Supplements in Metabolic Disease Flashcards
___ of patients didn’t report Integrative Health and Medicine (IHM) use to health care provider
72 %
_____ % of Adult American population that use IHM
33.2 %
Dietary Supplement and Health Education Act (DSHEA) 1994 states that the manufacturers of supplements are responsible for what 3 things?
1) Do not need to register or get FDA approval
2) Responsible to ensure product is safe
3) Ensure product label information is truthful and not misleading
what are the responsibilities of the FDA in terms of supplements
1) Takes action if product is unsafe once on the market
2) Monitors safety (ADR MedWatch reporting)
3) Monitors product information
what is the most used natural products by adult americans?
fish oil/omega 3
what are the adverse effects of fish oil/omega 3 supplements
Fish taste, GI upset, heartburn, and belching
what are the herb interactions with fish oil
(4 G’s) Garlic, Ginger, Ginkgo, and Ginseng
what is the MOA of fish oil
Decrease in hepatic secretion of VLDL-C, increase VLDL-C clearance, reduces TG transport
ω-3 fatty acids compete with arachidonic acid in the cyclooxygenase & lipoxygenase pathways
what should you monitor when a patient is taking Niacin supplements
Monitor: LFT’s due to Hepatotoxic risk
what is the mechanism of action of plant sterols
Inhibits about 50% intestinal absorption of cholesterol
what is the MOA of Plant Stanols
Inhibits dietary and biliary cholesterol
Plant Sterols & Stanols need to be taken for ____ to be effective
2-3 weeks
Certain products of red yeast rice contain about 10 mg of _______
HMG-CoA reductase inhibitors
name 3 drugs/supplements that can increase HDL-C
1) fibrates
2) Niacin
3) Statins
Patients will low _______ intake often gain more weight and have a higher BMI and maybe overweight or obese
calcium
_______ mg/daily dietary calcium had been shown to increase weight reduction & body fat loss
800-1200
what is the Mechanism of action of orlistat
Reversible inhibitor of pancreatic & gastric lipase
what population can benefit form orlistat
Drew B et al. 2007 meta-analysis review: patient with BMI ≥ 27 saw a significant reduction of weight loss ~ 3 % then diet alone
what is the MOA of chromium
Might reduce oxidative stress,
Low levels are associated with impaired glucose & insulin
______ found in food and supplements, while
_____ is used in welding industries and is carcinogenic
Chromium III,
Chromium VI
What is the MOA of Vanadium
Activates insulin receptor proteins, stimulates glucose oxidation & transport
Liver: stimulates glycogen synthesis
Adipose: inhibits lipolysis
Skeletal muscle: promotes glucose uptake
What is the MOA of Garlic
Allicin is the active ingredient
Inhibits hepatic cholesterol synthesis
Activates production of endothelium-derived relaxation factor to relax smooth muscle and vasodilation
what supplement should be Discontinued 2 - 3 weeks prior to surgery
Garlic
what is the indication for garlic supplements
Hypertension
what is the indications for coenzyme Q-10 supplements
Congestive heart failure
Preventing statin-induced myopathy
what is the Mechanism of action of Coenzyme Q-10
Has antioxidant properties to stop damage and give energy to cells
Cofactor in metabolic pathways
what evidence is there for the efficacy of Coenzyme Q-10
No evidence when taken as monotherapy, possibly useful with prescription treatment for HF
No significant benefit for myopathy or statin tolerability
which medications can lower Co Q 10 levels
Statins, beta blockers, and diuretics
Coenzyme Q-10 should be taken with ________
a fatty meal
