Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm Exam 1 > Herbal and Dietary Supplements > Flashcards

Herbal and Dietary Supplements Flashcards

1
Q

Definition of herbal supplements

A

Supplements sold to and consumed by the general population that include plants, plant components,
plant extracts and drinks, tablets, and capsules manufactured from plant sources

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are dietary supplements?

A
  • Intended to supplement dietary intake
  • contains one or more of the following: vitamin, mineral, herb botanical or amino acid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Roughly ____% of the general population use an herbal or dietary supplement of some sort

A

20-50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a mistake providers can make regarding supplements?

A

Many providers forget to ask if a patient is
taking a supplement or herbal medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T/F Herbal supplements can react with
medications that you will be prescribing

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

1962

A

Botanicals are not considered drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

1973

A

Standard identification of vitamins and minerals only. If the dosing exceeds 150% of recommended daily dosing it is then considered a drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

1977

A

Prohibiting the FDA from regulating vitamins and minerals as prescription drugs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

1990

A

Nutrition Labeling and Education Act (NLEA) - Nutrition facts must be on box, declaring all ingredients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

1994

A

Dietary Supplement Health and Education Act (DHSEA) - Senator Orrin Hatch (Utah) & Tom Harkin (Iowa)
- Dietary supplements are food (not medicine - therefore do not need to register with the FDA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Criticism for the DHSEA of 1994

A
  • Does not require that the supplement demonstrate safety prior to marketing or implementation on the market
  • Herbs and supplements do not have to demonstrate efficacy prior to being put on the market
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

1998

A

1998 - The Natural Product Association (NPA) good manufacturing practice (GMP) certification program (TruLabel) is formed
- Tests and maintains a minimum standard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

2007

A
  • Required manufacturers to evaluate identity, purity, strength and composition.
  • Required to submit ALL side effects of the FDA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T/F Research to prove that a supplement is safe
is not required prior to a dietary supplement
being put on the market (unlike drugs)

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Manufacturers may make three types of claims for their herbal or dietary supplements

A

1) health claims
2) structure/function claims
3) nutrient content claims.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If the manufacturer does make a claim, it must be followed by the statement:

A

“This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Factors for variability in dietary supplements (3)

A
  1. Constituents
  2. Contamination
  3. Standardization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Constituents

A

The parts of the dietary supplement
■ Remember dietary supplements can be a mixture
■ Some ingredients may conflict with others
■ Some ingredients may be synergistic with others
■ Even the way supplements are stored over time
can affect them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Contamination

A

Supplements can contain contaminants from the
environment, whether known or not known.
■ Heavy metals: lead, mercury
■ Processing and packaging
■ Mixing of other active ingredients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Standardization

A

Sometimes the active ingredient is unknown.
○ Variable consistency of known active ingredients.
■ Example - Ginseng products contained 10-300% of what was labeled
■ Example - Echinacea showed ≤ 50% of what was labeled.
○ FDA encouraging labeling standards.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

In 1998, the NIH established _____ (the National
Center for Complementary and Integrative Medicine)

A

NCCIM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Due to its many nutrients, which can satisfy almost all needs of the human body, acai is currently
referred to as _____

A

super food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Acai mechanism of action & suggested use

A

Antioxidant properties and strong nutritional value
○ Evidence: No well-done scientific studies with significant evidence
○ Often used for anti-inflammatory reasons, fever, pain, flu, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Black cohosh mechanism of action and suggested use

A

● Proposed Mechanism of Action:
○ Remains unclear; No apparent dietary impact
● Suggested Uses:
○ Breast cancer, infertility, postmenopausal hot flashes (most
popular use), menstrual-related migraines, osteoarthritis,
rheumatoid arthritis
○ Evidence is generally weak. Only short-term use advised
Contraindication: allergy or hypersensitivity interactions, lots of potential drug interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Known side effects and adverse reactions of black cohosh
Abdominal pain, bleeding, bradycardia, bruising, constipation, diaphoresis, dizziness, headaches, “heaviness in legs,” increased risk of stroke and hormone-sensitive cancers, hepatotoxicity,
26
Black cohosh: concerns for drug interactions
Because it is a known CYP450 enzyme player, there are lots of drug interactions possible, most notably with antiseizure medications, analgesics, anesthetics, and anticoagulants.
27
Uses and indications for calcium
Antacid, bone stress injury prevention, calcium deficiency, cancer, colorectal cancer, growth (low birth weight infants), hyperkalemia, hyperparathyroidism, HTN, lead toxicity (acute symptom management), magnesium toxicity, rickets, osteoporosis, PMS, preeclampsia
28
Contraindications for calcium
Ventricular arrhythmias, hypercalcemia, hypophosphatemia, renal stones, sarcoidosis
29
Vitamin D
● Ergocalciferol (D2), Cholecalciferol (D3). ● Protective of bone health/growth and required to absorb calcium. ○ Often provided together with Calcium in supplement form
30
Evidence based uses for Vitamin D
Osteoporosis, osteomalacia, hyperparathyroidism, diabetes, depression, psoriasis (topical preparation), acute infection
31
Known Side Effects and Adverse Reactions of Vitamin D
None unless reach toxic levels. Toxicity occurs at levels > 150 ng/mL - hypercalcemia, nephrocalcinosis, early aging, fatigue, nausea
32
Echinacea and mechanism of action
- Native American medicinal plant; part of Daisy family ● Proposed Mechanism of Action: ○ No consensus on primary active ingredient or mechanism of action. ○ Seems to somehow boost immune function, reduce pain and inflammation
33
Suggested use and contraindications for Echinacea
Suggested Uses: ○ Shorten duration of URI (common cold) and UTI infections, wound healing, yeast infections, immune system support. ○ Evidence: NCCIH-funded studies showed no benefit; Other studies suggest reduction in duration of symptoms ● Contraindications: ○ Not to be used along with Amoxicillin. ○ Contraindicated in ragweed, daisy, or marigold hypersensitivity
34
Ephedra synthetic version is called
pseudoephedrine
35
The alkaloid ____ was banned in US in 2004
ephedrine (component from the stem of ephedra)
36
Ephedra mechanism of action
○ Ephedrine acts as a direct agonist of 𝞪 and 𝞫-adrenergic receptors, stimulating the release of norepinephrine. ○ Acts as an amphetamine-like stimulant
37
Suggested uses for Ephedra
○ No FDA approved uses! ○ Uses included appetite suppression, weight loss, fatigue treatment, athletic performance, decongestant, asthma, sexual arousal. ○ Evidence: Supports appetite suppression and weight loss effects. ■ However, evidence shows risk outweighs the benefits
38
Known side effects and adverse reactions of ephedra
Excessive adrenergic stimulation, HTN, Seizure, Tachycardia, MI, CVA, excessive CNS stimulation, anxiety, sleeplessness, psychosis Concern for drug interactions: QT prolonging drugs (risk of ventricular arrythmias)
39
Fish oil (omega-3)
●Omega-3 fatty acids have been shown to be beneficial for general health and some medical conditions; must be obtained from the diet ● Omega-3 sources: Herring, halibut, salmon, mussels, tilapia, flax, hemp, walnuts, pecans, hazelnuts Mechanism of action
40
Mechanism of action for Fish oil
○ Vasodilator and inhibitor of platelet aggregation. ○ Decreases VLDLs, LDLs, and triglycerides (inhibition of hepatic triglyceride synthesis). ○ Weakly assists chemotaxic (aid in inflammatory responses)
41
Suggested use for fish oil
Evidence: CAD, HTN, hyperlipidemia, rheumatoid arthritis (RA), and post-MI
42
Conraindication for fish oil
Doses > 3g in DM patients (interacts with medications)
43
Known side effects and adverse reactions for fish oil
Abdominal pain, bleeding, fishy aftertaste, halitosis, heartburn, hemorrhagic stroke (large doses), gas, loose stools (large dose)
44
Drug interactions for fish oil?
Anticoagulants/antiplatelet drugs (↑ risk of bleeding), antidiabetic agents (↑ risk of hypoglycemia), antihypertensives (↑ risk of hypotension), contraceptives (altered effect)
45
Flaxseed is actually a strong source of _____ fatty acids, as well as _____
Omega-3; fiber
46
The Evidence for flaxseed is most supportive of its use in ______
Diabetes management and treatment of elevated cholesterol
47
Contraindications for flaxseed
Bowel obstruction, pregnancy & children (insufficient information), dehydration, immature seeds (toxic)
48
Side effects and adverse reactions of flaxseed
Diarrhea, abdominal pain, hypoglycemia, hypotension, headaches, possible increased risk of prostate cancer (?), hormone changes (?)
49
drug interactions with Flaxseed
Is believed to possibly cause decreased absorption of oral medications when given at the same time as the oil
50
Suggested uses for Garlic
○ Dyslipidemia, antiatherogenic, antibacterial, anti-HTN, anticancer. ○ Evidence: Mild antilipidemic effect, insufficient data on all other claims. Mayo Clinic gives it a “green light” for evidence and risk
51
Known side effects and adverse reactions for Garlic
○ Diaphoresis, dizziness, mild abdominal pain ○ Generally well tolerated with low side effect profile
52
Drug interactions with Garlic
Potentiate other anticoagulants, discontinue before oral or general surgery. Can cause marked reduction in levels of anti-AIDS/HIV medication
53
Ginger may act as a peripheral _____ agonist, but is mostly unknown
serotonin
54
Suggested uses for Ginger
○ Antiemetic, nausea reduction, dysmenorrhea, arthritis. ○ Evidence: Supports pregnancy-induced nausea, other uses are not supported.
55
Side effects and adverse reactions for ginger
○ No major side effects reported ○ Like Garlic, Ginger has a Mayo Clinic “green light” due to fairly strong evidence supporting antiemetic use and low side effect and contraindication profile
56
Antiplatelet activity may potentiate other anticoagulants and antiplatelet drugs with which supplement
Ginger
57
Suggested uses for Ginko Baloba
Evidence: Intermittent effects on claudication, mixed support for cognitive impairment. Not a “brain booster” as once thought ○ Commonly used for memory preservation, cognitive impairment, dementia, Alzheimer’s disease, Cerebrovascular and peripheral vascular disease, sexual dysfunction, tinnitus
58
Suggested uses for Ginseng
Evidence: Few studies, most claims are not supported, possible improved mental function
59
Known Side Effects and Adverse Reactions for Ginseng
○ Generally well tolerated. May cause headaches, GI upset, insomnia ○ Gets the Mayo Clinic “green light”
60
Mechanism of action for Glucosamine-Chondroitin
Believed to be prominent precursors in the biochemical synthesis of the building blocks of joint cartilage
61
There is some evidence supporting use for severe knee osteoarthritis, but other studies disagree - Which supplement?
Glucosamine-Chondroitin
62
Which supplement is Contraindicated if allergic to shellfish
Glucosamine-Chondroitin
63
Which supplement s believed to have a calming effect similar to a benzodiazepine medication?
Kava
64
Mayo Clinic states it is a “supplement to avoid”
Kava
65
Suggested uses for Kava
○ Anxiety, sleep disturbances, depression ○ Evidence: Supports anxiolytic effect, comparable to buspirone
66
Side effects and adverse reactions of Kava
Serious hepatotoxicity, even known to cause death
67
_____ is Usually supplied by a balanced diet, found abundantly in the body
Magnesium
68
_____ is a cofactor in more than 300 enzyme systems that regulate diverse biochemical reactions in the body, including protein synthesis, muscle and nerve function, blood glucose control, and blood pressure regulation.
Magnesium
69
Suggested uses for Magnesium
○ Several uses: Ventricular arrhythmias (like Torsades), asthma, anxiety, COPD, CAD, leg cramps, muscle spasm, preterm labor (tocolysis), preeclampsia, RLS, migraines, HTN, constipation, Mag replacement ○ Evidence: Mild evidence for HTN, preeclampsia, constipation, low Mag
70
Contraindications for magnesium
Heart block, coma, myocardial damage
71
Hormone produced in the pineal gland of the brain, synthesized from the amino acid tryptophan
Melatonin
72
Suggested uses for Melatonin
○ Insomnia, jet lag, other sleep disorders, arthritis, benzodiazepine withdrawal, cancer, headache syndromes, fatigue, stress, dementia, seasonal depression. ○ Evidence: Moderate evidence for insomnia, jet lag, sleep disorders
73
Mechanism of action for red yeast rice
Red Yeast Rice contains several compounds that seem to lower cholesterol levels. One is monacolin K, which is the same ingredient found in the cholesterol drug Lovastatin.
74
Which supplement shows evidence for hypercholesterolemia
Red yeast rice
75
Which supplement Should not be taken at the same time as Statins?
Red yeast rice
76
Taking _____ along with other cholesterol-lowering medications increases risks of DDIs significantly, especially Statins.
Red Yeast Rice
77
Contraindications for Red yeast rice
○ Abnormal LFTs, other liver dysfunction ○ Should not be taken at the same time as Statins
78
Mechanism of action for St. John's wart
Inhibition of norepinephrine, dopamine, and serotonin reuptake, possible suppression of ACTH and cortisol secretion
79
Which supplement is effective in mild to moderate depression
St. John's wart
80
Drug interactions for St. John's wart (There are LOTS)
Most notably antidepressant medications, birth control pills, anticoagulants, antiseizure medications, some asthma medications, and all corticosteroids.
81
This supplement may interact with dihydrotestosterone to inhibit production, inhibit binding, increase clearance
Saw Palmetto
82
While study results are contradictory, recent meta-analysis suggests that ______ does not have beneficial effects on BPH
saw palmetto
83
Pregnant women should avoid contact with this supplement
Saw palmetto
84
Which supplement is Believed to be an antioxidant with anti-inflammatory (COX inhibition) properties.
Tumeric
85
Some evidence to suggest _____ can lower cholesterol, decrease joint pain associated with arthritis, and treat dyspepsia
Tumeric
86
Contraindications for Tumeric
Gastric ulcer, bile duct obstruction
87
Supplement that is Likely helpful for insomnia, may have slight positive effects on anxiety, menstrual cramps, and menopausal symptoms
Valerian Root
88
Medscape cites 66 serious interactions, many of them also used for anxiety, sleep, and tremors for this supplement
Valerian Root

Pharm Exam 1 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions