Herbals and Dietary Supplements

Question 1

FDA Authority

Answer 1

MAY NOT require efficacy and safety testing prior to marketing, but may establish GMP and inspect facilities (cannot say Cures or Treats)

Question 2

Dietary Supplement

Answer 2

taken by mouth, at least 1 ingredient, examples: herbs vitamins enzymes

Question 3

Labeling Requirements

Answer 3

must be identified as a dietary supplement, has directions for use, manufacturer, etc.

Question 4

Structure/Function Claim

Answer 4

supports the immune system, promotes urinary tract health in women (may NOT say prevents)

Question 5

Reputable Sources

Answer 5

www.nccam.nih.gov

Question 6

Rating

Answer 6

Effective to Ineffective and Safe to Unsafe, or not sufficient information

Question 7

Vitamins

Answer 7

need tiny amount for metabolism, growth and development, now advertised for insufficiency

Question 8

Cranberry

Answer 8

PREVENTION of UTI, 400-800mg bid or 10-16oz of juice (blocks bacterial adhesion in urinary tract), nausea and diarrhea, do not delay medical evaluation of actual UTI (LIKELY SAFE/POSSIBLY EFFECTIVE)

Question 9

Echinacea

Answer 9

PREVENTION or treatment of cold, or URI, MOA: non-specific immune response, ADE: nausea, abdominal pain, caution in pts w/ autoimmune conditions (LIKELY SAFE/POSSIBLY EFFECTIVE)

Question 10

Feverfew

Answer 10

for Migraine HA prophylaxis, reduces fever/HA, MOA: cox-2 inhibitor (selective), ADE: NVD and heartburn, precautions: avoid in pregnancy (b/c of uterine contractions!!, interacts with anticoagulants/antiplatelet meds (LIKELY SAFE/POSSIBLE EFFECTIVE)

Question 11

Feverfew

Answer 11

for Migraine HA prophylaxis, reduces fever/HA, MOA: cox-2 inhibitor (selective), ADE: NVD and heartburn, precautions: avoid in pregnancy (b/c of uterine contractions!!, interacts with anticoagulants/antiplatelet meds (LIKELY SAFE/POSSIBLE EFFECTIVE)

Question 12

Omega-3 FA

Answer 12

contains DHA and EPA, lower CV risk, MOA: fewer inflammatory mediators like COX and lipoxygenase, decrease lipids, precaution: mercury content, (LIKELY EFFECTIVE/LIKELY SAFE)

Question 13

Garlic

Answer 13

for hyperlipidemia/hypertension and prevention of CV events,MOA:HMG-CoA reductase inhibitor Weakly!, antiplatelet activity, (LIKELY SAFE/POSSIBLY EFFECTIVE)

Question 14

Ginkgo biloba

Answer 14

improve memory, alzheimer’s disease, MOA: protection from oxidative stress, Gi Upset, diarrhea, spontaneous bleeding, may increase anticoagulants, LIKELY SAFE/POSSIBLY EFFECTIVE

Question 15

Ginger

Answer 15

for nausea associated w/ chemotherapy, motion sickness, MOA: antagonist of 5-HT3 in ilium, pepper like irritant in mouth, in pregnancy have pt check with OB, LIKELY SAFE/POSSIBLY EFFECTIVE

Question 16

Ginseng

Answer 16

for overall wellness and stamina, blood glucose lowering, MOA: unknown, ADE: all over the board, POSSIBLY SAFE/POSSIBLY EFFECTIVE

Question 17

Glucosamine

Answer 17

OA treatment and prevention, may help in 3-6 months (1500mg total, 500tid or 750bid!!)
not like NSAIDs, precautions in people w/ shellfish allergies, LIKELY SAFE/LIKELY EFFECTIVE

Question 18

Milk Thistle

Answer 18

for Cirrhosis, hepatitis, hepatoprotectant, MOA-prevention of hepatocytes to toxins

Question 19

Probiotics

Answer 19

for overall GI wellness, IBD & IBS, yogurt and cottage cheese, (yeast- Saccharomyces boulardii) LIKELY SAFE/POSSIBLY EFFECTIVE

Question 20

St. Johns Wort

Answer 20

like SSRI, for depression, Induces CYP450!, decreases levels of many other medicaions!!, LIKELY SAFE/LIKELY EFFECTIVE

Question 21

Saw Palmetto

Answer 21

for BPH, like finasteride, blocks testos. to DHT, POSSIBLY INEFFECTIVE

Question 22

Valerian

Answer 22

for insomnia and anxiety, works on GABA system LIKELY SAFE/POSSIBLY EFFECTIVE