Tox: nutritional supplements Flashcards
Do manufacturers need to demonstrate safety, efficacy or quality of their products?
No (at least in the US)
Function of vitamins ADEK
Vit A: maintains growth and differentiation of epithelial cells.
Vit D: regulates calcium homeostasis
Vit E: functions as antioxidant (may be pre-oxidant/antagonize vit K)
Vit K: required for development of clotting factors
Sources of vitamin A
Liver, fish, cheese, whole milk
Symptoms of vitamin A deficeincy
Dry skin/hair, broken fingernails, inc risk of resp infections, diarrhea, nephrolithiasis.
Symptoms of vitamin A toxicity
HA, papilledema, photophobia, seizures, psychosis, n/v, abdo pain, liver injury, desquamation.
hypercarotenemia causes yellow-orange skin discoloration.
Blindness may be complication of both overdose and deficiency.
Sources of vitamin D
Cod liver oil, fatty fish, dairy products
Symptoms of vitamin D deficiency
rickets
Vitamin D toxicity causes….
Hypercalcemia, hyperphosphatemia
Sources of vitamin E
nuts, wheat germ, whole grain, vegetable/seed oils.
Symptoms of vitamin E deficiency
peripheral neuropathy, spinocellular syndrome
Symptoms of vitamin E toxicity
N/v/d, abdominal cramps, coagulopathy
Examples of agents used as athletic performance enhancers
anabolic steroids, peptide hormones/growth factors, hormone agonists/metabolic modulators, stimulants
Examples of peptide hormones/growth factors used as performance enhancers
Creatine: resynthesized ATP for use as short term energy burst during exercise.
Human growth hormone, insulin-like growth factor: stimulate protein synthesis.
Potential systemic complications of anabolic steroids
1) Onc: increased cancer risk
2) Cardiac: MI, VTE, sudden cardiac death
3) Derm: Acne, ?striae, gynecomastia
4) Endo: gynecomastia in men, menstrual irregularities, breast atrophy in women
5) Hepatic: peliosis hepatis (blood-filled sinuses in liver)
6) Infectious: immunosuppression
7) MSK: tendon and ligament rupture. Can cause AVN and osteoporosis with prolonged use.
8) Neuropsych: mood lability, aggression, psychosis, insomnia
Potential complications from peptide hormones/growth factors
1) Human GH/IGF –> myalgias, arthralgias, carpal tunnel syndrome, edema
2) Creatine: water retention, diarrhea.
Ma huang: uses, toxic component, symptoms
Aka ephedra.
Used to treatment asthma, nasal congestion, for weight loss.
Active components: ephedrine, pseudoephedrine.
AE: HA, dizziness, seizures, sympathomimmetic efects.
Gingko balboa: uses, toxic component, symptoms
Used for asthma, chillblains, as digestive aid, for ‘cerebral dysfunction.’
Active components: Ginkgolides, bilobalide.
AE: GI upset, HA, skin reaction. Can have antiplatelet effect.
Ginseng: uses, tox component, AE
Uses: increase metabolism, regulate BP, glucose. Aphrodisiac. Used for resp illnesses and as anti-inflammatory agent.
Active comp: Ginsenosides (panax, ginseng).
AE: Stimulant effect, HTN, hypoglycemia
What is saw palmetto used for? SE?
To tx BPH.
Is a 5-a-reductase inhibitor.
AE: diarrhea.
St john’s wort: uses, SE
Uses: anxiety, depression, gastritis, insomnia, promote healing.
SE: MAOI properties, +drug-drug interactions (is a CYP3A4 inducer).
