Supplements

Question 1

St. John’s wart- mechanism

Answer 1

Inhibits metabolism/reuptake of serotonin, dopamine, epinephrine

Question 2

St. John’s Wart- effectiveness

Answer 2

No more effective than placebo for mild/mod depression

Question 3

St. John’s wart- limitations

Answer 3

• short duration
• did not use DSM criteria
• variable dose used
• comparative doses of Rx typically sub therapeutic
• allergic reactions and photosensitization
• drug interactions- strong inducer of CYP and p-glycoprotein

Question 4

Garlic- mechanism of action

Answer 4

• inhibits cholesterol synthesis
• effects plasma protein and cell membrane remodeling
• possible anti-hypertensive, lower LDLs
• anti platelet, andtithrombiotic and fibrinolytic activity

Question 5

Garlic recommendations

Answer 5

Useful for lowering cholesterol, probably safe, inexpensive, few side effects, must use high dose

Question 6

Glucosamine

Metabolized in/incorporated in/ distributed in

Answer 6

Metabolized in liver
incorporated into plasma proteins
Distributed in liver, kidneys, articular cartilage

Question 7

Chondroitin- distributed in

Answer 7

Various tissues, primarily cartilage

Question 8

Glucosamine effects

Answer 8

• In vitro anti-inflammatory activity, prevents breakdown of synovial structures
• distribute to joints, increase synthesis of hyaluronic acid

Question 9

Glucosamine chondroitin effects

Answer 9

• no benefit seen in short term
• moderate benefit in short term patients with mod to severe OA
• no long term benefits

Question 10

Glucosamine chondroitin contraindications

Answer 10

• pregnancy
• shellfish allergy
• diabetes/glucose intolerance
• CHF/renal impairment

Question 11

Glucosamine chondroitin drug interactions

Answer 11

Ace inhibitor
K sparing diuretics
Diabetic medications

Question 12

St. John’s wart- use

Answer 12

Mild to moderate depression