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Natural Products > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

NHPs used for RA

A

omega 3 fatty acids

gamma linolenic acid

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2
Q

NHPs used for osteoarthritis

A 
glucosamine
chondroitin 
turmeric 
MSM
SAMe
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3
Q

cause of RA

A

autoimmune
IS attacks joint tissue and over time cartilage and bone is damaged
parts that support the joints are weakened +

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4
Q

joints affected in RA

A

fingers and wrist

symmetrical

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5
Q

cause of OA

A

wear and tear

age or overuse of a joint causes top layer of cartilage to break down bones rub together

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6
Q

joints affected in OA

A 
hands
knees
hips
spine
not symmetrical
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7
Q

which one has more inflammation

A

RA

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8
Q

why isnt thunder god vine used

A

serious side effects

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9
Q

sources of omega 3 fatty acid

A

krill oil
algae
new zealand green lipped mussel

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10
Q

why might omega3 help with inflammation

A

DHA and EPA can make resolvins which help resolve inflammation

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11
Q

what is gamma linolenic acid found in

drug they interact with…

A

borage oil
black currant
evening primose oil

warfarin

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12
Q

rationale for gamma linolenic acid

A

if give extra may make some antiinflammatory prostaglandins instead of inflammatory

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13
Q

overall evidence for RA

A

no complementary medicines have demostrated efficacy

few have been suficiently tested using RCTs

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14
Q

glucosamine MOA

A

precursor to glycosaminoglycans and proteoglycans that make up articular cartilage
over time these levels get lower in the body

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15
Q

what might the efficacy of glucosamine depend on

A

which salt it is non studies on which one is better

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16
Q

what were the results for the joints on glucosamine study

A

no evidence of structural benefits vs placebo

no reduction in pain vs placebo

17
Q

contraidications to glucosamine

A

shellfish allergy - bioproduct of the seafood industry
diabetes- its a sugar
avoid in pregnancy
asthma
not studied in renal or hepatic impairment

18
Q

side effects of glucosamine

A

GI discomfort

19
Q

drug interactions for glucoamine

A

warfarin increases INR

20
Q

what is chondroitin

A

polymer isolated from animal sources

glycosaminoglycan

21
Q

chondroitin MOA

A

may prevent cartilage metabolism

22
Q

chondroitin drug interactions

A

may prolong bleeding times due to structural similarity to heparin

23
Q

results of the glucosamine/chondroitin arthritis intervention trial

A

celecoxib was heardly better than placebo everything else below
rate of response was better for moderate-severe pain

24
Q

collagen MOA - RA

A

inducing oral tolerance to reduce activity of t cells that release joint destroying factors

25
Q

why is there insufficient evidence for hyaluronic acid

A

evidence for when given by intra articular injections - not a NHP

26
Q

how does curcuma longa turmeric work

A

reduce inflammation by inhibiting cox2 prostaglandins leukotrienes and other cytokines involved in proinflammatory signalling pathways

27
Q

curcumin contraindication

A

can reduce levels of blood glucose and glycosylated hemoglobin in diabetes

28
Q

how much cetylated fatty acids- celedrin work

A

inhibit cox and 5 lipoxygenase

joint lubricant

29
Q

methylsulfonylmethane possible MOA

A

inhibit degenerative changes in joints

scavenge hydroxyl free radicals which trigger inflammation

30
Q

SAMe CI

A

taking antidepressants hepatotoxic drugs MAOIs

bipolar manic depression or hyperhomocysteinemia

31
Q

adverse effect of SAMe

A

dont take at night may cuase anxiety restlessness and insomnia

32
Q

what is all in eggshell membrane

A

collagen
glucosamine
chondroitin
hyaluronic acid

33
Q

a few tips for pharmacists

A

changing brand may affect benefit
recommend only one new NHP at a time to better assess benefit or reactions
new NHP should be tried for at least 2 months before assessing benefit

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