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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
what are some of the adverse effects of vitamin A supplements?
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
what are the adverse effects of vitamin D supplements?
N/V, poor appetite, constipation, weakness, weight loss, confusion, heart arrhythmia, CaPO4 deposits in soft tissues
27
which 2 fat soluble vitamins can antagonize warfarin?
Vitamin E or K
28
do antioxidants work in preventing alzheimer's dz?
No, The majority of antioxidants have limited success
29
what are benefits of using omega-3 fatty acids fish oil, alpha-linoleic acid?
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
what are the benefits to using coenzyme Q10 (ubiquinone)?
Potent antioxidant: healthy muscle HTN: lowers BP IHD: increased HDL, better excercise tolerance
31
coenzyme Q10 is structurally related to what anticoagulant?
warfarin
32
melatonin levels are altered by what kinds of drugs?
NSAIDs antidepressants beta-adrenoceptor agonists & antag. scopolamine sodium valproate
33
melatonin is metabolized by CYP1A2 and may intereact with what drug to cause decreased BP?
nifedipine
34
what are the main adverse effects of melatonin?
decreased male/female fertility + decreased milk prod.
35
what are the benefits of using beta-sitosterols?
decreased BPH symptoms and improved urine flow w/o shrinking prostate
36
what are the benefits of using CoQ?
decreased BP where diet is deficient
37
what are the benefits of using garlic?
decreased cholesterol
38
what are the benefits of using ginseng?
decreased LDL decreased BG boost immune system & antimicrobials & enhance response to flu vaccine
39
what are the shown benefits of melatonin?
decreases jet lag
40
what are some of the natural supplements for mental health?
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
what are the sources and role of selenium?
brazil nuts; antioxidants preventing free radical damage
42
what are the clinical effects of selenium ?
Cancer: some benefit in prostate, CRC, lung HIV: selenium deficiency assoc. w/ reduced immune function
43
what is the best place to get info on supplements?
national center for complementary and alternative medicine

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