Dietary Supplements and Natural Products (Laux)

___________________ medicine is bringing conventional and complementary approaches together

Integrative

_______________ is the idea that "like cures like"

Homeopathy

______________ __________________ are products used to supplement the diet, which contains one or more of a vitamin, mineral, herb, or botanical

Dietary supplements

True or False: dietary supplements are regulated by the FDA as OTC and prescription medications

False

True or False: only the active ingredient is listed on the label of a dietary supplemet

False: the label must contain all ingredients

True or False: there is no safety or efficacy required for dietary supplements

True

What statement is contained on all dietary supplements?

"This product is not intended to treat, cure, diagnose, or prevent disease"

Information regarding dietary supplements is provided to the U.S. Pharmacopeia by the ________________

Manufacturer

What products will USP not test?

Products that contain ingredients known to be unsafe

What is the purpose of the USP Verified Seal on the label of dietary supplements?

This indicates that the product contains the ingredients listed on the label, in the declared potency and amount

Which act made it a requirement for manufacturers, packers, or distributors of dietary supplements to submit reports of serious adverse events from the public to the FDA?

Dietary Supplement and Nonprescription Drug Consumer Protection Act

True or False: even if a dietary supplement says it is safe for pregnant/lactating patients, we should use caution when recommending

True: this is because these products are not tested, and safety is not proven

What are the reasons for being cautious when recommending dietary supplements to older adults?

1. drug-dietary supplement interactions

2. kidney function

_____________ is an herbal therapy that is an anxiolytic; however, is linked to liver toxicity

Kava

_________________ is an unsafe herbal therapy used as an anorexiant or decongestant; however, causes palpitations, MI, and death

Ephedra

______________ is an unsafe herbal therapy for low libido, ED, and depression; however, is linked to increased BP, liver/kidney problems, seizures, and death

Yohimbe

Which unsafe herbal therapy is known to lower LDL, but is also linked to kidney/liver problems and increased statin side effects?

Red Yeast Rice

_____________ is an herbal therapy used as an opioid substitute and for opioid withdrawal symptoms

Kratom

At _________ doses kratom is a stimulant, and at _________ doses, kratom is a sedative

Low, High

True or False: according to the FDA, cannabidiol (CBD) is considered to be a legal dietary supplement

False

Who should CBD use be avoided in?

Patients with multiple medications

Pregnant and Lactating patients

Which product may inhibit CYP450 and have additive effects with CNS depressants?

CBD

_________ claims to relieve chronic pain, anxiety, and insomnia

CBD

Which supplements are aimed at the cardiovascular system? (3)

-Coenzyme Q10 (Ubiquinone)

-Fish Oil

-Garlic

Coenzyme Q10 may decrease INR if used with _____________

Warfarin

Coenzyme Q10 (Ubiquinone) is effective for:

-CHF

-Reduction of statin adverse effects

-Migraine headache

___________ _______, a cardiovascular supplement, may be used for lower triglyceride levels

Fish Oil

Fish oil has an increased bleeding risk with __________________ and _________________

Antiplatelets and Anticoagulants

When is fish oil unsafe?

When used in large amounts

______________, a cardiovascular supplement, is used for hyperlipidemia and hypertension

Garlic

Garlic may have an increased INR with __________________ and ________________

Anticoagulants and Antiplatelets

When is garlic unsafe?

When used topically or when used in pregnancy and lactation

Garlic is effective for:

Atherosclerosis, hyperlipidemia, and HTN

Which products target the central nervous system? (5)

-Feverfew

-Gingko

-Melatonin

-St. John's Wort

-Valerian

What is the main use of Feverfew?

Migraine prevention

When is feverfew unsafe?

When fresh leaves are chewed and when pregnant

What are some of the main uses for Gingko?

-Tardive dyskinesia

-Dementia

-Intermittent claudication

True or False: Gingko has an additive effect with antiplatelet and anticoagulants

True

______________, a CNS supplement, is used for insomnia and jet lag

Melatonin

True or False: melatonin use is safe in adolescents

False

When is melatonin use unsafe?

When used in pregnancy and adolescence

What is the use of St. Johns Wort?

Depression

What is one of the main side effects to be aware of with St. Johns Wort?

Serotonin Syndrome

(St John's Wort is for depression)

Which supplement is used for insomnia?

Valerian

When is Valerian unsafe?

When used in pregnant and lactating patients

Which products are aimed at the digestive system? (3)

-Ginger

-Milk Thistle

-Peppermint

____________ can be used for the prevention of N/V in pregnancy as well as for motion sickness

Ginger

Ginger has additive effects with _________________ and ___________________ medications

Antiplatelet and Anticoagulant

What is milk thistle used for?

Liver disease and to Stimulate lactation

__________________ can be used for IBS, dyspepsia, or tension headache

Peppermint

Which products are targeted at the endocrine system? (2)

-Alpha lipoic acid

-Cinnamon

(These are both for diabetes)

Which endocrine system product can be used for diabetes and diabetic peripheral neuropathy?

Alpha lipoic acid

True or False: alpha lipoic acid can be used in children

False

Which product can be used for diabetes?

Cinnamon

(also alpha lipoic acid)

Cinnamon should not be used for diabetes in patients with _______________ disease

Liver

Which products are considered immune modulators? (1)

Echinacea

_______________ is used to prevent and treat colds or other respiratory infections

Echinacea

Asian ginseng is a type of _________________ ________________, used for cognitive and sexual function

Performance enhancer

Which products are used for physical and mental performance enhancement? (2)

-Asian Ginseng

-Green Tea

_____________ _____________ (a performance enhancer) can increase cognitive function and sexual function

Asian ginseng

Asian ginseng has unpredictable effects with ____________________ and __________________ medications

Aniplatelet and Anticoagulant

When is Asian Ginseng unsafe?

When used in children and pregnancy

What are the main uses for green tea?

Cancer prevention and CVD prevention

(Weight loss, Energy)

Which products are targeted at the kidney, urinary tract, and prostate? (3)

-Cranberry

-Dehydroepiandrosterone (DHEA)

-Saw Palmetto

_______________ is used to prevent urinary tract infections (UTIs)

Cranberry

___________ is used for the physical and mental symptoms of aging

DHEA

What is the main use of saw palmetto?

Benign prostatic hypertrophy

Which products are targeted at the musculoskeletal system? (3)

-Glucosamine/Chondroitin

-S-adenosyl-L Methionine (SAMe)

-Turmeric

What is the main use of glucosamine?

Osteoarthritis

Which product can be used for depression and osteoarthritis?

S-adenosyl-L Methionine (SAMe)

Which product can be used for inflammatory conditions and osteoarthritis?

Turmeric

True or False: turmeric is safe in pregnancy

False

Which product is used for skin conditions?

Aloe Vera

___________ ___________ can be used for burns, cuts, scrapes, and wound healing

Aloe Vera

True or False: it is unsafe to use aloe vera orally, especially in children, pregnancy, and lactation

True

Which products can be used for women's health? (2)

-Black Cohosh

-Phytoestrogens (Soy and Red Clover)

What is the main use of Black Cohosh?

Menopausal symptoms

Black-cohosh has anti-_____________ effects

Estronergic

(Black Cohosh is used for menopausal symptoms)

Who should avoid using black cohosh?

-Patients on ACEi, ARB, Beta-blockers

-Breast cancer patients

-Those with uterine cancer, ovarian cancer, and uterine fibroids

True or False: black cohosh is unsafe for pregnant and lactating patients

True

What is the main use of Phytoestrogens?

Menopausal symptoms

What are the 3 main uses of Ubiquinone?

1. Heart health, HTN, CHF

2. Reduce statin-associated side effects

3. Migraine prophylaxis