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WRAP UP > PHARM_NUTRACEUTICALS > Flashcards

PHARM_NUTRACEUTICALS Flashcards

1
Q

what are the top 2 reasons why people take supplements?

A

weight loss & heart probz

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2
Q

what is the DSHEA act (1994)?

A

established GMP standards for the supplement industry; however it was 2007 when FDA issued final ruling

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3
Q

what is the dietary supplement and non-prescription drug consumer protection act (2006)?

A

says that manufacturers, packers, or distributors must report serious adverse events to FDA

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4
Q

who is responsible for making sure a supplement is safe before marketing?

A

manufacturer

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5
Q

who is responsible for making sure supplement is safe after it reaches the market?

A

FDA

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6
Q

what does the word standardized mean regarding supplements?

A

nothing, doesn’t indicate product quality

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7
Q

Just because a supplement is natural doesn’t make it __________

A

safe

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8
Q

what kind of claim can supplements make?

A
  1. firms can make statements about classic nutrient deficiency dzs-as long as the statements disclose prevalence of dz in USA (folic acid fixes neural tube defects) 2. makers can: describe supplement’s effect on structure or function or well being 3. product label: “not been evaluated by FDA…”
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9
Q

regarding surgical pts what are some herbs that can cause prolonged bleeding?

A
  1. garlic 2. ginkgo biloba 3. panax ginseng Note: stop supplements 2 wks before surgery
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10
Q

what kind of toxicity is assoc. with ephedra?

A

cardiotoxicity (arrhythmias, sudden cardiac death)

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11
Q

what is ephedra used for?

A

weight loss

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12
Q

name 1 herbs that have hepatotoxicity

A
  1. kava-kava
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13
Q

what is the intended use of kava-kava?

A

sleeping aid, anti-anxiety

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14
Q

what is the intended use of licorice?

A

peptic ulcer, flavoring agent

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15
Q

what is the toxicity assoc. w/ licorice?

A

pseudo-hyperaldosteronism

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16
Q

what is the metabolite of licorice that promotes salt and water retention by the kidney?

A

glycyrhizzin

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17
Q

describe some herbals affecting coagulation status?

A
  1. natural coumarin (celery, red clover, anise)
  2. natural salicylates (meadowsweet, poplar, willowbark)
  3. antiplatelet action (garlic, ginkgo biloba)
  4. hypocoagulability (capiscum) note: interaction w/ coag. cascade or w/ warfarin
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18
Q

which herbs inhibit CYP3A4 (2)?

A

bitter orange

echinacea (intestinal CYP3A4)

19
Q

which herbs inhibit CYP1A2 (2)?

A

Echinacea

ginkgo biloba

20
Q

Which herbs induce CYP3A4 (2) ?

A

St. john’s wort

Echinacea

21
Q

which herbs inhibit CYP2D6 (2)?

A

Ginseng

Ginkgo Biloba

22
Q

what are the 3 CYPs that St. John’s wort messes with?

A

Induces CYP1A2

Induces CYP3A4

Induces CYP2C9

23
Q

Name the 2 herbs that antagonize immunosuppressants like azathioprine, corticosteroids, cyclosorine, and tacrolimus?

A

Echinacea & Ginseng

24
Q

what is cranberry juice used for?

A

most effective in women with recurrent UTIs, females, kids

25
Q

what are some of the adverse effects of vitamin A supplements?

A

N/V, headache, dizziness, blurred vision, clumsiness, birth defects, liver probs, risk of osteoporosis note: exacerbated by high amounts of alcohol, hepatic dysfunction, high cholesterol

26
Q

what are the adverse effects of vitamin D supplements?

A

N/V, poor appetite, constipation, weakness, weight loss, confusion, heart arrhythmia, CaPO4 deposits in soft tissues

27
Q

which 2 fat soluble vitamins can antagonize warfarin?

A

Vitamin E or K

28
Q

do antioxidants work in preventing alzheimer’s dz?

A

No, The majority of antioxidants have limited success

29
Q

what are benefits of using omega-3 fatty acids fish oil, alpha-linoleic acid?

A

increased HDL & LDL decreased risk of 2nd MI + death from any cause -additive effects may be seen b/c of CV drugs:

—decreased risk of developing CV dz

—protection from cyclosporine tox.

—improvement in RA pts Also has decreased risk of dementia

30
Q

what are the benefits to using coenzyme Q10 (ubiquinone)?

A

Potent antioxidant: healthy muscle

HTN: lowers BP

IHD: increased HDL, better excercise tolerance

31
Q

coenzyme Q10 is structurally related to what anticoagulant?

A

warfarin

32
Q

melatonin levels are altered by what kinds of drugs?

A

NSAIDs

antidepressants

beta-adrenoceptor agonists & antag.

scopolamine

sodium valproate

33
Q

melatonin is metabolized by CYP1A2 and may intereact with what drug to cause decreased BP?

A

nifedipine

34
Q

what are the main adverse effects of melatonin?

A

decreased male/female fertility + decreased milk prod.

35
Q

what are the benefits of using beta-sitosterols?

A

decreased BPH symptoms and improved urine flow w/o shrinking prostate

36
Q

what are the benefits of using CoQ?

A

decreased BP where diet is deficient

37
Q

what are the benefits of using garlic?

A

decreased cholesterol

38
Q

what are the benefits of using ginseng?

A

decreased LDL

decreased BG

boost immune system & antimicrobials & enhance response to flu vaccine

39
Q

what are the shown benefits of melatonin?

A

decreases jet lag

40
Q

what are some of the natural supplements for mental health?

A
  1. folic acid (combine w/ anti-depressant)
  2. ginkgo biloba (slows decline, use as additive w/ AChE inhibitors)
  3. SAMe (as effective as older TCAs; boost effect of SSRIs)
  4. valerian: (useful for sleep/anxiety in ADHD kids)
  5. omega-3 FA: (boost effect of antidepressants; may trigger mania in bipolar disorder; use w/ mood stabilizer)
  6. st. john’s wort (works w/ mod. depression)
  7. Melatonin (improves sleep quality in schizophrenics, major depression & seasonal affective disorder)
41
Q

what are the sources and role of selenium?

A

brazil nuts; antioxidants preventing free radical damage

42
Q

what are the clinical effects of selenium ?

A

Cancer: some benefit in prostate, CRC, lung

HIV: selenium deficiency assoc. w/ reduced immune function

43
Q

what is the best place to get info on supplements?

A

national center for complementary and alternative medicine

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