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Pharm 2 > Herbs and Vitamins > Flashcards

Herbs and Vitamins Flashcards

1
Q

Alternative medicine

A

Used instead of conventional medicines or treatments

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2
Q

Complementary medicine

A

Use of alternative medications alongside conventional medical practice

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3
Q

Integrative medicine

A

Seeks to combine the best of conventional therapy with evidence-based alternative therapeutics

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4
Q

Phytomedicines

A

Herbal medicines (Include preparations of whole herbs, herb parts - root, rhizome, flower, leaf, seed or stem)

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5
Q

When are vitamin therapies used?

A

Used to minimize the risk of vitamin deficiency in at-risk populations

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6
Q

Biologically-based therapies

A

Include nonbotanical, nonvitamin supplements such as fish oil, glucosamine, and melatonin

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7
Q

How are homeopathic remedies prepared?

A

By making a series of dilutions of an active ingredient (plant, mineral, or animal part)

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8
Q

How have homeopathic remedies been regulated?

A

As OTC drugs

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9
Q

What is the risk of allergic rxn/ drug-drug interaction with homeopathic remedies?

A

None d/t extensive dilution

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10
Q

DSHEA

A

Dietary supplement “regulation”

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11
Q

Safety concerns with dietary supplements used medicinally

A

Inherent toxicity
Contamination
Drug interactions

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12
Q

Echinacea use

A

Stimulant to enhance the immune response to a viral illness

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13
Q

What does echinacea stimulate within the immune system?

A

Increase production of interferons and interleukins

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14
Q

When should echinacea be avoided?

A

Severe viral illness - flu
Pregnancy
Autoimmune disease
HIV patients or others with high risk for lymphoproliferative disorders
Ragweed allergy

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15
Q

Cranberry use

A

Tx and prevent UTIs

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16
Q

How does cranberry prevent UTI?

A

Neutralize the ability of E. coli pili to attach to urothelium and skin by coating the area

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17
Q

Elderberry use

A

Used in a syrup-based extract as an adjunct to treat influenza

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18
Q

How does elderberry work?

A

Increases production of cytokines and interleukins as well as tumor necrosis factor

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19
Q

How should elderberries be taken?

A

Cooked! Raw/ ripe fruit is toxic

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20
Q

Raw elderberry SE

A

Diarrhea, nausea, and dizziness

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21
Q

How are probiotics made?

A

From Bifidobacterium or Lactobacillus species

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22
Q

When are probiotics used?

A

Upset stomach
Gastritis
Antibiotic-induced diarrhea
Inflammatory bowel disease

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23
Q

When are probiotics often recommended?

A

With the use of clindamycin

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24
Q

Black Cohosh

A

Menopause - mood disorder and hot flashes

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25
Q

Dong Quai

A

PMS, dysmenorrhea, and menopause

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26
Q

Red clover

A

Primarily used for hot flashes

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27
Q

When should red clover be avoided?

A

In breast CA, can stimulate estrogen mediated cells

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28
Q

Chaste Tree Berry

A

PMS and menopause remedies

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29
Q

When should chaste tree berry not be used?

A

With breast CA

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30
Q

Evening Primrose Oil

A

PMS and menopausal remedies

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31
Q

Lifelong soy intake has been correlated with?

A

Historically correlates well with lower risk of breast cancer, menopausal symptoms, and osteoporosis

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32
Q

Soy

A

May provide relief of hot flushes in the menopause

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33
Q

Which supplement has been best studied in tx of BPH?

A

Saw palmetto - as efficacious as finasteride

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34
Q

Herbs used for BPH

A

Stinging Nettle
Pumpkin Seed Extract or Pumpkin Seed Oil
Saw Palmetto
Pygeum (African Plum Tree)

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35
Q

Adaptogens

A

Help pts adapt to their environment - used for well being

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36
Q

Ashwagandha

A

Broad-ranging effects from antianxiety to immunomodulation to smooth muscle relaxation and thyroid stimulation

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37
Q

Ginseng use

A

Used as tonics for energy, with mild stimulant effects

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38
Q

Ginseng SE

A

Primarily nausea and insomnia

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39
Q

Where can ginseng often be found?

A

Often found in combination products with other stimulant botanicals, (caffeine, bitter orange, and guarana); widely included in energy drinks

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40
Q

Ginseng contains beta-sitosterol which can…

A

Cause a measurable increases in adrenocorticotropic hormone, endothelial nitric oxide production, and decreases in blood glucose

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41
Q

Dehydroepiandrostenedione (DHEA) use

A

Used as an adrenal tonic by patients who complain of fatigue and generalized malaise

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42
Q

What should be monitored in pts taking DHEA?

A

Monitor lipid levels, DHEA-S, and blood pressure periodically in all patients using DHEA

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43
Q

Supplements used for memory enhancement

A

Ginkgo biloba
Docosahexaenoic acid (DHA)

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44
Q

How is ginkgo used?

A

To minimize progression of dementia

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45
Q

How is DHA used?

A

To prevent dementia

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46
Q

How does slippery elm work to tx reflux?

A

Demulcent - coats irritated mucous membranes and stimulates secretion of additional mucus to soothe irritated tissues

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47
Q

How does Deglycyrrhizinated Licorice (DGL) work to tx reflux?

A

Reduces gastric inflammation; decreases gastric/esophageal spasms

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48
Q

What is the most widely used supplement to tx nausea?

A

Ginger

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49
Q

How does ginger tx nausea?

A

Increases the pyloric opening and reduce gastric irritability, effectively resulting in movement of stomach contents

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50
Q

Ginger use

A

Nausea - chemo, gastroparesis, and morning sickness
Anti-inflammatory (higher doses)

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51
Q

Herbs for bloating/ flatulence

A

Fennel
Caraway Seed

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52
Q

Chamomile use

A

Used in tea form to reduce GI cramping

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53
Q

What can increase the risk of chamomile allergic rxn?

A

Allergy to ragweed

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54
Q

In which pts should peppermint oil be avoided?

A

Should never be given orally to infants, may induce laryngospasm

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55
Q

Peppermint oil SE

A

Heartburn, nausea, and anal burning

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56
Q

Peppermint oil use

A

Widely used by patients with irritable bowel syndrome to relieve painful cramping and flatulence

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57
Q

Which constipation herb is the least likely to induce dependence or electrolyte imbalance?

A

Aloe

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58
Q

Long term aloe use can result in?

A

Hypokalemia and dehydration

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59
Q

Aloe use

A

Constipation

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60
Q

Aloe drug interaction

A

Drug interactions include potentiation of both diuretic potassium depletion and other stimulant laxatives

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61
Q

Triphala works to fight constipation by?

A

Stimulant laxative and bulk laxative effect

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62
Q

Senna SE

A

Long term use can cause laxative dependence

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63
Q

Senna use

A

Constipation

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64
Q

Senna drug interaction

A

Drug interactions may increase bleeding risk with warfarin use

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65
Q

Cascara use

A

Constipation - Cause stimulation of the large intestine

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66
Q

Cascara SE

A

Diarrhea, cramping, hypokalemia, and dependence WITH LONG TERM USE

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67
Q

Cascara can do what to urine?

A

Can discolor the urine (usually brown or amber)

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68
Q

Konjac Glucomannan use

A

Constipation
Lower lipid profile

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69
Q

Konjac Glucomannan possible hazards

A

Can block the throat and cause choking if not consumed with a full glass of water

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70
Q

Phosphate salts use

A

Used as fecal stimulants to cleanse the bowel before surgery or endoscopies

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71
Q

Phosphate salts work by

A

Cause water to be drawn into the gut

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72
Q

Herbs used for diarrhea

A

Black/ green tea (without caffeine)
Cinnamon
Rhubarb

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73
Q

What components of black/ green tea help fight diarrhea?

A

Contains tannins and polyphenols

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74
Q

Melatonin use

A

Helps regulate circadian rhythm and sleep cycles (in cases of insomnia or jet lag)

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75
Q

When is melatonin most effective?

A

Taken within 30 minutes of bedtime

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76
Q

Herbs used as sleeping aids

A

Melatonin
Valerian
Chamomile
Hops

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77
Q

Valerian has risk of

A

Becoming habit forming

78
Q

Valerian use

A

Initiate the sleep cycle

79
Q

Valerian interactions

A

Drug interactions with other CNS depressant drugs are noted

80
Q

Passionflower use

A

Can be used in low doses for anxiety and in higher doses for sedation and opiate withdrawal

81
Q

Passionflower SE

A

CNS depression

82
Q

Kava kava use

A

Anxiety
Anticonvulsant (high doses)

83
Q

Kava kava SE

A

Prolonged use at high doses results in kani kani, a kava-induced dermopathy
Liver failure is a known complication of use of the aerial portions of the herb

84
Q

St John’s Wort use

A

Effective antidepressant for mild to moderate depression

85
Q

St John’s Wort interactions

A

CYP 450 - will not be absorbing and benefiting from a wide variety of other therapeutic drugs, including many common anticonvulsants, antineoplastics, antiretrovirals, oral contraceptives, statins, cyclosporine, and antibiotics

86
Q

St John’s Wort SE

A

Photosensitivity

87
Q

S-adenosylmethionine (SAM-e) use

A

Depression

88
Q

S-adenosylmethionine (SAM-e) interactions

A

Drug interactions with selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) - can cause increased risk of serotonin syndrome

89
Q

Chondroitin Sulfate/Glucosamine Sulfate use

A

Produce a chondrocyte-stimulating effect - reducing the pain associated with moderate arthritis

90
Q

Chondroitin Sulfate/Glucosamine Sulfate benefits over NSAID use in tx arthritis?

A

Slower in onset but pain management without NSAID side effects (renal impairment, hypertension, and gastric ulceration)

91
Q

Methylsulfonylmethane (MSM) use

A

Anti-inflammatory often in combination with glucosamine and chondroitin

92
Q

Methylsulfonylmethane (MSM) safety issue

A

Safety data is limited to 12 weeks

93
Q

S-adenosylmethionine (SAM-e) dosing to tx arthritis?

A

Effective dose for arthritis is much lower than that used for depression

94
Q

S-adenosylmethionine (SAM-e) interactions

A

Concomitant use of SSRI and MAOI drugs

95
Q

Turmeric/Curcumin use

A

Arthritis
Local enteric anti-inflammatory

96
Q

Turmeric/Curcumin consumption

A

When taken with fat sources or black pepper, turmeric is easily absorbed and reaches significant serum concentrations

97
Q

Capsaicin use

A

Topical herb - Causes substance P release resulting in a diminished pain signal over time

98
Q

Ginger use

A

Anti-inflammatory - NO burning

99
Q

Wintergreen Oil use

A

Ointment to achieve anti-inflammatory effect, without the burning that capsaicin causes

100
Q

Wintergreen Oil drug interaction

A

Drug interactions, especially with warfarin, are possible with use over large surface areas

101
Q

Borage use

A

Can be used for PMS and menopausal symptoms, bronchitis, colds, and its anti-inflammatory properties

102
Q

Yohimbe use

A

Acts as an alpha-2 adrenergic receptor blocker - impotence

103
Q

Yohimbe SE

A

Hypertension, excitability, dizziness, and fluid retention at low doses, with hypotension, cardiac failure, and death at high doses

104
Q

Yohimbe interactions

A

Antidepressants, antihypertensives, and naloxone

105
Q

Feverfew use

A

Used by patients to reduce the frequency of migraine headaches, but not to stop an acute attack

106
Q

Riboflavin use

A

Vitamin B2 is a water-soluble vitamin to prevent headache

107
Q

How should riboflavin be used?

A

Prophylactic for HA

108
Q

Magnesium use

A

Often used as a migraine prophylactic

109
Q

Magnesium interactions

A

Magnesium may interfere with the absorption of other medications, so it should not be taken along with many other medications

110
Q

Cinnamon use

A

Most commonly used for glycemic control (improves insulin function)

111
Q

Cinnamon interactions

A

Drug interaction is noted in potentiation of hypoglycemic medications

112
Q

Omega-3 Fish Oils use

A

Lipid control

113
Q

Omega-3 Fish Oil examples

A

Alpha linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)

114
Q

Which omega-3 fish oil reduces risk of cardiovascular death, MI, and stroke?

A

Eicosapentaenoic acid (EPA) - Vascepa

115
Q

Omega-3 Fish Oils interactions

A

Drug interactions include potentiation of anticoagulants and antihypertensives

116
Q

Omega-3 Fish Oils can do what to bleeding times?

A

Increase them

117
Q

Olive Oil use

A

Lipid control
Anti-inflammatory

118
Q

Olive Oil interactions

A

Antihypertensives and hypoglycemics, which may need to be reduced

119
Q

Gum (Guar) use

A

Resin that provides a soluble fiber source to allow enteric trapping of cholesterol and fats, thus preventing enterohepatic recirculation of lipids

120
Q

Gum (Guar) efficacy

A

Lowering LDL and improving postprandial glucose

121
Q

Gum (Guar) interaction

A

Reduced absorption of drugs, including antibiotics, hypoglycemics, digoxin, and oral contraceptives

122
Q

Red Yeast Rice use

A

Inhibits HMG CoA reductase in the liver to lower lipids (acts similar to Lovastatin)

123
Q

Red yeast rice SE

A

Potential liver toxicity, myalgia (less than statins), myopathy

124
Q

Phytosterols (Plant Sterols) use

A

Decrease serum cholesterol levels by trapping and eliminating them

125
Q

Where are plant sterols found?

A

Margarines and liquid fiber sources, nuts, seeds, cereals, legumes, and vegetable oils

126
Q

Tea tree oil use

A

Used topically for skin infections including acne, minor cuts and scrapes, and tinea infections

127
Q

Tea tree oil has activity against which organisms?

A

Disrupts microbial walls - Candida, Malassezia, Trichophyton, Staphylococcus, Enterococcus, and Pseudomonas and Propionibacterium species

128
Q

Tea tree oil SE

A

Dry skin, eczema like lesions

129
Q

Aloe Vera use

A

Widely used in sunburn preparations (for mild burns) and provides infection control and pain management - contains antibradykinins/ antimicrobials

130
Q

When can aloe vera be used in 2nd degree burns?

A

For small second-degree burns, aloe gel may be used alternating with Silvadene to provide antibacterial coverage

131
Q

Melatonin CA use

A

High doses noted to slow tumor growth

132
Q

Ashwagandha CA use

A

Noted to decrease chemotherapy- induced cardiomyopathy in patients receiving doxorubicin

133
Q

Indole-3-Carbinole (I3C) use

A

Used as a chemopreventive agent by patients at risk of breast cancer

134
Q

Omega-3 Fatty Acids CA use

A

Reduce the progression of polyps in the colon
A diet rich in healthy omega-3 sources and low in omega-6 and saturated fats is prudent for colon cancer patients

135
Q

Vitamin

A

Refer to any of the organic compounds required by the body in small amounts (micronutrients) to protect health and for proper growth in living creatures

136
Q

When should water and fat soluble vitamins be taken?

A

Fat-soluble vitamins should be taken before meals
Water-soluble vitamins should be taken after meals

137
Q

Fat soluble vitamins

A

D, A, K, E

138
Q

Fat soluble vitamins may be difficult to absorb in pts who?

A

Have gallbladder disease or on severe fat-restricted diets

139
Q

Vitamin A (Retinoic Acid)

A

Essential for the normal development of the retina as well as the cornea, skin, bones, and teeth, and for normal function of the immune system

140
Q

Vit A deficiency

A

Most common cause of childhood blindness in the world
Can contribute to lethality of measles

141
Q

Vit A deficiency sxs

A

Deficiency results in night-blindness and Bitot spots, keratosis of the cornea (xerophthalmia) and blindness

142
Q

Vit A can be found in

A

Red, yellow, orange, and dark green vegetables; milk, butter, cheese, eggs

143
Q

Acute Vit A toxicity sxs

A

Liver failure, hemolysis, and headaches

144
Q

Chronic Vit A sxs

A

Osteolysis and increases the risk of some malignancies

145
Q

Vit A intake has been linked to…

A

Reduction in the risk of prostate cancer, macular degeneration, and cataracts

146
Q

Vitamin D (Calcitriol) is found in

A

Cod liver oil, fortified cow’s milk, orange juice, fortified cereals

147
Q

Vit D can normally be made with?

A

A combination of healthy skin, adequate sunlight exposure, normal liver and kidney function

148
Q

Vit D deficiency is common in

A

Patients with severe eczema, hepatitis, renal insufficiency, obesity, or who avoid sun exposure will be predictably deficient, along with those who live in northern areas during winter, Crohn’s or Celiac

149
Q

Vit D deficiency sxs

A

Myalgias, HTN, depression, hyperkeratotic skin lesions (psoriasis), insulin resistance, and osteopenia

150
Q

Vit D deficiency level

A

Below 20 mg/dL, clinical deficiency

151
Q

Most effective Vit D replacement

A

Vitamin D3 (cholecalciferol) or high doses of Ergocalciferol (vitamin D2) - require good hepatic/ renal fxn

152
Q

Vitamin E (Tocopherols/Tocotrienols) use

A

Aside from the treatment of vitamin E deficiency, which is rare, there are no clearly proven medicinal uses of vitamin E

153
Q

Alpha-tocopherol

A

Most commonly found form of Vit E in dietary supplements

154
Q

Vit E deficiency sxs

A

Vitamin E deficiency produces muscle weakness and decreased RBC survival

155
Q

Vit E deficiency occurs in

A

Occurs primarily in patients with severe dysregulation of fat absorption

156
Q

Excessive Vit E SE

A

Nausea, diarrhea, and fatigue

157
Q

Vitamin K (Phytonadione) production

A

Produced by intestinal bacteria in the ileum or absorbed from dark green leafy vegetables

158
Q

Vit K job

A

Essential for normal blood clotting and bone growth/maintenance because it is used by the liver for the formation of prothrombin

159
Q

Causes of Vit K deficiency

A

Caused by long-term use of antibiotics or the presence of drugs such as warfarin or aspirin, and leads to bleeding

160
Q

Newborns can present with what vitamin deficiency

A

Newborns (resulting in hemorrhagic disease) - receive one dose of phytonadione shortly after delivery

161
Q

Vit K toxicity sxs

A

Hypercoagulability, soft tissue calcification in dialysis patients, and hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency

162
Q

Which Vit is used to reverse warfarin affects when a pt is in need of urgent surgery (INR of 10)?

A

Vit K

163
Q

Pts on anticoagulant therapy should avoid combination vitamin products containing which vitamin?

A

Vit K

164
Q

Water soluble vitamins

A

C and Bs

165
Q

Fat soluble vitamin deficiency is rare because

A

They are stored within the body and contain stores which can be used during a time of low intake

166
Q

Vitamin B1 (Thiamine) deficiency

A

Deficiency in thiamine causes beriberi and wernicke encephalopathy

167
Q

Vit B1 plays a role in

A

Synthesis of nerve-regulating substances

168
Q

Vit B1 does what?

A

Acts as a catalyst in carbohydrate metabolism, enabling pyruvic acid to be absorbed and carbohydrates to release their energy

169
Q

Vitamin B2 (Riboflavin) does what?

A

Acts as a coenzyme in the metabolism of carbohydrates, fats, and respiratory proteins

170
Q

Vit B2 deficiency sxs

A

Perioral dermatitis and photosensitivity

171
Q

Vitamin B3 (Niacin) does what?

A

Works as a coenzyme in the release of energy from nutrients

172
Q

Vit B3 deficiency sxs

A

Pellagra, which is manifested as a photosensitive rash, glossitis, diarrhea, mental confusion, and irritability

173
Q

Vit B3 SE

A

Rash, flushing, and gastric upset are common with niacin use at these doses and may be minimized by using slow-acting agents

174
Q

Vitamin B6 (Pyridoxine) does what?

A

Essential for the production of vitamin B12 and folate

175
Q

Vit B6 deficiency sxs

A

Skin disorders, cracks at the mouth corners, smooth tongue, seizures, dizziness, nausea, anemia, and kidney stones

176
Q

Vit B6 toxicity sxs

A

Causes irreversible peripheral neurotoxicity when taken in high doses, over 300 mg daily

177
Q

Vitamin B9 (Folate) does what?

A

Needed to make red and white blood cells in the bone marrow

178
Q

Vit B9 deficiency sxs

A

Folic acid deficiency results in a high incidence of neural tube defect and impaired hematopoiesis, resulting in anemia

179
Q

Which syndromes can causeVit B9 deficiency?

A

Malabsorption syndromes - Celiac/ Crohn’s
Sickle cell
Spherocytosis

180
Q

Which drugs can cause a folate deficiency?

A

Drugs such as methotrexate also interfere with folate metabolism,

181
Q

Women of childbearing age are recommended to take what?

A

Women of childbearing age are recommended to take 0.4 mg of folic acid daily

182
Q

Vitamin B12 (Cyanocobalamin) does what?

A

Necessary in minute amounts for the formation of proteins, and RBCs, along with the functioning of the nervous system

183
Q

Vitamin B12 deficiency causes

A

Due to the inability of the stomach to produce acid, which aids in the absorption of this vitamin (PPIs and H2 blockers)

184
Q

Vit B12 deficiency sxs

A

Ineffective production of RBCs, faulty myelin (nerve sheath) synthesis, and loss of epithelium (membrane lining) of the intestinal tract

185
Q

What contains Vit B12?

A

Animal sources (vegans should be on supplementation)

186
Q

Vitamin C (Ascorbic Acid) does what?

A

Antioxidant vitamin essential for collagen synthesis - maintain soft tissue structure, wound healing, and hemostasis

187
Q

Vit C deficiency sxs

A

Scurvy

188
Q

Vit C deficiency is caused by

A

Impaired by poor diet, stress, trauma, and infection

189
Q

Where is Vit C found?

A

Citrus fruits

190
Q

Vitamin Coenzyme Q10 (CoQ10) does what?

A

Essential component of mitochondrial ATP electron transport

191
Q

CoQ10 deficiency is caused by

A

Statin drugs (HGM-CoA reductase inhibitors)

192
Q

CoQ10 deficiency sxs

A

Fatigue, myalgia, and exercise intolerance, which may be mistaken for statin-induced rhabdomyolysis

Pharm 2 (8 decks)

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