Meds And Botanicals Flashcards
Onset & Duration Time for Insulins
Short: onset = 30-45 mins before eating; duration = 3-6 hrs
Rapid: onset = 5-15 mins before eating; duration = 4 hours
Long: onset = 2-4 hrs; duration = 18-24 hrs
Intermediate: onset = 2-4 hrs; duration = 10-16 hrs
How do sulfonylureas lower BG?
Increase insulin secretion from the pancreas
May lead to hypoglycemia and wt gain
How does metformin (Biguanides) lower BG?
Suppresses hepatic glucose production
preferred first line of treatment; take with food to prevent GI distress; check B12 levels; weight neutral so LOW RISK OF HYPOGLYCEMIA
How do SGLT2 inhibitors work to reduce BG?
Blocks a protein that returns glucose to the blood after it’s filtered through the kidney —> more glucose excreted in urine, less reabsorbed
good for pts with T2DM and CKD
How do DPP-4 inhibitors lower BG?
Allows endogenous GLP-1 to stay active longer so glucose released by liver overnight is reduced
often used with metformin
How does GLP-1 (ozempic) work?
Stimulates insulin secretion and suppresses glucagon secretion after eating
slows gastric emptying, promotes fullness
How does TZD work?
Increases insulin sensitivity in muscle
Side effects of corticosteroids?
Hyperglycemia, thin skin, HTN, bone fractures
What nutrients are decreased with oral contraceptives?
B6, b9, vitamin C
Side effects of mineral oil, cholestyramine?
Decreased absorption of fat and vitamins ADEK
Side effects of phos binders (Velphoro, Auryxia, Fosrenol, Sevelamer, Renvela)?
Auryxia: darker stool d/t iron
May develop upset stomach
Levodopa (L-Dopa): what is it used for? What does it interact with? How do you take it?
Parkinson’s disease
Interacts with: iron and protein rich foods; b6 and protein decrease it’s effectiveness
Take it: TID, in the am with limited protein at first. Over time/chronic, on an empty stomach
Colchicine: what is it used for? Side effects? What is it supplemented with?
Used for gout
Side effects: lower joint pain and swelling
Supplement with: B12
Isoniazid: what is it used for? Side effects? Interactions?
Used for TB
Side effects: peripheral neuropathy, depletes b6
Interactions:
Avoid red wine, aged cheese, dried meats and tuna
Interferes with vit D, Ca, Phos
Omeprazole: what is it? What’s it used for? How does it work? Side effects? What’s it supplemented with?
PPI (proton pump inhibitor)
Used for: ulcers, GERD. Suppresses secretion of stomach acid.
Side effects:
depletes Ca absorption —> osteoporosis
Causes H. Pylori infection
B12 and IF deficiency
Supplement with B12
Digoxin: what’s it used for? Side effects? Interactions?
Used for: arrhythmia treatment, increases rate of heart contractions by acting on Na/K ATPase pump
Side effects: hyperkalemia
Interactions: senna, St. John’s wort, licorice, salt substitutes, fiber
NRTI aka Retrovir: side effects?
Macrocytic anemia, B12, Cu, Zn deficiency
SSRIs aka Sertraline aka Zoloft: what’s it used for? Side effects? Interactions?
Antidepressant
Side effects: weight gain and sleep pattern disturbance with chronic use
Interactions: grapefruit juice
MAOIs: what’s it used for? Interactions?
Antidepressant
Eliminate TYRAMINE, dopamine and tryptophan
Avoid aged, fermented, dried, pickled, smoked, spoiled foods; hard aged cheese (cheddar, Swiss), sauerkraut, some sausages/luncheon meats, tofu, miso, Chianti wine, tomatoes, sour cream, yogurt, buttermilk
Elavil: what’s it used for? Side effects?
Antidepressant, sedative effect
Side effects: weight gain, increases appetite
Lithium carbonate: what’s it used for? Side effects? Interactions?
Used for bipolar and depression
Side effects: weight gain, increased appetite
Interactions: keep consistent sodium and caffeine intake to stabilize levels. Don’t eat too little sodium either.
Antibiotics: side effects? Interactions?
Side effects:
- protein deficits
- possible depletion of B12, Ca, Mg & vitamin K with prolonged use
Interactions: Calcium (taken with quinolones like ciprofloxacin may reduce the drug’s effectiveness)
Spironolactone: what’s it used for? Side effects?
Aldosterone agonist; Diuretic used for HF, HTN, hypokalemia and edema
Side effects: spares K, depletes Na and Cl
Thiazide diuretics: what’s it used for? Side effects?
Used for HTN, edema, ESRD, CHF
Side effects: decreases Mg, K and reabsorbs Ca
Loop diuretics: what’s it used for? Side effects?
Used for HF, ESRD, ESLD, HTN, and edema
Side effects: hypokalemia, thiamin, Mg, Ca and Na deficiency
Glucocorticoids: what’s it used for? Side effects? What’s it supplemented with?
Used to work against inflammation, immunosuppressant, asthma, bronchitis, rash and swelling
Side effects: protein deficits, HTN, weight gain and hyperglycemia. Leads to osteoporosis, Na and water retention with chronic use
Supplement with: Ca, vit D, B6
Marinol: what’s it used for? Side effects?
Appetite stimulant
Side effects: weight gain
Adderall: what’s it used for? Side effects? Interactions?
ADHD, narcolepsy, appetite suppressant
Side effects: anorexia, weight loss, nausea
Interactions: avoid acidic food/juice/vitamin C
Ritalin: what’s it used for? Side effects?
ADHD
Side effects: anorexia, weight loss, nausea
Cyclosporine: what’s it used for? Side effects? Interactions?
Immunosuppressant, RA, psoriasis
Side effects: HTN, hyperglycemia, hyperkalemia, HLD
Interactions: grapefruit juice, papaya juice, pineapple juice
Phenobarbital (Dilantin/phenytoin): what’s it used for? Side effects?
Anti-convulsive, sedative
Side effects: folic acid, vitamin K, b6, b12, vit D loss
Warfarin/Coumadin: what’s it used for? Interactions?
Anticoagulant
Interactions: ginger, ginseng, ginkgo biloba, garlic, grapefruit juice, glucosamine, vitamin A and E (fish oil), primrose, St. John’s wort, green tea, coQ 10
Methotrexate: what’s it used for? Side effects? Interactions?
Chemotherapy and RA
Side effects: folate deficiency, mouth sores, weight loss, N/V
Interactions: avoid high folate foods like beetroot juice; PPI meds like omeprazole
Orlistat: what’s it used for? Side effects? Interactions?
Used for weight loss, lipase inhibitor
Side effects: KEDA deficiency
Interactions: cyclosporine and warfarin
Statins: what’s it used for? Side effects? Interactions?
Lowers LDL and TG, increases HDL
Side effects: coq10 deficiency
Interactions: avoid grapefruit juice, avoid niacin
Black cohosh: use and potential interaction?
eases menopause symptoms
Interaction:
- may act as a blood thinner
- affects statins
Comfrey: use and potential interaction?
soothes nerves
Interaction: irreversible liver disease
Echinacea: use and potential interaction?
prevents, moderates cold symptoms
Interaction: avoid taking >2 months
Ephedra: use and potential interactions?
promotes weight loss
Interactions: rapid heart rate, headaches, very likely hazardous
Garlic: use and potential interactions?
may decrease cholesterol, BP
Interaction:
- reduces clotting time
- avoid use with warfarin
Ginger: use and interaction?
antiemetic
Interaction: avoid use with drugs that affect bleeding
Ginkgo biloba: use and potential interaction?
vasodilation
Interaction: avoid with warfarin
Ginseng: use and interaction?
immunity, endurance
Interaction: high BP, avoid use with warfarin
Kava: use and interaction?
relieve anxiety
Interaction: liver failure
What is the primary use of milk thistle?
may help protect the liver
St. John’s Wort: use and interaction?
antidepressants, serotonin enhancing
Interaction:
- reduces effect of warfarin
- avoid with antihypertensive, oral contraceptives, and some statins
Licorice root: use and interactions?
ulcers
Interaction:
- avoid combination with spironolactone, thiazide and loop diuretics AND hypertensives
Saw palmetto: use and interactions?
relieves symptoms of enlarged prostate
Interactions: diuretics
valerian root: use and interactions?
calms nerves
Interaction: avoid with liver disease
Yohimbe: use and interactions?
erectile dysfunction
Interaction: elevates BP