP 3A4?
a. grapefruit
b. lemon
c. grapefruit juice
d. both A and C.
c. grapefruit juice (especially frozen concentrate vs freshly squeezed. Research are shown that fresh grapefruit does not seem to cause this effect.)
Grapefruit juice deactivates/destroys the intestinal CYP 3A4 enzymes & can increase the body’s exposure to the drug by five-fold!
The _________ cells in the liver help to detoxify and metabolize drugs, which is supported by the ______enzyme family.
a. rough endoplasmic reticulum (RER) cells, Cytochrome P-450 enzyme family
b. enterochromaffin cells, P-glycoprotein enzyme family
c. chief cells, P-glycoprotein enzyme family
d. parietal cells, Cytochrome P-450 enzyme family
a. rough endoplasmic reticulum (RER) cells, Cytochrome P-450 enzyme family
Deglycrrhizinated licorice (DGL) is often used in the treatment of:
a. peptic ulcers
b. pelvic pain
c. earache
d. sleep disorders
a. peptic ulcers
Which key nutrients can oral contraceptives deplete?
a. folate and Vitamin B6
b. magnesium
c. Vitamin A and Vitamin C
d. all of the above
d. all of the above
