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AIII-Natural Health Products > L8-Intro to NHPs > Flashcards

L8-Intro to NHPs Flashcards

1
Q

Define NHP.

List e.g. of

A

Naturally occurring substances that are used to maintain or restore health.

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2
Q

List the 6 categories of NHPs.

A
  1. Vitamins and minerals
  2. Herbal remedies
  3. Homeopathic medicines
  4. Traditional medicines
  5. Probiotics
  6. Other products (efa, aa)
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3
Q

T/F: NHPs are apart of CAM regulations.

A

FALSE.
-while they can be considered as such, here in Canada they are not as they are listed under drugs in the Food and Drugs Act

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4
Q

List some gucci properties re: NHP’s.

A
  • safe for consideration as over the counter products
  • available for self care
  • available for self selection
  • does not require a prescription to be sold
  • can include even shampoos and soaps
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5
Q

Function food v nutraceutical.

1. Definition.

A
  • FF: similar in appearance OR may be conventional food

- Nutraceutical: prod isolated/purified from foods

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6
Q

Difference between function food v nutraceutical.

2. Where is it sold?

A
  • FF: as part of usual diet

- Nut: sold in med forms not usually ass w/ food

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7
Q

Difference between function food v nutraceutical.

3. Benefits?

A

BOTH - demonstrated to have a physiological benefit or provide protection against a chronic disease

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8
Q

Difference between function food v nutraceutical.

4. What category is it regulated under?

A
  • FF: food

- Nut: drug

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9
Q

What percentage of Canadians use NHPs?

A

71%

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10
Q

Why do Canadians use NHPs?

A

52% maintain or promote good health

29% better or safer than conventional medications 20% recommendation (physician or other)

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11
Q

Do Canadians think NHPs are safe?

A

52% yes (b/c made from natural ingredients)

37% if for public sale, then safe

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12
Q

How do Canadians learn about NHPs?

A
  • fam and friends
  • pharmacist
  • internet
  • physician
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13
Q

What do Canadians want to know?

A
  • recalls of NHPs
  • side effects
  • DIs
  • uses/benefits
  • understanding NHP labels
  • NHP regulation
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14
Q

List the most commonly used NHPs & their indications.

A

1) glucosamine - OA
2) echinacea - immune stimulator
3) garlic - (reduce cholesterol)
4) fish oils/ w-3 fa - cdv health
5) evening primrose oil/ GLA - menopause
6) ginkgo biloba - memory
7) ginseng - immune
8) flaxseed oil - CDV health
9) St. John’s wart - depression
10) apple cider vinegar - general health????

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15
Q

List predictors of NHP users.

A
  • race (Caucasian > minority)
  • non-smokers > smokers
  • active > non-active lifestyle
  • health status (non-perfect health > perfect health)
  • use of conventional or OTC medication…(>57%!!!)
  • vitamin, mineral, or multivitamin usage
  • consultation with a CAM practitioner (esp. ND/HDs)
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16
Q
  1. Vitamins and minerals.

T/F: Education & annual income is NOT a good predictor of NHP use.

A

TRUE!

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17
Q
  1. Vitamins and minerals.

T/F: All vitamins are a factor in the maintenance of good health.

A

TRUE!

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18
Q
  1. Vitamins and minerals.

Which 3 vitamins are involved in helping to form RBC?

A

folate, niacin, vit B12

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19
Q
  1. Herbal remedies.

This category includes botanical therapy. Define botanical.

A
  • plant or plant part valued for its medicinal or therapeutic properties, flavour and/or scent
  • > herbs are a subcatagory of this
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20
Q
  1. Herbal remedies.

List the 3 NHPs included in the botanical category.

A
  1. Herbal remedies/products
  2. Botanical remedies/products
  3. Phytomedicines
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21
Q
  1. Herbal remedies.

List 4 e.g. of botanicals.

A
  • tea/infusion
  • decoction
  • tincture
  • extract
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22
Q
  1. Herbal remedies.

How does one prepare tea/infuson?

A
  • adding boiling water to fresh or dried botanical and steeping
  • cold or hot
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23
Q
  1. Herbal remedies.

How does one prepare decoction?

A
  • for botanicals that need more forceful Tx to extract desirable components (e.g. bark, root)
  • simmered longer in boiling water than tea/infusion
  • cold or hot
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24
Q
  1. Herbal remedies.

How does one prepare tincture?

A

-soaking botanical in a sol’n of
alcohol and water
-concentrates botanical
-sold in liquid form

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25
Q
  1. Herbal remedies.

How does one prepare extract?

A

-soaked with the goal of capturing

specific components

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26
Q
  1. Herbal remedies.

What are the 2 types of AE effects?

A
  1. Intrinsic AE: arise from herb itself

2. Extrinsic AE: unrelated to herb; likely due to prob in commercial manufacture or extemporaneous compounding

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27
Q
  1. Herbal remedies.

List the 2 types of intrinsic AEs.

A
  1. Type A: predictable toxicity, OD, DIs

2. Type B: idiosyncratic Rxns (e.g. allergy, ana)

28
Q
  1. Herbal remedies.

List 7 e.g. of extrinsic AEs.

A
  1. Misidentification
  2. Lack of standardization
  3. Contamination
  4. Substitution
  5. Adulteration
  6. Incorrect preparation and/or dosage
  7. Inappropriate labeling and/or advertising
29
Q
  1. Herbal remedies - extrinsic AEs.
    W/ regards to misidentification (1), it is important that plants are referred to as their ____.
    Why?
A
  • binomial Latin names/scientific name (genus & species).
  • b/c they have many different names!
30
Q
  1. Herbal remedies - extrinsic AEs.

List 3 challenges in standardizing (2) herbal medicines.

A
  1. No bioassay identified
  2. Active ingredient(s) of a herb often unknown
  3. If AI(s) are known, may be unknown which is better - crude herb or purified active principle
31
Q
  1. Herbal remedies - extrinsic AEs.

How are we trying to set better standards (2) for knowing the active ingredients?

A
  • how and where they are grown; how it is harvested or extracted
  • target values for several of its constituents following extraction
  • goal is chmemical consistency w the hope of therapeutic consistency
32
Q
  1. Herbal remedies - extrinsic AEs.

Does the goal of chemical consistency means therapeutic consistency always work out? (2)

A

no

  • ie st john’s wort
  • > for years, this herbal med was standardized to its hypericin content but was never confirmed as the herb’s active ingredient
  • it is now known that hyperforin is the more potent inhibitor of neuronal 5HT uptake
33
Q
  1. Herbal remedies - extrinsic AEs.

How can herbal remedies become contaminated (3)?

A
  • Via pesticides, etc
  • note that consumption of excessive amounts of heavy metals, such as lead, mercury, and arsenic, pose serious health risks because they may accumulate in vital organs of the body.
34
Q
  1. Herbal remedies - extrinsic AEs.

Substitution is the 4th extrinsic AE. Explain how this could be a problem.

A

-you cannot just switch to another plant species that is close to the same.

35
Q
  1. Herbal remedies - extrinsic AEs.

Provide an example of substitution.

A

-ie Chinese fang chi can accidentally be switched for Aristolochia fangchi root.
>Chinese: used as agent to control BP, fever and pain, edema, eliminate stagnant bronchial mucous, and detoxify.
>Substituted (accidentally) to aristolochia fangchi root: nephrotox, carcinogenic, and mutagenic

36
Q
  1. Herbal remedies - extrinsic AEs.

Describe adulteration.

A
  • sometimes companies put in ACTUAL meds into a NATURAL product and then make claims (wo indicating that they added this to the product)
  • ie acet, caffeine, ccs, diazepam
37
Q
  1. Probiotics

Define.

A

-culture of live microbes that when ingested improves host’s intestinal microbial balance
>Non-pathogenic microbes
>Dose forms: capsules or supps
>Beneficial effect in Px & Tx of certain medical conditions.

38
Q
  1. Probiotics

Probiotics works by colonization resistance. Explain what that means.

A
  • limit the potentially harmful bact in the digestive tract

- supply enzymes or influence enzyme activity in GIT

39
Q
  1. Probiotics.

List the accepted criteria for use.

A
  • Indigenous to humans (already present in our gut)
  • Resistance to acidity and bile toxicity (survive stomach)
  • Adherence to human intestinal cells
  • Colonize in the human gut
  • Antagonism against pathogenic bacteria
  • Clinically proven health effects (dose-response data)
  • History of safe use in humans
40
Q
  1. Probiotics.

What is it used to Tx? List 3 examples.

A
  1. improve gut health
  2. reduce risk of colon cancer
  3. immune modulation
41
Q
  1. Probiotics.

Probiotics are used to improve gut health. Explain!

A
  • increase healthy bact
  • decrease pop of pathogenic microbes (using Lactobacillus rhamnosus GG, L. reuteri, Saccharomyces boulardii, Bifidobacteria sp.)
  • more commonly used to decrease diarrhea (try to get balance back btwn healthy and pathogenic bact)
42
Q
  1. Probiotics.

Probiotics are indicated to reduce the risk of colon cancer. Explain!

A

-alter metabolic activities of intestinal microflora, ie suppress bact enzymes such as β-glucuronidase&
nitroreductase, which increase the levels of procarcinogens
-alter the physico-chemical conds in colon to discourage growth of pro-carcinogenic microflora
-bind/degrade potential carcinogens, ie mutagenic pyrolyzates found in red meat
-enhance the host’s IR

43
Q
  1. Probiotics.

Probiotics are indicated to modulated the immune system. EXPLAIN.

A

-Lactobacillus acidophilus and Bifidobacterium bifidum augment humoral and cellular immunity

44
Q
  1. Probiotics.

What is the body’s most important immune function related organ?

A

intestine (60% of immune cells located here)

45
Q
  1. Probiotics.

Re: safety, list some issues to consider.

A
  • antibiotic resistance gene profile
  • production of antibiotic modifiers
  • pathogenic potential (should have demonstrated to be free of virulent factors and toxin production)
  • metabolic activities (no production of any byproducts or enzymes that may adversely affect human physiology)
46
Q
  1. Probiotics.

List 3 promising strains.

A
  1. Lactobacillus: acidophilus, johnsonii, casei, gasseri, plantarum, rhamnosus
    >most common: friendly bact found in guts; used in yogurt; used to treat AB-induced diarrhea
  2. Bifidobacterium: longum, breve, bifidum, infantis, lactis
  3. Enterococcus: faecalis, faecium
47
Q
  1. Probiotics.

List some efficacy considerations.

A

-min daily dose
-acid and bile stability
-intestinal mucosal adhesion properties
-viability through the product shelf life
>ie microtechnology-> trying to maintain the viability of the probiotics -> may be sensitive to heat, light, pH, moisture

48
Q
  1. Probiotics.

List the 2 goals of therapy.

A
  1. Healthy maintenance of intestinal microflora

2. Therapeutic

49
Q
  1. Probiotics.

State the dosing when the goal is to maintain a healthy intestinal microflora.

A

-depends on the extent of microbial depletion and the presence of harmful bacteria
-1-2 billion cfu viable organisms/day of L. acidophilus or B. lactis
(cfu=colony forming unit)

50
Q
  1. Probiotics.

State the dosing when the goal is therapeutics.

A

10-100 billion or higher

51
Q
  1. Others.

List 2 e.g. in this category.

A
  1. EFAs

2. AAs

52
Q
  1. Others.

Define EFAs.

A

-fatty acids that cannot be synthesized in the body (must be supplied through diet or supplement)

53
Q
  1. Others.

List the 2 cases of polyunsaturated FAs.

A
  1. Omega-6: linoleic acid (LA)

2. Omega-3: alpha-linolenic acid (ALA)

54
Q
  1. Others.
    T/F: All other fatty acids, including docosahexaneoic acid (DHA) and eicosapentaenoic acid (EPA), are considered derivatives
A

TRUE!

55
Q
  1. Others.

List 2 functions of EFAs.

A
  1. Components of cell membs that increase memb fluidity - cell memb function
  2. Proper function of the brain and nervous system
56
Q
  1. Others.

List the benefits of Omega-3s.

A
  • cdv benefits (anti-platelet aggregation, anti-inflam, pro-VD)
  • evidence used for/in hyperglycemia, depression, cancer, lupus, asthma, and rheumatoid arthritis
57
Q
  1. Others.

What ratio of LA:ALA is needed to reap the benefits of a dietary sup of EFAs?

A

<5:1.

58
Q
  1. Others.

The ratio of LA:ALA in a western diet, can be as high as?

A

30:1

59
Q 
6. Others.
List some food sources of:
1. ALA
2. EPA/DHA
3. LA
4. GLA
A
  1. ALA: flaxseeds, walnuts, canola oil
  2. EPA/DHA: fatty fish, fish oil
  3. LA: veg/plant oils, leafy veg, seeds, nuts
  4. GLA: evening primrose oil
60
Q
  1. Others.

List & define the 3 types of AAs.

A

1) essential: obtained from diet
2) nonessential: produced by liver enzymes
3) conditional: not essential except in times of stress

61
Q
  1. Others.

___ AAs are the most common essential AAs.

A

Branched!

-40% of the daily requirement of the essential amino acids

62
Q
  1. Others.

Branched aa - list benefits.

A
  1. Increase carbohydrate bioavailability in muscles &
    prevent muscle breakdown during rigorous exercise
  2. Reduce fatigue in both anaerobic and endurance sports
63
Q
  1. Others.

Branched aa - used to Tx?

A
  • Allow proper synthesis of proteins, energy source, preserve/restore muscle mass after surgery or trauma, cancer
  • Amyotrophic lateral sclerosis
  • Anorexia
  • Burn patients
  • Protein metabolism (in COPD patients)
  • Muscle fatigue and soreness
  • Exercise performance
  • Cirrhosis
  • Diabetes
64
Q
  1. Others.

Essential AAs - list rules.

A
  1. Arginine is essential for children up to 5 yrs old and the elderly (60+ yrs)
  2. Histidine is essential for children up to 5 yrs old
  3. Arginine is synthesized by the body but not at rates sufficient to support growth. Also, most arginine is cleaved to form urea.
  4. If cysteine is not adequately provided in the diet, then methionine is required in high amounts.
  5. If tyrosine is not adequately provided in the diet, then phenylalanine is required in high amounts.
65
Q
  1. Others.

List & define the 3 types of Pr sources.

A
  1. Complete: provides all essential AAs
  2. Incomplete: 1+ low in
  3. Complementary: 2+ incomplete sources together to provide adequate amount of EAAs.

AIII-Natural Health Products (19 decks)

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