Herbs and Vitamins Flashcards
1
Q
Alternative medicine
A
Used instead of conventional medicines or treatments
2
Q
Complementary medicine
A
Use of alternative medications alongside conventional medical practice
3
Q
Integrative medicine
A
Seeks to combine the best of conventional therapy with evidence-based alternative therapeutics
4
Q
Phytomedicines
A
Herbal medicines (Include preparations of whole herbs, herb parts - root, rhizome, flower, leaf, seed or stem)
5
Q
When are vitamin therapies used?
A
Used to minimize the risk of vitamin deficiency in at-risk populations
6
Q
Biologically-based therapies
A
Include nonbotanical, nonvitamin supplements such as fish oil, glucosamine, and melatonin
7
Q
How are homeopathic remedies prepared?
A
By making a series of dilutions of an active ingredient (plant, mineral, or animal part)
8
Q
How have homeopathic remedies been regulated?
A
As OTC drugs
9
Q
What is the risk of allergic rxn/ drug-drug interaction with homeopathic remedies?
A
None d/t extensive dilution
10
Q
DSHEA
A
Dietary supplement “regulation”
11
Q
Safety concerns with dietary supplements used medicinally
A
Inherent toxicity
Contamination
Drug interactions
12
Q
Echinacea use
A
Stimulant to enhance the immune response to a viral illness
13
Q
What does echinacea stimulate within the immune system?
A
Increase production of interferons and interleukins
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
15
Q
Cranberry use
A
Tx and prevent UTIs
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
17
Q
Elderberry use
A
Used in a syrup-based extract as an adjunct to treat influenza
18
Q
How does elderberry work?
A
Increases production of cytokines and interleukins as well as tumor necrosis factor
19
Q
How should elderberries be taken?
A
Cooked! Raw/ ripe fruit is toxic
20
Q
Raw elderberry SE
A
Diarrhea, nausea, and dizziness
21
Q
How are probiotics made?
A
From Bifidobacterium or Lactobacillus species
22
Q
When are probiotics used?
A
Upset stomach
Gastritis
Antibiotic-induced diarrhea
Inflammatory bowel disease
23
Q
When are probiotics often recommended?
A
With the use of clindamycin
24
Q
Black Cohosh
A
Menopause - mood disorder and hot flashes
25
Dong Quai
PMS, dysmenorrhea, and menopause
26
Red clover
Primarily used for hot flashes
27
When should red clover be avoided?
In breast CA, can stimulate estrogen mediated cells
28
Chaste Tree Berry
PMS and menopause remedies
29
When should chaste tree berry not be used?
With breast CA
30
Evening Primrose Oil
PMS and menopausal remedies
31
Lifelong soy intake has been correlated with?
Historically correlates well with lower risk of breast cancer, menopausal symptoms, and osteoporosis
32
Soy
May provide relief of hot flushes in the menopause
33
Which supplement has been best studied in tx of BPH?
Saw palmetto - as efficacious as finasteride
34
Herbs used for BPH
Stinging Nettle
Pumpkin Seed Extract or Pumpkin Seed Oil
Saw Palmetto
Pygeum (African Plum Tree)
35
Adaptogens
Help pts adapt to their environment - used for well being
36
Ashwagandha
Broad-ranging effects from antianxiety to immunomodulation to smooth muscle relaxation and thyroid stimulation
37
Ginseng use
Used as tonics for energy, with mild stimulant effects
38
Ginseng SE
Primarily nausea and insomnia
39
Where can ginseng often be found?
Often found in combination products with other stimulant botanicals, (caffeine, bitter orange, and guarana); widely included in energy drinks
40
Ginseng contains beta-sitosterol which can...
Cause a measurable increases in adrenocorticotropic hormone, endothelial nitric oxide production, and decreases in blood glucose
41
Dehydroepiandrostenedione (DHEA) use
Used as an adrenal tonic by patients who complain of fatigue and generalized malaise
42
What should be monitored in pts taking DHEA?
Monitor lipid levels, DHEA-S, and blood pressure periodically in all patients using DHEA
43
Supplements used for memory enhancement
Ginkgo biloba
Docosahexaenoic acid (DHA)
44
How is ginkgo used?
To minimize progression of dementia
45
How is DHA used?
To prevent dementia
46
How does slippery elm work to tx reflux?
Demulcent - coats irritated mucous membranes and stimulates secretion of additional mucus to soothe irritated tissues
47
How does Deglycyrrhizinated Licorice (DGL) work to tx reflux?
Reduces gastric inflammation; decreases gastric/esophageal spasms
48
What is the most widely used supplement to tx nausea?
Ginger
49
How does ginger tx nausea?
Increases the pyloric opening and reduce gastric irritability, effectively resulting in movement of stomach contents
50
Ginger use
Nausea - chemo, gastroparesis, and morning sickness
Anti-inflammatory (higher doses)
51
Herbs for bloating/ flatulence
Fennel
Caraway Seed
52
Chamomile use
Used in tea form to reduce GI cramping
53
What can increase the risk of chamomile allergic rxn?
Allergy to ragweed
54
In which pts should peppermint oil be avoided?
Should never be given orally to infants, may induce laryngospasm
55
Peppermint oil SE
Heartburn, nausea, and anal burning
56
Peppermint oil use
Widely used by patients with irritable bowel syndrome to relieve painful cramping and flatulence
57
Which constipation herb is the least likely to induce dependence or electrolyte imbalance?
Aloe
58
Long term aloe use can result in?
Hypokalemia and dehydration
59
Aloe use
Constipation
60
Aloe drug interaction
Drug interactions include potentiation of both diuretic potassium depletion and other stimulant laxatives
61
Triphala works to fight constipation by?
Stimulant laxative and bulk laxative effect
62
Senna SE
Long term use can cause laxative dependence
63
Senna use
Constipation
64
Senna drug interaction
Drug interactions may increase bleeding risk with warfarin use
65
Cascara use
Constipation - Cause stimulation of the large intestine
66
Cascara SE
Diarrhea, cramping, hypokalemia, and dependence WITH LONG TERM USE
67
Cascara can do what to urine?
Can discolor the urine (usually brown or amber)
68
Konjac Glucomannan use
Constipation
Lower lipid profile
69
Konjac Glucomannan possible hazards
Can block the throat and cause choking if not consumed with a full glass of water
70
Phosphate salts use
Used as fecal stimulants to cleanse the bowel before surgery or endoscopies
71
Phosphate salts work by
Cause water to be drawn into the gut
72
Herbs used for diarrhea
Black/ green tea (without caffeine)
Cinnamon
Rhubarb
73
What components of black/ green tea help fight diarrhea?
Contains tannins and polyphenols
74
Melatonin use
Helps regulate circadian rhythm and sleep cycles (in cases of insomnia or jet lag)
75
When is melatonin most effective?
Taken within 30 minutes of bedtime
76
Herbs used as sleeping aids
Melatonin
Valerian
Chamomile
Hops
77
Valerian has risk of
Becoming habit forming
78
Valerian use
Initiate the sleep cycle
79
Valerian interactions
Drug interactions with other CNS depressant drugs are noted
80
Passionflower use
Can be used in low doses for anxiety and in higher doses for sedation and opiate withdrawal
81
Passionflower SE
CNS depression
82
Kava kava use
Anxiety
Anticonvulsant (high doses)
83
Kava kava SE
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
St John's Wort use
Effective antidepressant for mild to moderate depression
85
St John's Wort interactions
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
St John's Wort SE
Photosensitivity
87
S-adenosylmethionine (SAM-e) use
Depression
88
S-adenosylmethionine (SAM-e) interactions
Drug interactions with selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) - can cause increased risk of serotonin syndrome
89
Chondroitin Sulfate/Glucosamine Sulfate use
Produce a chondrocyte-stimulating effect - reducing the pain associated with moderate arthritis
90
Chondroitin Sulfate/Glucosamine Sulfate benefits over NSAID use in tx arthritis?
Slower in onset but pain management without NSAID side effects (renal impairment, hypertension, and gastric ulceration)
91
Methylsulfonylmethane (MSM) use
Anti-inflammatory often in combination with glucosamine and chondroitin
92
Methylsulfonylmethane (MSM) safety issue
Safety data is limited to 12 weeks
93
S-adenosylmethionine (SAM-e) dosing to tx arthritis?
Effective dose for arthritis is much lower than that used for depression
94
S-adenosylmethionine (SAM-e) interactions
Concomitant use of SSRI and MAOI drugs
95
Turmeric/Curcumin use
Arthritis
Local enteric anti-inflammatory
96
Turmeric/Curcumin consumption
When taken with fat sources or black pepper, turmeric is easily absorbed and reaches significant serum concentrations
97
Capsaicin use
Topical herb - Causes substance P release resulting in a diminished pain signal over time
98
Ginger use
Anti-inflammatory - NO burning
99
Wintergreen Oil use
Ointment to achieve anti-inflammatory effect, without the burning that capsaicin causes
100
Wintergreen Oil drug interaction
Drug interactions, especially with warfarin, are possible with use over large surface areas
101
Borage use
Can be used for PMS and menopausal symptoms, bronchitis, colds, and its anti-inflammatory properties
102
Yohimbe use
Acts as an alpha-2 adrenergic receptor blocker - impotence
103
Yohimbe SE
Hypertension, excitability, dizziness, and fluid retention at low doses, with hypotension, cardiac failure, and death at high doses
104
Yohimbe interactions
Antidepressants, antihypertensives, and naloxone
105
Feverfew use
Used by patients to reduce the frequency of migraine headaches, but not to stop an acute attack
106
Riboflavin use
Vitamin B2 is a water-soluble vitamin to prevent headache
107
How should riboflavin be used?
Prophylactic for HA
108
Magnesium use
Often used as a migraine prophylactic
109
Magnesium interactions
Magnesium may interfere with the absorption of other medications, so it should not be taken along with many other medications
110
Cinnamon use
Most commonly used for glycemic control (improves insulin function)
111
Cinnamon interactions
Drug interaction is noted in potentiation of hypoglycemic medications
112
Omega-3 Fish Oils use
Lipid control
113
Omega-3 Fish Oil examples
Alpha linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)
114
Which omega-3 fish oil reduces risk of cardiovascular death, MI, and stroke?
Eicosapentaenoic acid (EPA) - Vascepa
115
Omega-3 Fish Oils interactions
Drug interactions include potentiation of anticoagulants and antihypertensives
116
Omega-3 Fish Oils can do what to bleeding times?
Increase them
117
Olive Oil use
Lipid control
Anti-inflammatory
118
Olive Oil interactions
Antihypertensives and hypoglycemics, which may need to be reduced
119
Gum (Guar) use
Resin that provides a soluble fiber source to allow enteric trapping of cholesterol and fats, thus preventing enterohepatic recirculation of lipids
120
Gum (Guar) efficacy
Lowering LDL and improving postprandial glucose
121
Gum (Guar) interaction
Reduced absorption of drugs, including antibiotics, hypoglycemics, digoxin, and oral contraceptives
122
Red Yeast Rice use
Inhibits HMG CoA reductase in the liver to lower lipids (acts similar to Lovastatin)
123
Red yeast rice SE
Potential liver toxicity, myalgia (less than statins), myopathy
124
Phytosterols (Plant Sterols) use
Decrease serum cholesterol levels by trapping and eliminating them
125
Where are plant sterols found?
Margarines and liquid fiber sources, nuts, seeds, cereals, legumes, and vegetable oils
126
Tea tree oil use
Used topically for skin infections including acne, minor cuts and scrapes, and tinea infections
127
Tea tree oil has activity against which organisms?
Disrupts microbial walls - Candida, Malassezia, Trichophyton, Staphylococcus, Enterococcus, and Pseudomonas and Propionibacterium species
128
Tea tree oil SE
Dry skin, eczema like lesions
129
Aloe Vera use
Widely used in sunburn preparations (for mild burns) and provides infection control and pain management - contains antibradykinins/ antimicrobials
130
When can aloe vera be used in 2nd degree burns?
For small second-degree burns, aloe gel may be used alternating with Silvadene to provide antibacterial coverage
131
Melatonin CA use
High doses noted to slow tumor growth
132
Ashwagandha CA use
Noted to decrease chemotherapy- induced cardiomyopathy in patients receiving doxorubicin
133
Indole-3-Carbinole (I3C) use
Used as a chemopreventive agent by patients at risk of breast cancer
134
Omega-3 Fatty Acids CA use
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
Vitamin
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
When should water and fat soluble vitamins be taken?
Fat-soluble vitamins should be taken before meals
Water-soluble vitamins should be taken after meals
137
Fat soluble vitamins
D, A, K, E
138
Fat soluble vitamins may be difficult to absorb in pts who?
Have gallbladder disease or on severe fat-restricted diets
139
Vitamin A (Retinoic Acid)
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
Vit A deficiency
Most common cause of childhood blindness in the world
Can contribute to lethality of measles
141
Vit A deficiency sxs
Deficiency results in night-blindness and Bitot spots, keratosis of the cornea (xerophthalmia) and blindness
142
Vit A can be found in
Red, yellow, orange, and dark green vegetables; milk, butter, cheese, eggs
143
Acute Vit A toxicity sxs
Liver failure, hemolysis, and headaches
144
Chronic Vit A sxs
Osteolysis and increases the risk of some malignancies
145
Vit A intake has been linked to...
Reduction in the risk of prostate cancer, macular degeneration, and cataracts
146
Vitamin D (Calcitriol) is found in
Cod liver oil, fortified cow’s milk, orange juice, fortified cereals
147
Vit D can normally be made with?
A combination of healthy skin, adequate sunlight exposure, normal liver and kidney function
148
Vit D deficiency is common in
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
Vit D deficiency sxs
Myalgias, HTN, depression, hyperkeratotic skin lesions (psoriasis), insulin resistance, and osteopenia
150
Vit D deficiency level
Below 20 mg/dL, clinical deficiency
151
Most effective Vit D replacement
Vitamin D3 (cholecalciferol) or high doses of Ergocalciferol (vitamin D2) - require good hepatic/ renal fxn
152
Vitamin E (Tocopherols/Tocotrienols) use
Aside from the treatment of vitamin E deficiency, which is rare, there are no clearly proven medicinal uses of vitamin E
153
Alpha-tocopherol
Most commonly found form of Vit E in dietary supplements
154
Vit E deficiency sxs
Vitamin E deficiency produces muscle weakness and decreased RBC survival
155
Vit E deficiency occurs in
Occurs primarily in patients with severe dysregulation of fat absorption
156
Excessive Vit E SE
Nausea, diarrhea, and fatigue
157
Vitamin K (Phytonadione) production
Produced by intestinal bacteria in the ileum or absorbed from dark green leafy vegetables
158
Vit K job
Essential for normal blood clotting and bone growth/maintenance because it is used by the liver for the formation of prothrombin
159
Causes of Vit K deficiency
Caused by long-term use of antibiotics or the presence of drugs such as warfarin or aspirin, and leads to bleeding
160
Newborns can present with what vitamin deficiency
Newborns (resulting in hemorrhagic disease) - receive one dose of phytonadione shortly after delivery
161
Vit K toxicity sxs
Hypercoagulability, soft tissue calcification in dialysis patients, and hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency
162
Which Vit is used to reverse warfarin affects when a pt is in need of urgent surgery (INR of 10)?
Vit K
163
Pts on anticoagulant therapy should avoid combination vitamin products containing which vitamin?
Vit K
164
Water soluble vitamins
C and Bs
165
Fat soluble vitamin deficiency is rare because
They are stored within the body and contain stores which can be used during a time of low intake
166
Vitamin B1 (Thiamine) deficiency
Deficiency in thiamine causes beriberi and wernicke encephalopathy
167
Vit B1 plays a role in
Synthesis of nerve-regulating substances
168
Vit B1 does what?
Acts as a catalyst in carbohydrate metabolism, enabling pyruvic acid to be absorbed and carbohydrates to release their energy
169
Vitamin B2 (Riboflavin) does what?
Acts as a coenzyme in the metabolism of carbohydrates, fats, and respiratory proteins
170
Vit B2 deficiency sxs
Perioral dermatitis and photosensitivity
171
Vitamin B3 (Niacin) does what?
Works as a coenzyme in the release of energy from nutrients
172
Vit B3 deficiency sxs
Pellagra, which is manifested as a photosensitive rash, glossitis, diarrhea, mental confusion, and irritability
173
Vit B3 SE
Rash, flushing, and gastric upset are common with niacin use at these doses and may be minimized by using slow-acting agents
174
Vitamin B6 (Pyridoxine) does what?
Essential for the production of vitamin B12 and folate
175
Vit B6 deficiency sxs
Skin disorders, cracks at the mouth corners, smooth tongue, seizures, dizziness, nausea, anemia, and kidney stones
176
Vit B6 toxicity sxs
Causes irreversible peripheral neurotoxicity when taken in high doses, over 300 mg daily
177
Vitamin B9 (Folate) does what?
Needed to make red and white blood cells in the bone marrow
178
Vit B9 deficiency sxs
Folic acid deficiency results in a high incidence of neural tube defect and impaired hematopoiesis, resulting in anemia
179
Which syndromes can causeVit B9 deficiency?
Malabsorption syndromes - Celiac/ Crohn's
Sickle cell
Spherocytosis
180
Which drugs can cause a folate deficiency?
Drugs such as methotrexate also interfere with folate metabolism,
181
Women of childbearing age are recommended to take what?
Women of childbearing age are recommended to take 0.4 mg of folic acid daily
182
Vitamin B12 (Cyanocobalamin) does what?
Necessary in minute amounts for the formation of proteins, and RBCs, along with the functioning of the nervous system
183
Vitamin B12 deficiency causes
Due to the inability of the stomach to produce acid, which aids in the absorption of this vitamin (PPIs and H2 blockers)
184
Vit B12 deficiency sxs
Ineffective production of RBCs, faulty myelin (nerve sheath) synthesis, and loss of epithelium (membrane lining) of the intestinal tract
185
What contains Vit B12?
Animal sources (vegans should be on supplementation)
186
Vitamin C (Ascorbic Acid) does what?
Antioxidant vitamin essential for collagen synthesis - maintain soft tissue structure, wound healing, and hemostasis
187
Vit C deficiency sxs
Scurvy
188
Vit C deficiency is caused by
Impaired by poor diet, stress, trauma, and infection
189
Where is Vit C found?
Citrus fruits
190
Vitamin Coenzyme Q10 (CoQ10) does what?
Essential component of mitochondrial ATP electron transport
191
CoQ10 deficiency is caused by
Statin drugs (HGM-CoA reductase inhibitors)
192
CoQ10 deficiency sxs
Fatigue, myalgia, and exercise intolerance, which may be mistaken for statin-induced rhabdomyolysis
