UWorld Ch 79 Dietary Supplements

Dietary Supplements

What is the term used by the FDA to describe herbals, vitamins, minerals, and many substances that are not plant-derived but exist in nature, such as glucosamine from shellfish?

Dietary Supplement Health and Education Act (DSHEA) of 1994

What regulates dietary supplements to ensure products are safe before they are marketed?

Manufacturer

According to DSHEA, what entity is responsible for ensuring product safety prior to release?

USP

What entity establishes standards for dietary supplements?

St. John's Wort

What supplement is known to decrease the level of other drugs (including oral contraceptives, transplant drugs, and warfarin), is serotonergic, can cause photosensitivity, and may lower seizure threshold?

Garlic, Ginger, Ginko, Ginseng, Glucosamine

What are the "5 G's" known to increase the risk of bleeding and should be discontinued in advance of surgery?

Willow bark

What supplement is a salicylate and, therefore, should not be used with anticoagulants due to an increased bleeding risk?

Hepatotoxicity

What adverse effect are the following natural products associated with?

Black cohosh

Kava

Chaparral, comfrey

Green tea "extracts"

Bitter orange

What natural product replaced ephedra following reports of cardiotoxicity, but is still associated with dose-dependent cardiac toxicity due to being a stimulant?

DMAA (dimethylamylamine)

What natural product is an amphetamine derivative commonly used in body building or performance-enhancement products, including powdered supplement mixtures, and causes cardiotoxicity?

Yohimbine

What natural product commonly used to increase libido and treat erectile dysfunction may increase heart rate and has a risk of causing seizures?

GRAS (generally recognized as safe)

What acronym is used by the FDA to label food additives as safe when used as intended and is a requirement for all ingredients in medical food?

Anxiety

What are the following supplements commonly used to treat?

Valerian

Passionflower

Kava

St. John's Wort

Chamomile

5-Hydrocytryptophan (5-HTP)

Cold Sores

What are the following supplements commonly used to treat?

L-Lysine

Colds and Flu

What are the following supplements commonly used to treat?

Echinacea

Zinc

Vitamin C (ascorbic acid)

Eucalyptus oil

Probiotics

Dementia/ Memory

What are the following supplements commonly used to treat?

Ginko

Vitamin E (alpha-tocopherol)

Vitamin D

Acetyl-L-carnitine

Vinpocetine

Depression

What are the following supplements commonly used to treat?

St. John's Wort

SAMe

5-HTP

Valerian

Diabetes

What are the following supplements commonly used to treat?

Alpha lipoic acid (neuropathy)

Chromium

Cassia cinnamon

Magnesium

American ginseng

Pan ginseng

Dyslipidemia

What are the following supplements commonly used to treat?

Red yeast rice

Omega-3 fatty acids

Garlic

Plant sterol

Fiber

Artichoke extract

Dyspepsia

What are the following supplements commonly used to treat?

Calcium

Magnesium

Peppermint

Chamomile

Energy/ Weight Loss

What are the following supplements commonly used to treat?

Bitter orange

Caffeine

Guarana, green tea powder

Garcinia cambogia

Erectile Dysfunction

What are the following supplements commonly used to treat?

Ginseng

L-arginine

Yohimbe

Heart Failure

What are the following supplements commonly used to treat?

Coenzyme Q10

Hawthorn

Omega-3 fatty acids

Hypertension

What are the following supplements commonly used to treat?

Omega-3 Fatty Acids

Garlic

Fiber

Potassium

GI Health

What are the following supplements commonly used to treat?

Fiber

Chamomile

Probiotics

Ginger

Peppermint

Horehound

Wheatgrass

Inflammation

What are the following supplements commonly used to treat?

Omega-3 Fatty Acids

Flax seeds/oil

Turmeric

Insomnia/Sleep

What are the following supplements commonly used to treat?

Melatonin

Valerian

Chamomile

Lemon balm

Passionflower

5-HTP and L-tryptophan

Liver Disease

What are the following supplements commonly used to treat?

Milk thistle

Menopause

What are the following supplements commonly used to treat?

Black cohosh

Dong quai

Evening primrose oil

Soy, red clover

Migraine Prophylaxis

What are the following supplements commonly used to treat?

Feverfew

Butterbur

Magnesium

Riboflavin (vitamin B12)

Coenzyme Q10

Guarana

Motion Sickness

What are the following supplements commonly used to treat?

Ginger

Peppermint

Osteoarthritis

What are the following supplements commonly used to treat?

Glucosamine

Chondroitin

SAMe

Turmeric

Osteoporosis

What are the following supplements commonly used to treat?

Calcium

Vitamin D

Soy

Ipriflavone

Prostate Health

What are the following supplements commonly used to treat?

Saw palmetto

Lycopene

Pygeum

Pumpkin seed

Tea tree oil

What supplement is commonly used to treat acne, dandruff, or fungal infections?

Aloe Vera

What supplement is commonly used to treat lichen plants, psoriasis, HSV, or burns?

Topical Vitamin D

What supplement is commonly used to treat psorasis or seborrheic keratosis (diaper rash)?

UTI

What are the following supplements commonly used to treat?

Cranberry

Yogurt

Probiotics

Serotonergic

What is the primary safety concern with 5-HTP, especially with other drugs with the same effect?

Beta Carotene

What supplement is most associated with an increased risk of lung cancer in smokers or asbestos exposure and increased cardiovascular mortality?

Bitter orange

What supplement is a stimulant and is, therefore, most associated with a dose-related increase in blood pressure, heart rate, and may cause arrhythmias?

Black cohosh

What supplement may be hepatotoxic and should not be used with medications for heart failure, including ACE inhibitors, ARBs, beta blockers, and amiodarone?

Chondroitin

What supplement has a bleeding risk at higher doses and can increase INR with warfarin?

Hawthorne

What supplement is a positive inotrope and should, therefore, be avoided with digoxin due to the additive effect of lowering blood pressure?

Probiotics

What supplements should use be separated from oral antibiotics due to a safety concern with the use of live bacteria in immunocompromised states?

SAMe

What supplement is serotonergic, has an increased risk of bleeding, and should not be used in bipolar disorder due to an increased risk of manic behavior?

400 mcg

How much dietary folate equivalents (DFE) should ALL women of childbearing age consume of folic acid?

600 mcg

How much DFE should women consume of folic acid during pregnancy?

Vitamin E

What supplement is NOT recommended for prevention of cardiovascular disease or cancer due to a lack of benefit in either condition and increased risk with more than 400 IU daily?

Thiamine (vitamin B1)

What supplement is commonly used in alcohol use disorder to prevent Wernicke's encephalopathy?

Magnesium, potassium

What two nutrients are commonly depleted with use of amphotericin B?

Calcium

What nutrient is commonly depleted with use of antiseizure medications (carbamazepine, lamotrigine, oxcarbazepine, phenobarbital/primidone, phenytoin, topiramate, valproic acid/divalproex, zonisamide)?

Vitamin B6

What nutrient is commonly depleted with use of isoniazid

Potassium

What nutrient is commonly depleted with use of loop diuretics?

Vitamin B12

What nutrient is commonly depleted with use of metformin?

Folate

What nutrient is commonly depleted with use of methotrexate?

Beta carotene, fat-soluble vitamins

What nutrients are commonly depleted with use of orlistat?

Magnesium, vitamin B12

What nutrients are commonly depleted with use of proton pump inhibitors?