Flashcards in 1: Herbals and Supplements Deck (26):
1
difference b/w dietary supplement and a drug
dietary supplements:
-can't be sold as drugs
-can't say they are good for any disease state
-CAN say helps you relax/etc.
-can't patent
essentially don't have definitive proof for FDA
2
Dietary Supplement and Non-Rx Drug Consumer Protection Act (DSHEA)
-2006
-required manufacturer to report serious adverse effects
3
St. John's Wort - where found, uses
-perennial weed in USA, Europe, Asia (hypericum perforatum)
-for mild/moderate depression
-clinical studies show efficacy
4
St. John's Wort - active ingredients, mechanism, side effects
-active ingredients: hyperforin, hypericin
-induces CYP3A4, 2C9, P-gp
-AE: photosensitivity, reduced efficacy of some drugs (oral contraceptives!!)
5
Echinacea - uses, actions
-for common cold and flu
-immunostimulant - potential decreased Sx and duration
6
Echinacea - active ingredients, side effects, contraindications
-active: polysaccharides, chicoric acid, alkamides
-AE: minimal - GI upset, headache
-don't use in kids
-don't take more than 10d
-don't use in patients using immunosuppressants or with immunodeficiency/autoimmune diseases
7
Ginkgo - uses, actions
-proven for peripheral vascular disease
-unproven to prevent cognitive impairment or dementia
-antagonize platelet activating factor
-increase NO release
8
Ginkgo - active ingredients, side effects, contraindications
-flavone glycosides, terpenoids, antioxidants
-AE: headache, GI upset, some bleeding
-don't use with antiplatelet or anticoagulant drugs
-don't use for epileptics
9
Ginseng - uses, actions
-some evidence for preventing colds, cancer, and reducing postprandial blood glucose levels
-stimulates immune system
-antiplatelet activity
10
Ginseng - active ingredients, contraindications
-triterpenoids (ginsenosides)
-methylxanthines - caffeine like effect
-don't use with antipsychotics, estrogens, hypoglycemics, or anticoagulants
11
Garlic = allium sativum - uses, actions
-may reduce incidence of some cancers
-not proven to reduce LDL cholesterol
-anti-vampire
-antiplatelet, fibrinolytic, antioxidant
12
Garlic - active ingredients, contraindications
-contains organosulfur compounds including allicin
-don't co-administer with anticoagulants
13
Milk Thistle = silybum marianum - uses, actions
-some anti-inflammatory activities
-reduced leukotriene formation
-reduced leukocyte migration
14
Milk Thistle - side effects
-few AE or drug interactions reported
-no clear evidence for prevention of alcoholic liver cirrhosis or other hepatotoxicities
15
Red clover = trifolium pratense - uses, actions
-phytoestrogen
-may prevent hot flashes, osteoporosis, and CV disease
-may bind estrogen receptor and cause selective estrogen-mediating effects
16
Soy bean = glycine max - uses, actions
-phytoestrogen
-may prevent hot flashes, osteoporosis, and CV disease
-may bind estrogen receptor and cause selective estrogen-mediating effects
17
Saw palmetto = serenoa repens - uses, actions
-no clear evidence for improvement of symptoms of BPH
-phytosterols inhibit 5a reductase in vitro (enzyme that forms active form of testosterone)
18
Saw palmetto - side affects, contraindications
-low incidence of side effects
-no reported drug interactions
19
vitamin C supplement
-MDR based on deficiency symptoms
-high doses = immunostimulant, antioxidant
-regular supplementation decreases duration of colds
20
vitamin E supplement
-dangerous!
-claims cardioprotective over 800 IU/day
-meta-analysis showed increased death with 400 IU
-safe up to 130 IU/day
-MDR 30 IU/day
21
coQ 10 (ubiquinone) - uses, actions
-electron carrier in mitochondria of all tissues
-highest in heart, some in brain
-decreases with age
-used in therapy of mitochondrial disease (ex: Leigh's encephalomyopathy)
-some benefit in ischemic heart disease
22
coQ - side effects
-may increase bleeding with warfarin
23
Leigh's encephalomyopathy
-ataxia, decreased growth
-familial defect in coQ 10 synthesis
24
melatonin - uses, actions
-principal indoleamine in pineal gland
-synthesis controlled by light
-5 methoxy-N-acetyl tryptamine (lipid soluble)
-0.3 - 8 mg p.o. used as sleep aid and for jet lag
-metabolized by CYP1A2
25
melatonin - side effects, contraindications
-drowsiness and ataxia
-synergistic with alcohol
-may interfere with warfarin action
26