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Phar 714 > **Exam 1 Study Guide** > Flashcards

**Exam 1 Study Guide** Flashcards

1
Q

define homeopathy

A

the idea that a disease can be cured by a substance that produces similar symptoms in healthy people

believes the lower the dose of med, the greater its effectiveness

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2
Q

define naturopathy, who is it practiced by? (type of physician)

A

based on a combo of traditional practices and health care approaches and is practiced by naturopathic physicians

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3
Q

what is ayervedic medicine?

A

ancient Indian medical system which relies on natural holistic approaches to physical and mental health

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4
Q

examples of traditional Chinese medicine

A

acupuncture
tai chi
herbal products

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5
Q

dietary supplements health and education act (DSHEA)
what did it do?
who is responsible for the supplements safety?
when must a supplement label be given to the FDA? (how many days)

A

excludes dietary supplements from being defined as “food additives”

safety of supplements is up to manufacturers, but proof is determined by FDA

supplement label must be given to FDA within 30 days of marketing

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6
Q

8 steps in developing safe and effective botanical dietary supps

A
  1. search scientific literature
  2. acquire and authenticate plant material
  3. determine mechanisms of action and identify active compounds
  4. prep for preclinical and clinical studies
  5. investigate metabolism of active compounds
  6. test drug metabolizing enzymes and transporters
  7. develop formulation
  8. conduct phase 1 & 2 clinical trials
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7
Q

what does cGMP stand for and what is it?

A

current Good Manufacturing Processes

An FDA requirement on producers of botanical dietary supplements

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8
Q

what types of claims are permitted for dietary supplements?
is supporting data required by manufacturer for any claims?
What must every claim be accompanied with? (Hint: FDA)

A

health claims
structure/function claims
nutrient content claims

Yes

This statement has not been evaluated by the U.S. Food and Drug Administration (FDA). This product is not intended to diagnose,
treat, cure, or prevent any disease

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9
Q

what dietary supplements are not allowed by DSHEA?

A

any supplement not already on U.S. market or commonly used

if it contains a drug approved by FDA

anything toxic or harmful

Any dietary supplement containing synthetic constituent(s)

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10
Q

who regulates accurate labeling of dietary supplements?

A

The U.S. Federal Trade Commission (FTC)

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11
Q

define complementary medicine

A

an uncommon practice (herb,drug,meditation,etc) used together with conventional medicine

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12
Q

Which state banned yoga in 1993?

A

Alabama

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13
Q

When was the ban on yoga lifted?

A

May 2021

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14
Q

Who is more likely to see a chiropractor, men or women?

A

Women

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15
Q

What did DSHEA define a dietary supplement as?

A 
A product intended to supplement the diet that contains one or more of   
(a) Vitamin,  
(b) Mineral, 
(c) Herb/Botanical, 
(d) Amino acid 
(e) Supplement 
that increases total dietary intake
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16
Q

what is the mission of the Office of Dietary Supplements (ODS)?

A

strengthen knowledge of supplements by educating the public through scientific research in order to enhance the quality of life and health for the U.S.

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17
Q

T/F Aristolochia species is commonly in weight loss supplements in many countries?

A

False: It is toxic to humans and is banned

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18
Q

How Can Accidental Contamination of Botanical

Dietary Supplements be Prevented? (2 Main practices)

A

Implement Good Agricultural Practices (GAP)

Implement Good Manufacturing Practices (GMP)

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19
Q

What are mycotoxins?

How does it affect humans?

A

toxic compounds naturally produced by certain types of fungus
causes disease and death in humans

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20
Q

What does cGMP not do?

A

Limit consumers’ access to products

Evaluate the safety of dietary supplement ingredients

Evaluate product efficacy

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21
Q

Define a structure/function claim

A

describes the role of a nutrient or dietary ingredient intended to affect normal structure or function of the human body

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22
Q

if a product treats/prevents a disease, can it be regulated as a dietary supplement?
Does this type of product violate DSHEA?

A

No

Yes

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23
Q

If a supplement is not produced using cGMP, who has the right to remove it from the market?

A

The FDA

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24
Q

Who can prosecute offenders of making a false label or advertising claim?

A

The federal trade commission (FTC)

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25
Q

T/F A supplement must be for oral consumption only according to DSHEA

A

True

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26
Q

Who reviews products on the market that are not dietary supplements after DSHEA was enacted?

A

NDI

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27
Q

What was PC-SPES?

Why was it removed from market?

A

dietary supplement for men with prostate cancer

reported to be adulterated with prescription-only drugs

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28
Q

How many warnings does the FDA give to a manufacturer and what can they do if compliance is not met?

A

2 warnings

FDA may seize products and refer the case to the Department of Justice

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29
Q

What website is used to access dietary supplement product labels?

A

NIH Office of Dietary Supplements

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30
Q

Accurate labeling of dietary supplements is regulated by?

A

Federal Trade Commission (FTC)

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31
Q

What is the lead agency in the U.S. for scientific research on complementary and integrative health?

A

National Center for Complementary and Integrative Health (NCCIH)

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32
Q

Most B Vits function as? (inside your body)

A

co-enzymes

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33
Q

Vit B1:
Name?
function?
Involvement in Krebs cycle

A

Thiamin
helps metabolize macronutrients
required as a coenzyme in metabolism of carbs and proteins
plays a critical role in production of energy

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34
Q

What is the citric acid (Krebs) cycle?

A

metabolism in mitochondria that oxidizes acetyl compounds from food to make ATP

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35
Q

What foods contain Vit B1?

A

meat/meat subs
cereals & grains
fruit

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36
Q

ADME for Thiamin

A

A: active transport
D:50% skeletal muscle 50% other organ tissues
M: intestinal enzymes
E: high dose causes rapid urine excretion
** idk if we need to know half life

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37
Q

How does alcohol effect thiamin absorption?

A

impairs intestinal ability to absorb

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38
Q

name of disease from severe thiamin deficiency?

A

Beriberi

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39
Q

Negative outcomes of too much thiamin?

A

None

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40
Q 
Vit B2:
Name?
Function?
its two primary coenzymes?
What is it a part of in the mitochondria?
A

Riboflavin
assists antioxidant enzymes, converts food to energy
FAD & FMN
electron xport chain

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41
Q

what foods contain Vit B2?

A

meat/meat subs
cereals & grains
dairy
veggies

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42
Q

ADME for Riboflavin

A

A: active xport
D: small amounts in liver, heart, kidneys
M: intestinal enzymes
E: urine excretion

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43
Q

Ariboflavinosis occurs when?

A

deficient in riboflavin

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44
Q

T/F low B2 impairs iron metabolism

A

True

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45
Q

Common symptoms of riboflavin deficiency?

A 
skin disorders
hyperemia (excess blood)
edema of mouth and throat
hair loss
reproductive problems
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46
Q

Negative outcomes of too much riboflavin?

A

None

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47
Q

Vit B3:
Name?
Function?
Active forms?

A

Niacin
coenzyme for many redox rxns
NAD & NADP

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48
Q

what foods contain Vit B3?

A

Cereals & grains
meat/meat subs
veggies

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49
Q

ADME for Niacin

A

A:active xport and passive diffusion
D: all tissues as NAD
M: hydrolysis and conversion to NAD
E: urine excretion

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50
Q

disease from severe niacin deficiency

A

pellagra

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51
Q

Negative outcomes of too much Niacin?

A

flushing, itching, rashes, GI upset

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52
Q

Max dose of Niacin for adults?

A

35 mg/day

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53
Q

Vitamins 1,2,and 3 are required for what enzyme?

A

pyruvate dehydrogenase

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54
Q

NAD synthesis requires which two vitamins?

A

thiamin (B1) and riboflavin (B2)

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55
Q

Which forms of a supplement are typically better for more nutrients per serving?

A

lozenges, softgels, and tablets

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56
Q

which forms of a supplement are typically better if someone wants a pleasant experience from taking it?

A

chewables, gummies, powders

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57
Q

Recommended intake for calcium?

A

1000-1300 mg/day

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58
Q

Rank from least absorption to most absorption for compounds combined with magnesium:

A

Inorganic salts (magnesium oxide) -> Organic salts (magnesium citrate) -> chelates (magnesium glycinate)

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59
Q

name of the only organization recognized for verifying dietary supplements?

A

United States Pharmacopeia (USP)

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60
Q

Vit B5:
Name?
function?

A

Pantothenic Acid

component of coenzyme A (CoA) in krebs cycle

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61
Q

What is CoA needed for? (fatty acids, amino acids, bioactive compounds)

A

beta-oxidation of fatty acids
oxidative degradation of amino acids
synthesis of bioactive compounds

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62
Q

what foods contain Vit B5?

A

meat
eggs
cereals & grains
certain veggies

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63
Q

ADME for Pantothenic Acid

A

A: active xport at low doses, passive diffusion at high doses
D: rapid uptake by blood cells to tissues
M: intestinal enzymes
E: hydrolyzed to pantothenate before urine excretion

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64
Q

disease from too little pantothenic acid?

A

pantothenate kinase-associated neurodegeneration (PKAN)

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65
Q

symptoms of pantothenic acid deficiency?

A 
numbness
headache
fatigue
restlessness
irratibility
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66
Q

symptoms of too much pantothenic acid?

A

mild GI upset if over 10mg consumed in a day

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67
Q

Vit B7:
Name?
Function?

A

Biotin

convert food to energy and makes glucose

68
Q

5 essential carboxylases vit b7 is a co-factor for?

A 
acetyl-coa carboxylase 1
acetyl-coa carboxylase 2
methylcrotonyl-carboxylase
propionyl-coa carboxylase
pyruvate carboxylase
69
Q

what foods contain Vit B7?

A

cereals & grains
eggs
meat
veggies

70
Q

ADME for Biotin

A

A: active xport
D: mostly stored in liver
M: protein bound biotin in stomach. intestinal enzymes
E: urine excretion

71
Q

common symptoms for rare deficiency of Biotin

A

brittle nails
rashes
hair thinning/loss
depression, hallucinations

72
Q

symptoms of too much biotin?

A

none

73
Q

how can high levels of biotin interfere with medical testing?

A

can cause false high or low results

74
Q

Humans lack which enzyme to synthesize vit C?

A

gulonolactone oxidase

75
Q

foods containing vit C?

A

citrus fruits, brussels sprouts, broccoli, kiwi

76
Q

Absorption of Vit C

A

sodium-dependent co-xporters

secondary active transport

77
Q

Other name for Vit C?

A

Ascorbic Acid

Ascorbate

78
Q

oxidized form of ascorbic acid?

A

dehydro-ascorbic acid

79
Q

dehydro-ascorbic acid is xported by?

A

sodium-independent glucose xporters (GLUTs)

80
Q

ascorbic acid in plasma is actively xported into cells by which xporters?

A

sodium-ascorbate co transporters SVCTs

81
Q

ascorbate functions as a co-factor in what type of reactions? what does it maintain?

A

hydroxylation

iron or copper

82
Q

Examples of processes ascorbate is used in? (forms of synthesis/catabolism)

A

collagen synthesis
carnitine synthesis
tyrosine catabolism
neurotransmitter synthesis

83
Q

what is alkaptonuria?

A

prevents the body from fully breaking down tyrosine and phenylalanine which results in an accumulation of homogentisic acid leading to painful joints

84
Q

What is converted in collagen synthesis? (main compounds)

A

proline converts to hydroxyproline

85
Q

What is converted in carnitine synthesis? (main compounds)

A

trimethyllysine converts to carnitine

86
Q

What is converted in tyrosine catabolism? (main compounds)

A

two reactions:

tyrosine converts to homogentisate which converts to maleylacetoacetate

87
Q

What does Vit C help defend against?

A

cardiovascular disease
cataracts
cancer
colds

88
Q

where is Vit C filtered? (nephron)

A

glomerular capsule

89
Q

ascorbic acid breaks down into what other acids?

A

oxalic acid, threonic acid, and xylonic acid

90
Q

why is high vit C intake dangerous? (which dangerous acid does it break down into and what can form as a result?)

A

vit c breaks down into oxalic acid which causes kidney stones to form

91
Q

ascorbic acid enhances intestinal absorption of? (iron)

A

non-heme iron

92
Q

T/F too much vitamin C can cause you to pee more?

A

True

93
Q

T/F over 2g of vit C a day helps prevent disorders involving iron metabolism

A

False

94
Q

Define polypharmacy

A

the use of 5 or more drugs

95
Q

which age population of people is most susceptible to potential drug interactions?

A

Elderly

96
Q

Which vitamin did we discuss in class that can cause impairment of micronutrient metabolism/ micronutrient synthesis?

A

Vit D

97
Q

which class of drugs did we discuss in class that can increase intestinal/renal excretion?

A

diuretics

98
Q

what common OTC drug class did we discuss in class that can impair absorption/bioavailability?

A

antacids

99
Q

which amino acid did we discuss in class can disrupt metabolism? (cause metabolic dysfunction)

A

homocysteine

100
Q

T/F iron or folic acid supplements should be separated by 2 hours

A

True

101
Q

T/F proton-pump inhibitors and histamine-2 receptor antagonists have been associated with Vit B12 malabsorption and deficiency

A

True

102
Q

if antacids are used long-term, how does this effect calcium absorption in the gut? what can malabsorption of calcium lead to?

A

antacids make the GI more basic, thus decreasing the solubility and absorption of calcium since it requires an acidic environment for absorption.
dec absorption of calcium will lead to dec. bone mineral density

103
Q

Which diet is a concern for calcium content, especially if someone is taking a proton-pump inhibitor (PPI)

A

vegan

104
Q

if antacids are used long-term, how does this affect iron absorption in the gut?

A

gastric acid is needed for iron absorption, thus dec gastric acid production could dec iron absorption

105
Q

which prescription drug decreases vit B12 absorption from food?

A

Colchicine

106
Q

which drug-nutrient interaction can lead to a hemorrhagic event?

A

warfarin and vit K

107
Q

T/F pts should consume the same amount of vit K in their diet while taking warfarin

A

True

108
Q

what is vit C an inhibitor of which allows it to counteract cancer?

A

hypoxia-induced factor-1 (HIF-1)

109
Q

what is the goal of supplementing folic acid with pts taking methotrexate?

A

reduce adverse rxs to methotrexate treatment

110
Q

T/F individuals with obesity who undergo bariatric surgery end up having less complications with malabsorption

A

False, they are at an inc risk of malabsorption

111
Q

Vit B6
Name?
function?

A

Pyridoxine

heavily involved in enzyme rxns for protein metabolism

112
Q

enzymatic processes that require B6 include?

A

releasing glucose from stored glycogen
making glucose from amino acids
synthesis of heme

113
Q

foods containing vit b6?

A

meat
cereals & grains
fruits
spinach

114
Q

ADME Pyridoxine

A

A: passive diffusion
D: binds to albumin, goes to muscle and liver
M: intestinal enzymes
E: urine excretion

115
Q

common symptoms of pyridoxine deficiency

A

confusion
dermatitis
epileptic convulsions
microlytic anemia

116
Q

who’s at risk of pyridoxine deficiency?

A

alcoholics
autoimmune disorder
impaired renal function

117
Q

too much pyridoxine?

A

high doses can cause sensory neuropathy

118
Q

Vit B9
Name? (2, difference between them?)
Function?

A

Folate: natural form in food and body
folic acid: supplemental form
DNA synthesis, cell growth and repair
prevents neural tube defects

119
Q

DNA synthesis is dependent on? (Vit B9)

A

folate coenzymes

120
Q

folate is required to make __________ which controls gene expression

A

S-adenosylmethionine (SAM)

121
Q

Is folate beneficial during pregnancy?

A

Yes

122
Q

Why is folate beneficial for depression? (what does it synthesize and what does the thing synthesized do?)

A

neurotransmitters, increases serotonin, norepinephrine, and dopamine

123
Q

Foods containing folate?

A

beans & lentils
cereals & grains
Broccoli, spinach

124
Q

ADME folate

A

A: active xport at normal dose, passive diffusion at high dose
D: liver before circulation
M: intestinal enzymes hydrolyze folates
E: most secreted folates is reabsorbed

125
Q

who is at risk of folate deficiency?

A

pregnant women/ childbearing age

126
Q

common symptoms of folate deficiency?

A

changes in skin, hair, fingernail color
GI issues
oral/tongue sores
Megaloblastic Anemia

127
Q

too much folate?

A

high doses can mask vit b12 deficiency which could result in neurological damage

128
Q

Vitamin B12
Name?
Function?

A

Cobalamin
makes red blood cells
required for nerve function
works with folate to make methionine from homocysteine

129
Q

since vt B12 and B9 convert methionine from homocysteine, what is methionine needed for to make which is needed for dna methylation?

A

S-adenosylmethionine (SAM)

130
Q

Vit B12 is needed to make which enzyme?

A

succinyl-CoA

131
Q

what does the enzyme succinyl-CoA do?

A

produces energy from fat and protein and synthesizes hemoglobin

132
Q

Why is vit b12 important in regulating hemoglobin?

A

because it helps make succinyl-CoA which synthesizes hemoglobin

133
Q

foods containing cobalamin?

A

eggs
milk & dairy
meat

134
Q

ADME Cobalamin

A

A: active xport
D: 50% liver, 50% other tissues
M: transported bound to proteins
E: urine excretion

135
Q

whos at risk of cobalamin deficiency?

A

elderly

vegans/vegetarians

136
Q

common symptoms of cobalamin deficiency?

A 
megaloblastic anemia
neurological disorders
fatigue
weakness
constipation
loss of appetite
weight loss
137
Q

too much cobalamin?

A

nothing

138
Q

Some diagnostic lab tests may show false results in presence of elevated vitamin C due to an interaction with this molecule

A

H2O2 (hydrogen peroxide)

139
Q

These four vitamins are legally mandated as food supplements due to their importance in this role

A

B1, B2, B3, B9

Pregnancy, fetal development, neural development

140
Q

Prolonged use of this drug class is correlated with B12 malabsorption

A

Antacids/ PPIs & H2RAs

141
Q

Methotrexate inhibits the conversion of ______ to THF

A

Dihydrofolate

142
Q

B vitamins important for the Krebs Cycle?

A

B1, B2, B3, B5, B7

143
Q

B vitamins important for One Carbon Metabolism

A

B6, B9, B12

144
Q

which B vits can cause hyperemia?

A

B6, B9, B12, B2

145
Q

Which B Vit helps protect against neural tube defects?

A

B9

146
Q

acute beriberi in infants is caused by ________ and is characterized by ________

A

thiamin deficiency

acidosis due to conversion of pyruvate into lactic acid

147
Q

wernicke-korsakoff syndrome is associated with?

A

thiamin deficiency

148
Q

what symptom can excessive vit b12 cause?

A

acne

149
Q

patients on methotrexate should not take supplemental _____?

A

Vit B9

150
Q

thiamin’s role in health?

A

Alzheimer’s
diabetes
heart failure

151
Q

riboflavin role in health?

A

early development
eyes
migraines

152
Q

ariboflavinosis resembles what other disease/deficiency?

A

pellagra and vit b6 deficiency

153
Q

niacin role in health?

A

cardiovascular health

skin

154
Q

symptoms of pellagra include:

A

dermatitis
diarrhea
dementia

155
Q

pantothenic acid role in health?

A

heart health

wound healing

156
Q

biotin role in health?

A

early development

hair, skin, nails

157
Q

whats a major concern of high levels of biotin? (false low for what?)

A

troponin

158
Q

which B vitamins play a role in the electron transport chain?

A

B2, B3, B5

159
Q

what is the metabolically active form of folic acid?

A

5-methyltetrahydrofolate (5-MTHF)

160
Q

What are the forms of cobalamin?

A

cyanocobalamin
methylcobalamin
hydroxycobalamin
adenosylcobalamin

161
Q

one carbon metabolism role on health?

A

cancer
cardiovascular health
cognition

162
Q

T/F plasma B12 is associated with a higher risk of breast cancer

A

true

163
Q

does vitamin B6 reduce cancer risk?

A

yes

164
Q

pyridoxine role in health?

A

immune system support

nervous system function

165
Q

folate role in health?

A

early development

mental wellness

Phar 714 (10 decks)

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