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81 Cards in this Set
- Front
- Back
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How many Herbals and Supplements to know? Acronym?
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8
GGGGEMSS |
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What is GGGGEMSS?
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-Glucosamine + Chondroitin
-Ginkgo -Garlic -Ginseng -Echinacea -Melatonin -Saw palmetto -St. John's Wort |
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What are the 2 NON-herbal supplements? Why? What are the other 6?
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Nonherbals: Glucosamine + Chondroitin, melatonin - bc they are purified.
Rest: supplements/herbals |
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What does the FDA define botanicals and herbals as?
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Dietary supplements
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How are dietary supplements regulated?
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Different from foods and drugs
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What Can't dietary supplements claim to do for disease?
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-Treat
-Diagnose -Cure -Mitigate -Prevent |
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What CAN dietary supplements claim?
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-Health benefits
-Nutrient content -Structure/function on the BODY and ORGANS (not specific disease) |
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What doesn't have to be included on the labels of dietary supplements?
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Side effect warnings
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Do dietary supplements have to be proven to be safe or effective?
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-Safe yes
-Effective no |
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Are dietary supplements required to undergo safety review?
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no
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Do dietary supplement manufacturers have any content standardization to comply with?
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no
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So what is a major issue with herbals?
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They are highly variable!
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What are 2 potential issues with herbal dietary supplement quality/packaging?
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-Contamination
-Adulteration |
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What is contamination?
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Unintentional alteration of the herbal content by environmental and other factors
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What is adulteration?
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Adding other products to increase the product's activity - a lie
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What is Echinacea used for?
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Acute prevention of colds and other infections
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How is Echinacea proposed to prevent colds/infections?
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Boosts the immune system thru increased cytokine production
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What does the increased cytokine production result in?
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-Increased phagocytosis
-Activation of some lymphocytes |
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What is a toxic side effect of Echinacea?
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Hypersensitivity dt ragweed cross allergy
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What should NOT be done with echinacea?
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Should not be taken for longer than 6-8 weeks!
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What are 2 contraindications to taking echinacea?
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-Multiple sclerosis
-Autoimmune disease |
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With what drugs does Echinacea interact?
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Immunosuppressants (duh they have opposite goals)
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What are the 2 NON-herbal supplements? (acronym)
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Glucosamine + chondroitin
melatonin |
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Why are these considered NONherbal?
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They are purified
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What is Glucosamine + chondroitin used for?
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Moderate to severe osteoarthritis - increase cartilage production and strength
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How long does it take to see effects of Glucosamine + chondroitin?
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Weeks (it is not immediate)
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What are 2 side effects of Glucosamine + Chondroitin?
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-Minor GI effects
-Shellfish allergies |
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What is the source of Glucosamine + Chondroitin?
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Shells of lobster/crab/shrimp
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What is Echinacea used for?
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Acute prevention of colds and other infections
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How is Echinacea proposed to prevent colds/infections?
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Boosts the immune system thru increased cytokine production
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What does the increased cytokine production result in?
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-Increased phagocytosis
-Activation of some lymphocytes |
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What is a toxic side effect of Echinacea?
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Hypersensitivity dt ragweed cross allergy
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What should NOT be done with echinacea?
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Should not be taken for longer than 6-8 weeks!
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What are 2 contraindications to taking echinacea?
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-Multiple sclerosis
-Autoimmune disease |
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With what drugs does Echinacea interact?
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Immunosuppressants (duh they have opposite goals)
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What is Glucosamine + chondroitin used for?
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Moderate to severe osteoarthritis - increase cartilage production and strength
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How long does it take to see effects of Glucosamine + chondroitin?
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Weeks (it is not immediate)
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What are 2 side effects of Glucosamine + Chondroitin?
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-Minor GI effects
-Shellfish allergies |
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What is the source of Glucosamine + Chondroitin?
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Shells of lobster/crab/shrimp
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What is the M in GEMS?
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Melatonin
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What is the proposed active ingredient in melatonin?
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A serotonin derivative produced by the pineal gland
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What is Melatonin primarily used for?
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Regulating sleep-wake cycles as a sleep aid
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What are 2 other uses of melatonin?
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-Antioxidant
-Prevents aging |
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What is a side effect of melatonin?
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Minor next-day drowsiness
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What is a drug interaction of melatonin?
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Anti-depressents (melatonin promotes depression)
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What is the primary use of Saw palmetto?
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Treatment of symptoms of BPH
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Why might saw palmetto have an advantage over other drugs that treat BPH?
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It doesn't affect PSA levels so it can continue to be used for monitoring cancer risk.
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What are 3 mechanisms of saw palmetto?
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-Inhibits 5a-reductase
-Inhibits DHT binding to androgen receptors -Some a1-adrenergic blockade |
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What is Melatonin primarily used for?
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Regulating sleep-wake cycles as a sleep aid
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What are 2 other uses of melatonin?
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-Antioxidant
-Prevents aging |
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What is a side effect of melatonin?
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Minor next-day drowsiness
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What is a drug interaction of melatonin?
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Anti-depressents (melatonin promotes depression)
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What is the primary use of Saw palmetto?
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Treatment of symptoms of BPH
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Why might saw palmetto have an advantage over other drugs that treat BPH?
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It doesn't affect PSA levels so it can continue to be used for monitoring cancer risk.
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What are 3 mechanisms of saw palmetto?
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-Inhibits 5a-reductase
-Inhibits DHT binding to androgen receptors -Some a1-adrenergic blockade |
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What are the 2 uses and claimed benefits of Ginkgo?
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-Improves cognitive function and memory
-Relieves circulatory insufficiency |
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What is the proposed mechanism of how Ginkgo works?
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It stimulates release of endothelial-derived relaxing factor and PGI2 to vasodilate
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What are the 3 cardiovascular effects of Ginkgo?
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-Increased bloodflow
-Reduced blood viscosity -Enhanced tissue perfusion |
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What is a metabolic effect of ginkgo?
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Reduced free radical formation
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What are 4 DISADVANTAGES/side effects of ginko?
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-GI upset
-Headache -Allergic skin reactions -Anticoagulation |
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What should you make sure of if a person is going to have surgery?
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They stop taking Ginkgo before it due to its anticoagulative properties
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What can the seeds of Ginkgo do?
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Cause seizures by poisoning children
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With what drugs does Ginkgo interact?
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Anticoagulants
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How does Ginkgo interact with anticoagulants?
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Enhances the effects of them and antithrombotics
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What is St. John's wort's main clinical use?
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Treatment of mild to moderate depression
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What is the proposed mechanism for how St. John's wort treats depression?
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MAOI
and/or SSRI |
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Has any evidence shown that inhibition of MAO or Serotonin reuptake actually occurs with St. John's wort?
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no
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What are 4 toxic side effects of St. John's wort?
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-Photosensitivity rash
-Induction of CYP enzymes so many drug interactions -Fatigue -Abortifacent |
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So what is a contraindication to St. John's wort?
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Pregnancy
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What are 4 drug interactions seen with SJW?
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-Increased metabolism via upregulation of Cyp enzymes
-Antidepressants -Alcohol/narcotics -Tyramine |
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What is probably the best area that produces Ginseng?
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Wisconsin!
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Why does it matter what your source of Ginseng is?
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There are various products that are not equivalent in all respects.
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What are the proposed actions of Ginseng?
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-Energizing
-Mind-enhancing -Immunomodulating |
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What are Ginseng's 2 main uses?
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-Anti-stress
-Increased stregnth/stamina |
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What are 4 toxic side effects of Ginseng?
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-Nervous/excited
-Hypoglycemia -Hormonal effects -Inhibits Platelet aggregation |
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What can occur with long-term use of ginseng?
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Ginseng-abuse syndrome
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What are 4 drug interactions with Ginseng?
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-Diabetes drugs
-MAOIs -Anticoagulants/antiplatelets -Diuretics |
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What are the claimed benefits of GARLIC?
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-Reduces cholesteral and triglycerides
-Improves bloodflow via anti-platelet effects -Antiseptic and antibacterial |
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How do you give garlic for its antibacterial effects?
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Topically
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What are 3 side effects of garlic?
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-Gastric/oral/esophageal irritation
-Increased bleeding tendencies -Allergic reactions |
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What are 2 drug interactions with garlic?
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-Enhanced anticoag effects
-Antidiabetic drugs - there is a risk of hypoglycemia |
