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Nutraceuticals Flashcards

1
Q

Which is more common: supplements or vitamins?

A

supplement use is much more common than vitamin. Women are more likely to take than men

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2
Q

What is most common reason for taking a supplement?

A

weight loss and heart problems equal. Followed by digestion, pain and allergies

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3
Q

What is DSHEA?

A

established standards for supplement industry. Pretty lax rules of self-regulation. If adverse effects occur, must report to FDA

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4
Q

What kind of ADE do kava-kava and comfrey have?

A

serious liver damage

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5
Q

Are supplments regulated by FDA?

A

only if there is an adverse effect. Otherwise no.

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6
Q

Are supplements required to be standardized in US?

A

no. no legal or regulatory definition exists in US. Even if label says standardized, doesnt mean it’s quality

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7
Q

Do nutritional support statments on packages need FDA approval? Do health claims?

A

no.

Health claims do however need approval.

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8
Q

What is the general rule for surgery and supplements?

A

stop them 2 weeks ahead of surgeries

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9
Q

Are most people willing to disclose supplement use?

A

Yes. 92% are but ONLY if asked

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10
Q

What is ephedra for and what is its possible toxicity?

A

for weight loss.

Cardiovascular toxicity

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11
Q

What is kava-kava for and what is its possible toxicity?

A

sleeping aid/antianxiety.

hepatotoxicity

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12
Q

Which herbals are natural salicylates?

A

WILLOWBARK

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13
Q

What is licorice for and what is its possible toxicity?

A

peptic ulcer, flavoring agent.

Psuedo-hyper aldosteronism

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14
Q

How does licorice cause pseudo-hyperaldosteronism?

A

it is metabolized to glycrhizzin, which promotes salt and water retention by kidney. Occurs despite normal aldosterone levels.

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15
Q

Which herbals have antiplatelet function?

A

garlic, ginkgo biloba

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16
Q

What can bitter orange do to CYP?

A

inhibit CYP3A4

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17
Q

What can echinacea do to CYP?

A

Inhibit CYP1A2, inhibit ntestinal 3A4, and induce normal CYP3A4

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18
Q

What can ginkgo biloba do to CYP?

A

INhbiit CYP1A2 and 2D6

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19
Q

What can ginseng do to CYP?

A

inhibit CYP 2D6

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20
Q

What can st. John’s wort do to CYPs?

A

induce CYP 1A2, 3A4, and 2C9

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21
Q

Which common drugs rely on CYP1A2?

A

duloxetine, fluvoxamine, frovatriptan, mexiletine, olanzapine, ropinirole, tacrine, tizanidine, zileuton

22
Q

Which common drugs rely on CYP2D6?

A

amitriptyline, codeine, desipramine, dextromethorphan, metorolol, oxycodone, tamoxifen, timolol

23
Q

Which common drugs rely on CYP3A4?

A

verapamil, cyclosporine, protease inhibitors, midazolam, simvastatin, atorvastatin, tacrolimus, tamoxifem, triazolam

24
Q

Which common drugs rely on CYP2C9

A

ARBs, NSAIDs, oral hypoglycemics and warfarin

25
Q

What are the interactions of echinacea and Ginseng?

A

antagonize immunosuppressants like azathioprine, corticosteroids, cyclosporine and tacrolimus

26
Q

What are the interactions of pomegranate juice?

A

effective for treating prostatic cancer. increase in mean PSA doubling time (15 months to 54 months) Good thing.
Inhbiits CYP3A4 and can cause rhabodmylysis with statins

27
Q

What can taking > 1 g of Vit C per day for many months cause?

A

oxalate crystal deposition causing tubulointerstitial nephritis, predominantly in distal tubules

28
Q

What can excessive vitamin A cause?

A

N/V, headache, dizziness, blurred vision, clumsiness, birth defects, liver problems, osteoporosis

29
Q

What can excessive vitamin D levels cause?

A

N/V, poor appetite, constipation, weight loss, constipation, weakness, weight loss, confusion, arrhythmia, Ca and P deposits in soft tissues

30
Q

What can excessive vitamin E or K do?

A

antagonize warfarin anticoagulant

31
Q

Is there evidence that multivitamins are helpful?

A

no

32
Q

Is there evidence that Coenzyme Q10 or melatonin can help prevent alzeimers by antioxidation?

A

no

33
Q

Is there evidence omega-3 fatty acids help?

A

yes. they decrease BP. Increase HDL and LDL (not good) and decrease risk of MI and dementia

34
Q

What does Coenzyme Q10 (ubiquinone) do?

A

potent antioxidant. Lowers both systolic and diastolic BP. Improves HDL and exercise tolerance. Prevents statin-induced myopathy.
Can reduce warfarin activity though.

35
Q

What does melatonin do?

A

serotonin derivative produced in pineal gland.
Useful for resetting jet-lag. Prescription form = ramelteon used for insomnia.
metabolized by CYP 1A2. May interact with Nifedipine.
Can cause psychosis and antagonise SSRIs.
Decreases M/F fertility and breast milk production.

36
Q

What do beta-sitosterols do?

A

good evidence that they decrease BPH symptoms without shrinking prostate

37
Q

What does echinacia do?

A

no evidence for therapy

38
Q

Where is zinc found and what does it do?

A

beef, fish, spinach. Important cofactor for many enzymes, including SOD involved in protein and carb metabolism. Increases healing of gastric ulcers.

39
Q

What does garlic do?

A

evidence that it lowers cholesterol

40
Q

What does ginseng do?

A

MAY provide benefit for CV. Decreases LDL and blood sugar, boost immune system and antimicrobial agents. Enhances response to flu vaccine

41
Q

Which supplement is good for jet lag?

A

melatonin

42
Q

What natural supplement is good to combine with antidepressants?

A

folic acid
OR
omega3FA boosts effectivness but may trigger mania in bipolar

43
Q

What supplement can be given with AchE inhibitors like donepezil?

A

Ginkgo Biloba

44
Q

What supplement can be given as a sleep aid in children with ADHD?

A

valerian

45
Q

What supplment works for mild depression?

A

St. John’s wort

46
Q

What mineral should be supplmented in HIV patients?

A

selenium

47
Q

What mineral should be supplemented in 3rd world childhood diarrhea?

A

zinc

48
Q

What mineral can interact with BBs, insulin or NSAIDs?

A

chromium can enhance them or these drugs can increase chromium’s absorption

49
Q

Where is chromium obtained and what does it do?

A

broccoli. Enhances insulin, carb fat and protein metabolism

50
Q

Where is selenium found and what does it do?

A

brazil nuts. Important for antioxidant

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