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14 Onco > Nutritional Supplements and CA Treatment > Flashcards

Nutritional Supplements and CA Treatment Flashcards

1
Q

t/f natural is safe / better

A

false, most toxic substances occur naturally

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2
Q

t/f long term use is not proof that it works or that it’s safe

A

true, traditional medical systems did not have scientific methods

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3
Q

t/f megadosing antioxidants like vitamin c, beta carotene, and vitamin e are ok

A

false!! large doses of vitamins/ minerals are toxic

vit c can interfere with body’s ability to absorb copper
phosphorus can inhibit ca absorption

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4
Q

expected to satisfy needs of 50% of people in that age group based on rrl

A

estimated average requirements

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5
Q

the daily dietary intake levels of a nutrient considered sufficient by f&n board to met reqs of most people

A

recommended dietary allowance (computed from ear)

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6
Q

where no rda has been established, but amount established is somewhat less firmly believed to be adequate

A

adequate intake

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7
Q

to caution against excessive intake of nutrients that can be harmful in large amounts

A

tolerable upper intake levels

highest level of daily consumption with no side effects

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8
Q

vitamin c toxicity

A
  • > 2000 mg/day
  • well tolerated unless not absorbed or degraded into oxalate
  • oxalate nephrolithiasis
  • higher risk if iv form
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9
Q

vitamin a toxicity

A
  • does not lower cancer risk
  • long term use causes inc risk for lung ca in high risk individuals
  • hepatotoxicity
    (>600kU)
  • toxicity is associated with idiopathic intracranial hpn
  • skin manifestations: xerosis, pruritus, erythema, skin hyperfragility, desquamation
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10
Q

vitamin e toxicity

A
  • antioxidant but at megadoses
  • no prooxidant effects on ldl
  • production of a-tocopheroxyl radicals
  • antagonizes effects of vit k (>1000 IU/d) = bleeding
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11
Q

vitamin d and k toxicity

A

d: hypercalcemia
k: interfere with coumarin based anticoagulation (warfarin)

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12
Q

toxicity of vit b6, b3, b1

A

b6: neurotoxicity
(b1, b6, b12 protect nerves)

b3: hepatotoxicity
b1: lethargy and ataxia

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13
Q

zinc toxicity

A
  • gastric erosions
  • low hdl levels
  • impaired cellular immunity (but helps when normal levels)
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14
Q

iodine toxicity

A
  • hypothyroidism (wolff-chaikoff effect)
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15
Q

t/f it can’t hurt to take supplements with regular medicines

A

false, it can block or speed up absorption of drugs

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16
Q

t/f the fda wouldn’t let them make it if it wasn’t true

A

false, safety is up to the manufacturer

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17
Q

fda regulations

A
  • all prescription and non prescription drugs are regulated
  • dietary supplements are like special foods (no strict safety)
  • drugs are unsafe until proven safe
  • dietary supplements are considered safe until proven unsafe
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18
Q

problems with supplements

A
  • tainted with germs, pesticides, or toxic heavy chemicals
  • do not contain what is listed
  • contain different amount than listed
  • have ingredients that are not listed
19
Q

t/f people in chemo may be at higher risk for drug interactions if they take dieteary supplements

A

true

20
Q

grapefruit juice and st john’s wort

A

grapefruit juice: enzyme inhibitor = accumulates drugs

st john’s wort: enzyme inducer = faster clearance of chemo drugs

21
Q

t/f patients using antioxidants (vit a c e, carotenoids, coq10) were 41% more likely to have recurrence if they use before and during chemo

A

true

22
Q

herbs that can increase risk of bleeding

A

dang gui and botanicals

- should not use these herbs at least 2 weeks prior

23
Q

herbs that interfere with hormone therapy

A

red clover and soy = mildly estrogenic and can stimulate hormone sensitive cancers (tamoxifen)

24
Q

immunosupp and immunostim herbs

A

immunosupp: st john’s wort
immunostim: astragalus

25
Q

what is turmeric

A
  • to improve circulation and digestion
  • marketed for arthritis and cancer prevention
  • active constituent: curcumin
  • helps relieve adverse effects due to ca treatments
26
Q

consensus on turmeric

A
  • safe but antioxidant = can decrease side effects of chemo
  • interfere with cyp450
  • antiplatelet activity = bleeding, thrombocytopenia
27
Q

what is green tea

A
  • prevent hyperlipiedmia, hypertensioin, atherosclerosis, and cancer
  • active constituent: epigallocatechin 3 gallate: chemopreventive and can reduce myelodysplastic syndromes
28
Q

negative effects of green tea

A
  • can negate the therapeutic effect of bortezomib
  • increases risk of toxicity when used with tamoxifen and irinotecan
  • elevated risk of hepatotoxicity
  • interfere with cyp450
29
Q

what is ginger

A
  • for common cold, headache, fever, gi and inflammatory disorders
  • reduce nausea and vomiting
30
Q

side effects of ginger

A
  • for patients on warfarin, elevates risk of bleeding

- discontinue before op due to bleeding

31
Q

what is ashwagandha

A
  • relieve stress, anxiety, and fatigue
  • treat osteoarthritis and skin diseases
  • rejuvenate and improve endurance
  • active constituent: withanolides
32
Q

drug interactions of ashwagandha

A
  • potentiates sedative effects of triazolam
  • has antioxidant and antiplatelet properties
  • can alter cyp450 hepatic enzymes
33
Q

what is reishi mushroom

A
  • strengthen body, increase vitality, treat insomnia
  • enhance immune response in late ca
  • remission of hepatocellular ca
34
Q

drug interactions of reishi mushroom

A
  • antiplatelet effects = bleeding
  • antioxidant property
  • alter immune response
  • inhibit cyp450 = increase toxicity
35
Q

what is boston c

A

bullshit

36
Q

what is deer placenta

A
  • boost immune system
  • regenerate and repair damaged tissues
  • wakes dormant cells

UNAPPROVED AND MISLEADING!!

37
Q

what is moringa oleifera

A
  • promotes natural serum cholesterol
  • anti-inflammatory
  • fights many types of cancers

NO PROOF THAT MORINGA CAN FIGHT MANY TYPES OF CANCERS, GENOTOXIC

38
Q

what is laetrile (amygdalin or vitamin b17)

A
  • contains cyanide

- promoted to be alternative to cancer treatment

39
Q

what is noni juice

A
  • hepatotoxic, hyperkalemia

- should be avoided with chemo and radio

40
Q

what is active hexose correlated compound

A
  • shiitake mushrooms
  • improves immune function
  • can reduce the side effects of chemo (induces cyp450 2d6 = decrease activity of drugs)
41
Q

what is spirulina

A
  • modulate immune functiong and exhibit anti-inflammatory properties
42
Q

what are transfer factors

A
  • proteins with many molecules
  • antigen specific activity
  • can have immunomodulating capabilities
  • not enough evidence
43
Q

what are probiotics

A
  • daily use can protect from severe radio/chemo effects

- lower chance of responding to checkpoint inhibitor immunotherapy

44
Q

what is medical cannabis

A
  • thc = mental state
  • cbd = no high but sleepy, diarrhea, liver function
  • epidiolex for seizures for two rare and severe forms of epilepsy (lennox gestaut syndrome or dravet syndrome)

14 Onco (27 decks)

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