Lecture 5: Vitamins, Herbals and Minerals Flashcards

1
Q

Nonprescriptions Medications

A
  • Regulated by FDA Center for Drug Evaluation and research

- held to same standards as prescription medications as far as efficacy, labeling, purity, safety, and stability

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2
Q

Dietary Supplement Health and Education Act (DSHEA)

A
  • Products intended to supplement the diet

- contain at least one dietary ingredient ( amino acid, herb, mineral and/or vitamin

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3
Q

FDA requirements (Supplement Labeling)

A
  • Evidence of safety and good manufacturing practices
  • “Supplements facts”
  • Name of product and “dietary supplement”
  • Net quantity of contents
  • Manufacturers, packers, or distributor’s name and address
  • Directions of use
  • “supplement facts” panel
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4
Q

Dietary Supplement Labeling

A
  1. Serving Size
  2. List of Dietary Supplements
  3. Amount per Serving Size
  4. Percent of Daily Value
  5. Plant’s Scientific Name of Latin Binomial
  6. Specific Plant part used
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5
Q

Proprietary Blend Label

A

List of total weight of blend and individual component names in order or predominance

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6
Q

Dietary Supplement Claims

A
  1. Health Claim
  2. Nutrient Claim
  3. Structure-Function Claim
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7
Q

Health Claim

A
  • Relationship between a substance and resulting reduction in risk of disease or health-related condition
  • Requires FDA approval
  • Ex “ Diets low in sodium “may” reduce the risk of high blood pressure, a disease associated with many factors
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8
Q

Nutrient Claim

A
  • Relative amount of nutrient/ dietary substance in a product
  • Requires FDA approval
  • Ex “ fat free”, “reduced sodium”, “no added sugars”
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9
Q

Structure-Function Claim

A
  • Description of how a product may mantain the normal healthy structure of function of the body without discussing a specific disease state
  • Does not require FDA approval
  • Ex “ supports healthy cholesterol levels”, “promotes the body’s natural immune function
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10
Q

All claims state

A

“This product is not intended to diagnose, treat, cure, or prevent disease.”

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11
Q

Consumer Protection Act

A
  • Applies to dietary supplements and nonprescription drugs
  • Reporting of serious adverse effects to FDA
  • Manufacturing reporting (Manufacturers, packers, distributors)
  • Voluntary reporting (consumers, health care providers)
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12
Q

Counseling on Dietary Supplements

A
  • Only use for a limited amount of time
  • Inform doctors of dietary supplement use
  • FDA does not require data on efficacy or safety prior to marketing
  • Recommend : products with seal on label
  • large, reputable companies
  • maintain therapy with the same brand and formulation
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13
Q

Fat Soluble Vitamins

A

A,D, E

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14
Q

Water Soluble Vitamins

A

C, B12, B9

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15
Q

Minerals

A

Calcium, Magnesium and Iron

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16
Q

Herbal

A

St. John’s Wort, Glucosamine

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17
Q

Vitamin A Ingredients

A

Alpha-carotene, Beta-carotene, Retinol

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18
Q

Vitamin D Ingredients

A

Ergocalciferol (D2), Cholecalciferol (D3)

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19
Q

Vitamin E Ingredient

A

Alpha-tocopherol

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20
Q

Vitamin C Ingredient

A

Ascorbic Acid

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21
Q

Vitamin B12 Ingredient

A

Cyanocobalamin

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22
Q

Vitamin B9

A

Folic Acid

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23
Q

Calcium Compounds

A

various salts like carbonate, citrate, gluconate

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24
Q

Iron Compounds

A

various salts like fumarate, gluconate, sulfate

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25
Q

Magnesium Compounds

A

various salts like oxide, sulfate

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26
Q

Proposed uses for vitamin A

A

Skin disorders like acne and psoriasis, vision

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27
Q

Proposed uses for vitamin D

A

Bone formation and calcium regulation

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28
Q

Proposed uses for vitamin E

A

Cognitive decline (dementia) , eye disorders, heart disease

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29
Q

Proposed uses for vitamin C

A

Cold prophylaxis (prevention and treatment of common cold), wound healing

30
Q

Proposed uses for vitamin B12

A

Cardiovascular disease, fatigue (tiredness)

31
Q

Proposed uses of vitamin B9

A

Heart Disease, prevention of neural tube defects (severe birth defects that affect brain and spine)

32
Q

Proposed uses of calcium

A

Bone and teeth formation

33
Q

Proposed uses of iron

A

Red blood cell production

34
Q

Proposed uses of magnesium

A

Leg cramps and migraines

35
Q

Proposed uses for omega 3 fatty acids

A

Anti-inflammatory, cardiovascular disease, lowering cholesterol

36
Q

Proposed uses for St. John’s Wort

A

Anxiety and Depression

37
Q

Proposed uses for glucosamine

A

Osteoarthritis

38
Q

Adverse effects for vitamin A

A

Diarrhea, nausea, vomiting

39
Q

Adverse effects for vitamin D

A

Constipation, nausea, vomiting

40
Q

Adverse effects for vitamin E

A

Increased bleeding risk

41
Q

Adverse effects for vitamin C

A

Abdominal cramps, diarrhea, nausea, nephrolithiasis (kidney stones)

42
Q

Adverse effects for vitamin B12

A

Arthralgia (joint pain), dizziness, headache

43
Q

Adverse effects for vitamin B9

A

Anorexia, confusion, irritability, nausea

44
Q

Adverse effects of calcium

A
  1. Abdominal pain, constipation, flatulence (most common with calcium carbonate)
  2. Increased risk of nephrolithiasis (kidney stones)
45
Q

Adverse effects of iron

A

Black tarry stool, constipation, GI upset

46
Q

Adverse effects of magnesium

A

Diarrhea, nausea, vomiting

47
Q

Adverse effects of omega 3

A

Fishy aftertaste, upset stomach

48
Q

Adverse effects of St. John’s Wart

A

Agitation, dry mouth, insomnia/restlessness, vivid dreams

49
Q

Adverse effects of glucosamine

A

Headache, nausea, vomiting

50
Q

Vitamin A drug interactions

A
  1. . Orlistat - decreases vitamin A absorption
  2. Retinoids/Vitamin A derivatives
    - hypervitaminosis
51
Q

Vitamin D drug interactions

A
  1. Many anticonvulsants ( preventing seizures) - increased vitamin D metabolism
  2. Orlistat - decreased vitamin D absorption
52
Q

Vitamin E drug interactions

A
  1. anticoagulants and antiplatelets - increased bleeding risk
  2. Orlistat - decreased vitamin E absorption
53
Q

Vitamin C drug interactions

A

Iron - increases iron absorption

54
Q

Vitamin B12 drug interactions

A
  1. Antacids/H2 receptor antagonists/proton pump inhibitors - decreased vitamin B12 absorption
  2. metformin - decreased vitamin B12 absorption
55
Q

Vitamin B9 drug interactions

A

Anticonvulsants (anit-seizure)- decreased anticonvulsant levels

56
Q

Calcium drug interactions

A

Fluoroquinolone and tetracycline antibiotics - decreased absorption of these antibiotics

57
Q

Iron drug interactions

A
  1. Antacids/H2 receptor antagonists/proton pump inhibitors - decreased iron absorption
  2. Fluoroquinolone and tetracycline antibiotics - decreased absorption of these antibiotics
  3. Levothyroxine - decreased absorption of levothyroxine
58
Q

Magnesium drug interactions

A
  1. Fluoroquinolone and tetracycline antibiotics - decreased absorption of these antibiotics
  2. Levothyroxine - decreased absorption of levothyroxine
59
Q

Omega 3 drug interactions

A

NSAIDs and warfarin - increased risk of bleeding

60
Q

St. John’s Wort Drug Interactions

A
  1. ALL antidepressants - reduced efficacy of antidepressants (possible serotonin syndrome)
  2. Antiretrovirals (ART)- treats HIV- decreased levels of antiretrovirals
  3. Oral contraceptives - reduced levels of oral contraceptives
  4. Warfarin - may increase or decrease warfarin levels
61
Q

Glucosamine drug interactions

A

anti-diabetic drugs (controls blood glucose levels)- decreased effects of these agents

62
Q

Vitamin A counseling points

A

Avoid use in smokers (cancer) and excess vitamin A can have teratogenic ( cause or raise risk of birth effect)effects in pregnancy

63
Q

Vitamin D Counseling Points

A

The body forms some Vitamin D naturally when exposed to sunlight

64
Q

Vitamin E Counseling Points

A

Swallow capsule whole, do not crush, cut or chew

65
Q

Vitamin C Counseling Points

A
  1. May shorten the duration of the common cold and decrease symptom severity, but not proven to prevent colds.
  2. Take with food
66
Q

Vitamin B12 Counseling Points

A

May cause urine to be bright yellow

67
Q

Vitamin B9 Counseling Points

A

All women of childbearing age should take 400 mcg/day (higher doses in pregnancy) to prevent neural tube defects in newborns.

68
Q

Calcium Counseling Points

A
  1. Limit doses to no more than 500mg of elemental calcium

2. Take with food (calcium carbonate)

69
Q

Iron Counseling Points

A
  1. Keep out of reach of children (fatal)

2. Take on an empty stomach to increase absorption

70
Q

St. John’s Wort Counseling Points

A
  1. Do not use to self treat depression or other psychiatric issues
  2. Do not stop administration abruptly
  3. May take several weeks for therapeutic effect
71
Q

Glucosamine Counseling Points

A
  1. Use caution with shellfish allergy

2. Requires 4-6 weeks of treatment for benefits to be seen