**Exam 1 Study Guide** Flashcards
(165 cards)
1
Q
define homeopathy
A
the idea that a disease can be cured by a substance that produces similar symptoms in healthy people
believes the lower the dose of med, the greater its effectiveness
2
Q
define naturopathy, who is it practiced by? (type of physician)
A
based on a combo of traditional practices and health care approaches and is practiced by naturopathic physicians
3
Q
what is ayervedic medicine?
A
ancient Indian medical system which relies on natural holistic approaches to physical and mental health
4
Q
examples of traditional Chinese medicine
A
acupuncture
tai chi
herbal products
5
Q
dietary supplements health and education act (DSHEA)
what did it do?
who is responsible for the supplements safety?
when must a supplement label be given to the FDA? (how many days)
A
excludes dietary supplements from being defined as “food additives”
safety of supplements is up to manufacturers, but proof is determined by FDA
supplement label must be given to FDA within 30 days of marketing
6
Q
8 steps in developing safe and effective botanical dietary supps
A
- search scientific literature
- acquire and authenticate plant material
- determine mechanisms of action and identify active compounds
- prep for preclinical and clinical studies
- investigate metabolism of active compounds
- test drug metabolizing enzymes and transporters
- develop formulation
- conduct phase 1 & 2 clinical trials
7
Q
what does cGMP stand for and what is it?
A
current Good Manufacturing Processes
An FDA requirement on producers of botanical dietary supplements
8
Q
what types of claims are permitted for dietary supplements?
is supporting data required by manufacturer for any claims?
What must every claim be accompanied with? (Hint: FDA)
A
health claims
structure/function claims
nutrient content claims
Yes
This statement has not been evaluated by the U.S. Food and Drug Administration (FDA). This product is not intended to diagnose,
treat, cure, or prevent any disease
9
Q
what dietary supplements are not allowed by DSHEA?
A
any supplement not already on U.S. market or commonly used
if it contains a drug approved by FDA
anything toxic or harmful
Any dietary supplement containing synthetic constituent(s)
10
Q
who regulates accurate labeling of dietary supplements?
A
The U.S. Federal Trade Commission (FTC)
11
Q
define complementary medicine
A
an uncommon practice (herb,drug,meditation,etc) used together with conventional medicine
12
Q
Which state banned yoga in 1993?
A
Alabama
13
Q
When was the ban on yoga lifted?
A
May 2021
14
Q
Who is more likely to see a chiropractor, men or women?
A
Women
15
Q
What did DSHEA define a dietary supplement as?
A
A product intended to supplement the diet that contains one or more of (a) Vitamin, (b) Mineral, (c) Herb/Botanical, (d) Amino acid (e) Supplement that increases total dietary intake
16
Q
what is the mission of the Office of Dietary Supplements (ODS)?
A
strengthen knowledge of supplements by educating the public through scientific research in order to enhance the quality of life and health for the U.S.
17
Q
T/F Aristolochia species is commonly in weight loss supplements in many countries?
A
False: It is toxic to humans and is banned
18
Q
How Can Accidental Contamination of Botanical
Dietary Supplements be Prevented? (2 Main practices)
A
Implement Good Agricultural Practices (GAP)
Implement Good Manufacturing Practices (GMP)
19
Q
What are mycotoxins?
How does it affect humans?
A
toxic compounds naturally produced by certain types of fungus
causes disease and death in humans
20
Q
What does cGMP not do?
A
Limit consumers’ access to products
Evaluate the safety of dietary supplement ingredients
Evaluate product efficacy
21
Q
Define a structure/function claim
A
describes the role of a nutrient or dietary ingredient intended to affect normal structure or function of the human body
22
Q
if a product treats/prevents a disease, can it be regulated as a dietary supplement?
Does this type of product violate DSHEA?
A
No
Yes
23
Q
If a supplement is not produced using cGMP, who has the right to remove it from the market?
A
The FDA
24
Q
Who can prosecute offenders of making a false label or advertising claim?
A
The federal trade commission (FTC)
25
T/F A supplement must be for oral consumption only according to DSHEA
True
26
Who reviews products on the market that are not dietary supplements after DSHEA was enacted?
NDI
27
What was PC-SPES?
| Why was it removed from market?
dietary supplement for men with prostate cancer
| reported to be adulterated with prescription-only drugs
28
How many warnings does the FDA give to a manufacturer and what can they do if compliance is not met?
2 warnings
| FDA may seize products and refer the case to the Department of Justice
29
What website is used to access dietary supplement product labels?
NIH Office of Dietary Supplements
30
Accurate labeling of dietary supplements is regulated by?
Federal Trade Commission (FTC)
31
What is the lead agency in the U.S. for scientific research on complementary and integrative health?
National Center for Complementary and Integrative Health (NCCIH)
32
Most B Vits function as? (inside your body)
co-enzymes
33
Vit B1:
Name?
function?
Involvement in Krebs cycle
Thiamin
helps metabolize macronutrients
required as a coenzyme in metabolism of carbs and proteins
plays a critical role in production of energy
34
What is the citric acid (Krebs) cycle?
metabolism in mitochondria that oxidizes acetyl compounds from food to make ATP
35
What foods contain Vit B1?
meat/meat subs
cereals & grains
fruit
36
ADME for Thiamin
A: active transport
D:50% skeletal muscle 50% other organ tissues
M: intestinal enzymes
E: high dose causes rapid urine excretion
** idk if we need to know half life
37
How does alcohol effect thiamin absorption?
impairs intestinal ability to absorb
38
name of disease from severe thiamin deficiency?
Beriberi
39
Negative outcomes of too much thiamin?
None
40
```
Vit B2:
Name?
Function?
its two primary coenzymes?
What is it a part of in the mitochondria?
```
Riboflavin
assists antioxidant enzymes, converts food to energy
FAD & FMN
electron xport chain
41
what foods contain Vit B2?
meat/meat subs
cereals & grains
dairy
veggies
42
ADME for Riboflavin
A: active xport
D: small amounts in liver, heart, kidneys
M: intestinal enzymes
E: urine excretion
43
Ariboflavinosis occurs when?
deficient in riboflavin
44
T/F low B2 impairs iron metabolism
True
45
Common symptoms of riboflavin deficiency?
```
skin disorders
hyperemia (excess blood)
edema of mouth and throat
hair loss
reproductive problems
```
46
Negative outcomes of too much riboflavin?
None
47
Vit B3:
Name?
Function?
Active forms?
Niacin
coenzyme for many redox rxns
NAD & NADP
48
what foods contain Vit B3?
Cereals & grains
meat/meat subs
veggies
49
ADME for Niacin
A:active xport and passive diffusion
D: all tissues as NAD
M: hydrolysis and conversion to NAD
E: urine excretion
50
disease from severe niacin deficiency
pellagra
51
Negative outcomes of too much Niacin?
flushing, itching, rashes, GI upset
52
Max dose of Niacin for adults?
35 mg/day
53
Vitamins 1,2,and 3 are required for what enzyme?
pyruvate dehydrogenase
54
NAD synthesis requires which two vitamins?
thiamin (B1) and riboflavin (B2)
55
Which forms of a supplement are typically better for more nutrients per serving?
lozenges, softgels, and tablets
56
which forms of a supplement are typically better if someone wants a pleasant experience from taking it?
chewables, gummies, powders
57
Recommended intake for calcium?
1000-1300 mg/day
58
Rank from least absorption to most absorption for compounds combined with magnesium:
Inorganic salts (magnesium oxide) -> Organic salts (magnesium citrate) -> chelates (magnesium glycinate)
59
name of the only organization recognized for verifying dietary supplements?
United States Pharmacopeia (USP)
60
Vit B5:
Name?
function?
Pantothenic Acid
| component of coenzyme A (CoA) in krebs cycle
61
What is CoA needed for? (fatty acids, amino acids, bioactive compounds)
beta-oxidation of fatty acids
oxidative degradation of amino acids
synthesis of bioactive compounds
62
what foods contain Vit B5?
meat
eggs
cereals & grains
certain veggies
63
ADME for Pantothenic Acid
A: active xport at low doses, passive diffusion at high doses
D: rapid uptake by blood cells to tissues
M: intestinal enzymes
E: hydrolyzed to pantothenate before urine excretion
64
disease from too little pantothenic acid?
pantothenate kinase-associated neurodegeneration (PKAN)
65
symptoms of pantothenic acid deficiency?
```
numbness
headache
fatigue
restlessness
irratibility
```
66
symptoms of too much pantothenic acid?
mild GI upset if over 10mg consumed in a day
67
Vit B7:
Name?
Function?
Biotin
| convert food to energy and makes glucose
68
5 essential carboxylases vit b7 is a co-factor for?
```
acetyl-coa carboxylase 1
acetyl-coa carboxylase 2
methylcrotonyl-carboxylase
propionyl-coa carboxylase
pyruvate carboxylase
```
69
what foods contain Vit B7?
cereals & grains
eggs
meat
veggies
70
ADME for Biotin
A: active xport
D: mostly stored in liver
M: protein bound biotin in stomach. intestinal enzymes
E: urine excretion
71
common symptoms for rare deficiency of Biotin
brittle nails
rashes
hair thinning/loss
depression, hallucinations
72
symptoms of too much biotin?
none
73
how can high levels of biotin interfere with medical testing?
can cause false high or low results
74
Humans lack which enzyme to synthesize vit C?
gulonolactone oxidase
75
foods containing vit C?
citrus fruits, brussels sprouts, broccoli, kiwi
76
Absorption of Vit C
sodium-dependent co-xporters
| secondary active transport
77
Other name for Vit C?
Ascorbic Acid
| Ascorbate
78
oxidized form of ascorbic acid?
dehydro-ascorbic acid
79
dehydro-ascorbic acid is xported by?
sodium-independent glucose xporters (GLUTs)
80
ascorbic acid in plasma is actively xported into cells by which xporters?
sodium-ascorbate co transporters SVCTs
81
ascorbate functions as a co-factor in what type of reactions? what does it maintain?
hydroxylation
| iron or copper
82
Examples of processes ascorbate is used in? (forms of synthesis/catabolism)
collagen synthesis
carnitine synthesis
tyrosine catabolism
neurotransmitter synthesis
83
what is alkaptonuria?
prevents the body from fully breaking down tyrosine and phenylalanine which results in an accumulation of homogentisic acid leading to painful joints
84
What is converted in collagen synthesis? (main compounds)
proline converts to hydroxyproline
85
What is converted in carnitine synthesis? (main compounds)
trimethyllysine converts to carnitine
86
What is converted in tyrosine catabolism? (main compounds)
two reactions:
| tyrosine converts to homogentisate which converts to maleylacetoacetate
87
What does Vit C help defend against?
cardiovascular disease
cataracts
cancer
colds
88
where is Vit C filtered? (nephron)
glomerular capsule
89
ascorbic acid breaks down into what other acids?
oxalic acid, threonic acid, and xylonic acid
90
why is high vit C intake dangerous? (which dangerous acid does it break down into and what can form as a result?)
vit c breaks down into oxalic acid which causes kidney stones to form
91
ascorbic acid enhances intestinal absorption of? (iron)
non-heme iron
92
T/F too much vitamin C can cause you to pee more?
True
93
T/F over 2g of vit C a day helps prevent disorders involving iron metabolism
False
94
Define polypharmacy
the use of 5 or more drugs
95
which age population of people is most susceptible to potential drug interactions?
Elderly
96
Which vitamin did we discuss in class that can cause impairment of micronutrient metabolism/ micronutrient synthesis?
Vit D
97
which class of drugs did we discuss in class that can increase intestinal/renal excretion?
diuretics
98
what common OTC drug class did we discuss in class that can impair absorption/bioavailability?
antacids
99
which amino acid did we discuss in class can disrupt metabolism? (cause metabolic dysfunction)
homocysteine
100
T/F iron or folic acid supplements should be separated by 2 hours
True
101
T/F proton-pump inhibitors and histamine-2 receptor antagonists have been associated with Vit B12 malabsorption and deficiency
True
102
if antacids are used long-term, how does this effect calcium absorption in the gut? what can malabsorption of calcium lead to?
antacids make the GI more basic, thus decreasing the solubility and absorption of calcium since it requires an acidic environment for absorption.
dec absorption of calcium will lead to dec. bone mineral density
103
Which diet is a concern for calcium content, especially if someone is taking a proton-pump inhibitor (PPI)
vegan
104
if antacids are used long-term, how does this affect iron absorption in the gut?
gastric acid is needed for iron absorption, thus dec gastric acid production could dec iron absorption
105
which prescription drug decreases vit B12 absorption from food?
Colchicine
106
which drug-nutrient interaction can lead to a hemorrhagic event?
warfarin and vit K
107
T/F pts should consume the same amount of vit K in their diet while taking warfarin
True
108
what is vit C an inhibitor of which allows it to counteract cancer?
hypoxia-induced factor-1 (HIF-1)
109
what is the goal of supplementing folic acid with pts taking methotrexate?
reduce adverse rxs to methotrexate treatment
110
T/F individuals with obesity who undergo bariatric surgery end up having less complications with malabsorption
False, they are at an inc risk of malabsorption
111
Vit B6
Name?
function?
Pyridoxine
| heavily involved in enzyme rxns for protein metabolism
112
enzymatic processes that require B6 include?
releasing glucose from stored glycogen
making glucose from amino acids
synthesis of heme
113
foods containing vit b6?
meat
cereals & grains
fruits
spinach
114
ADME Pyridoxine
A: passive diffusion
D: binds to albumin, goes to muscle and liver
M: intestinal enzymes
E: urine excretion
115
common symptoms of pyridoxine deficiency
confusion
dermatitis
epileptic convulsions
microlytic anemia
116
who's at risk of pyridoxine deficiency?
alcoholics
autoimmune disorder
impaired renal function
117
too much pyridoxine?
high doses can cause sensory neuropathy
118
Vit B9
Name? (2, difference between them?)
Function?
Folate: natural form in food and body
folic acid: supplemental form
DNA synthesis, cell growth and repair
prevents neural tube defects
119
DNA synthesis is dependent on? (Vit B9)
folate coenzymes
120
folate is required to make __________ which controls gene expression
S-adenosylmethionine (SAM)
121
Is folate beneficial during pregnancy?
Yes
122
Why is folate beneficial for depression? (what does it synthesize and what does the thing synthesized do?)
neurotransmitters, increases serotonin, norepinephrine, and dopamine
123
Foods containing folate?
beans & lentils
cereals & grains
Broccoli, spinach
124
ADME folate
A: active xport at normal dose, passive diffusion at high dose
D: liver before circulation
M: intestinal enzymes hydrolyze folates
E: most secreted folates is reabsorbed
125
who is at risk of folate deficiency?
pregnant women/ childbearing age
126
common symptoms of folate deficiency?
changes in skin, hair, fingernail color
GI issues
oral/tongue sores
Megaloblastic Anemia
127
too much folate?
high doses can mask vit b12 deficiency which could result in neurological damage
128
Vitamin B12
Name?
Function?
Cobalamin
makes red blood cells
required for nerve function
works with folate to make methionine from homocysteine
129
since vt B12 and B9 convert methionine from homocysteine, what is methionine needed for to make which is needed for dna methylation?
S-adenosylmethionine (SAM)
130
Vit B12 is needed to make which enzyme?
succinyl-CoA
131
what does the enzyme succinyl-CoA do?
produces energy from fat and protein and synthesizes hemoglobin
132
Why is vit b12 important in regulating hemoglobin?
because it helps make succinyl-CoA which synthesizes hemoglobin
133
foods containing cobalamin?
eggs
milk & dairy
meat
134
ADME Cobalamin
A: active xport
D: 50% liver, 50% other tissues
M: transported bound to proteins
E: urine excretion
135
whos at risk of cobalamin deficiency?
elderly
| vegans/vegetarians
136
common symptoms of cobalamin deficiency?
```
megaloblastic anemia
neurological disorders
fatigue
weakness
constipation
loss of appetite
weight loss
```
137
too much cobalamin?
nothing
138
Some diagnostic lab tests may show false results in presence of elevated vitamin C due to an interaction with this molecule
H2O2 (hydrogen peroxide)
139
These four vitamins are legally mandated as food supplements due to their importance in this role
B1, B2, B3, B9
| Pregnancy, fetal development, neural development
140
Prolonged use of this drug class is correlated with B12 malabsorption
Antacids/ PPIs & H2RAs
141
Methotrexate inhibits the conversion of ______ to THF
Dihydrofolate
142
B vitamins important for the Krebs Cycle?
B1, B2, B3, B5, B7
143
B vitamins important for One Carbon Metabolism
B6, B9, B12
144
which B vits can cause hyperemia?
B6, B9, B12, B2
145
Which B Vit helps protect against neural tube defects?
B9
146
acute beriberi in infants is caused by ________ and is characterized by ________
thiamin deficiency
| acidosis due to conversion of pyruvate into lactic acid
147
wernicke-korsakoff syndrome is associated with?
thiamin deficiency
148
what symptom can excessive vit b12 cause?
acne
149
patients on methotrexate should not take supplemental _____?
Vit B9
150
thiamin's role in health?
Alzheimer's
diabetes
heart failure
151
riboflavin role in health?
early development
eyes
migraines
152
ariboflavinosis resembles what other disease/deficiency?
pellagra and vit b6 deficiency
153
niacin role in health?
cardiovascular health
| skin
154
symptoms of pellagra include:
dermatitis
diarrhea
dementia
155
pantothenic acid role in health?
heart health
| wound healing
156
biotin role in health?
early development
| hair, skin, nails
157
whats a major concern of high levels of biotin? (false low for what?)
troponin
158
which B vitamins play a role in the electron transport chain?
B2, B3, B5
159
what is the metabolically active form of folic acid?
5-methyltetrahydrofolate (5-MTHF)
160
What are the forms of cobalamin?
cyanocobalamin
methylcobalamin
hydroxycobalamin
adenosylcobalamin
161
one carbon metabolism role on health?
cancer
cardiovascular health
cognition
162
T/F plasma B12 is associated with a higher risk of breast cancer
true
163
does vitamin B6 reduce cancer risk?
yes
164
pyridoxine role in health?
immune system support
| nervous system function
165
folate role in health?
early development
| mental wellness
