MSK Pharm 2 Flashcards
What’s Bromelain?
proteolytic enzyme in pineapple
Is Bromelain successful?
questionable if we can achieve adequate plasma levels to be beneficial
Which bromelain at 2 tablets tid appeared to be as effective as diclofenac 50 mg tid for OA?
Phlogenzym
What’s cat’s claw?
freeze-dried extract
What’ does cat’s claw help with?
possibly reduces pain with exertion but not at rest
What’s Devils claw?
harpagoside is the primary glycoside attributed to anti-inflammatory effects
Is Devil’s claw effective?
50-100 mg harpagoside formulation QD appeared equally effective to vioxx
What’s the deal with l-tryptophan and 5-HTP?
linked to eosinophilia-myalgia syndrome and several deaths resulted
What’s stinging nettle used for?
allergic rhinitis; some add to NSAID regimen for OA
What’s the active constituent of tumeric?
curcumin
What tumeric product may improve pain and function in OA?
Meriva 500 mg
What may tumeric help with?
OA and maybe RA
What are some SE of tumeric?
AV block with high dose; may decrease blood sugar; anti-platelet effects
What’s the deal with Willow bark?
converted to salicylic acid in vivo
Is acetyl-l-carnitine helpful?
doses of 1000 mg bid-tid significantly reduced diabetic neuropathic pain
Is alpha-lipoic acid (ALA) helpful?
600 mg-1800 mg qd for 3-5 weeks decreases neuropathy symptoms
SE of alpha-lipoic acid?
GI upset and HA
How long does it take for capsaicin to work?
3 days of multiple applications
What does capsaicin do?
inhibits and depletes substance P
What is SAMe used for?
improving symptoms of OA, possibly mildly effective in depression, fibromyalgia
Which SAMe has the greatest bioavailability?
Butanedisulfonate salt
What’s the issue with SAMe?
poor quality with little active ingredient on the marker; very expensive
What’s glucosamine used for?
treatment of OA pain
How does glucosamine work?
increases production of synovial fluid, repair of damaged tissue, new cartilage synthesis
Patients taking glucosamine up to 3 years have shown?
significant improvement as well as over 50% reduction in risk of OA progression
What brand is most researched for glucosamine?
DONA
What maybe added to glucosamine products?
chondroitin and manganese
What joint is most of the research for glucosamine for?
knees
Does glucosamine impact blood sugar?
no
