CMN E2 -Herbs and Supplements

What is the MC alternative therapy used today?

dietary supplements

What dietary supplement can reduce the ability of Warfarin to prevent blood from clotting?

Vitamin K

What dietary supplement may inc risk of bleeding?

Omega 3 or fish oil

What dietary supplement can speed the breakdown of many drugs (including antidepressants & OCP) reducing their effectiveness and inc risk of serotonin syndrome?

St. John's wort

What dietary supplements might reduce the effectiveness of some types of cancer chemotherapy?

Antioxidants- Vitamins C & E

What is a botanical?

substance made from part of a plant (includes bark, roots, or leaves)

What is herbalism?

study & practice of using plant material for food, medicine and health promotion

What is the fundamental principle of herbalism?

promote preventive care & simple treatment

What is phyto therapy?

term used primarily in Europe for the treatment and prevention of disease by using herbal medicines

What are the two most abundant and well-known compounds found in marijuana plants?

Tetrahydrocannabinol (THC)

Cannabidiol (CBD)

What distinguishes one cannabis strain from another and can vary with changes to the soil and/or the temp in which it is cultivated?

Terpenes

What gives cannabis its scent and flavor?

Terpenes

Where is THC found?

exclusively in the cannabis plant

Where is CBD found?

cannabis AND industrial hemp

What is the difference between Cannabis and Hemp?

Cannabis is a flowering plant; hemp is mainly grown for seeds & fiber (has only tiny amount of THC)

What conditions are approved for medical marijuana use?

CA, epilepsy, glaucoma, HIV/AIDS, PTSD, ALS, MS, chronic pain, terminal conditions

What is the tx for cannabis hyperemesis syndrome?

Benzos, antiemetics, IV fluids, capsaicin cream on the abdomen

Who should avoid the use of herbal meds?

(contemplated) pregnancy & lactation

What pts should extreme care be used when dosing herbs?

children

*doses are wt based

It’s estimated how much of the world’s population relies on herbal medicine?

80%

What medication is derived from opium poppy?

Morphine

What medication is derived from foxglove?

Digitalis (Digoxin)

What medication is derived from rauwolfa?

Reserpine (antihypertensive)

What type of herbal preparations are rapidly absorbed?

Teas & Tincture

What is the role of the Dietary Supplement Health & Education Act (DSHEA)?

regulates herbs as dietary supplements, regulated AFTER they are on market

Does the FDA regulate dietary supplements?

NO- No standardized purity, bioavailability guarantees. No requirement for reporting SEs

Who handles complaints of false or misleading advertising or SEs of dietary supplements?

Federal trade commission

Pts should try to buy what kind of supplements?

3rd party tested

What are the most widely used dietary supplements?

Multivitamins & minerals

Why should pts taking multiminerals NOT use salt substitutes?

prevent elevated levels of K+

What should minerals NOT be taken with?

Milk or Antacids

What are the actions of Fish oil, Omega-3 fatty acids, & DHA?

dec: BP, TG levels, clotting time, inflammation, mild dilation of blood vessels

What are the SEs of Fish oil/Omega-3 fatty acids/DHA?

Mercury levels in fish

Interact w/ NSAIDs and blood thinners

What is Glucosamine used for?

treat OA, joint problems

What herbal med should be AVOIDED in patients with shellfish allergies?

Glucosamine

What herbal supplement should you use cautiously in those taking K+ supplements or anticoagulants?

Glucosamine

*also interacts with: NSAIDs, Diabetic agents (including insulin)

What is Methylsulfonylmethane (MSM) used for?

OA (MC use), alleviating GI upset, MSK pain, Allergies, Boosting immune system, Fighting microbial infection

What is Flaxseed used for?

Hypercholesterolemia, cardioprotective, immune function

What effect does Flaxseed have on medications?

can slow absorption of all meds

Interacts w/: Anticoagulants, Diabetes meds, Contraceptives, Hormones, Antihyperlipidemic agents

What is Ginseng used for?

fatigue, sexual dysfunction, stomach disorders, asthma

What herbal med should be AVOIDED with products containing caffeine?

Ginseng

*interacts w/ diabetes meds, psych meds, opiate pain meds, anticoagulants, CCBs, NSAIDs

What is Chamomile used for?

*typically not useful on its own, but in combo

sleeplessness, anxiety, GI upset, gas, diarrhea, used topically for skin conditions and mouth sores from cancer tx

What medications does Chamomile interact with?

Cyclosporin, Coumadin

What is Lavender used for?

flavoring, anxiety, depression, digestive sxs, hair loss, pain after C-section, cancer-related pain, dementia, topical use in aromatherapy

What medications does Lavender interact with?

Sedatives, HTN meds

*topical can cause allergic skin rxn

What is Echinacea used for?

tx for common cold & other infections based on the idea that it might stimulate the immune system

topical use for wounds & skin problems, vaginal yeast infections, increasing exercise performance

**LOW medication interaction risk

In what situations should Echinacea NOT be used?

Autoimmune disorders, Anxiety/depression, Asthma, Cancer, Migraines, Seizures

What is Lemon balm used for?

effects on CNS: dec. stress & agitation in patients with dementia & Alzheimer's disease

cholesterol benefit, anti-inflammatory, cancer

What is Peppermint used for?

digestive disorders, IBS, common cold, sinus infections, HA, Oil → topical use, muscle aches, joint pain, itching

What medications does Peppermint interact with?

Iron supplements, Cyclosporine, Antibiotics/Antifungals, Seizure meds, HTN meds

What herbal oil should NOT be applied to the face of infants or young children as serious side effects may occur if they inhale the menthol?

Peppermint oil

What herbs are used for liver disease?

Milk thistle, Burdock, Chicory, Dandelion

What is a SE of milk thistle?

Hypoglycemia

What herb is used for liver disease and is a good source of Fe, K, and Zn?

Dandelion

What is Alpha lipoic acid (ALA) effective for?

liver damage, antioxidant, chelates heavy metals, supports insulin resistance in T2DM, tx of diabetic neuropathy

What is N-acetyl cysteine used for?

counteracting acetaminophen and CO poisoning, tx unstable angina, keratoconjunctivitis, bile duct blockage in infants, ALS, complications of kidney dialysis, heavy metal detox

What is Glutathione a combination of?

Cysteine, glycine, and glutamine

What does glutathione deficiency cause?

inc susceptibility to oxidative stress

-found in nearly every chronic illness pt

What boosts your glutathione levels?

Exercise & Milk thistle

*B6, B12, folate help sustain levels

What is the cancer chemopreventative polyphenol found in green tea?

Epigallocatechin gallate (EGCG)

Green tea contains small amounts of what vitamin?

Vitamin K → makes anticoagulants less effective

What is the likely active compound within turmeric credited with the benefits of the herb?

Curcumin

What are Turmeric and Curcumin used for?

relief of arthritis pain & inflammation, anticancer, antioxidant

What are adaptogens?

natural substances that help the body adapt to stress, support metabolic functions, and help restore balance

What is an essential component of healthy mitochondrial function?

CoQ10

In what tissue is CoQ10 most densely populated?

*production decline w/ advancing age

Cardiac

What meds cause a decrease in CoQ10 levels?

Statins & Diabetic meds

What is the reduced form of CoQ10?

*absorbs 8x greater

Ubiquinol

What is the oxidized form of CoQ10 (must be converted back to reduced form for utilization)?

Ubiquinone

What is a critical drug interaction with St. John's Wort?

Antidepressants: serotonin related SEs

What dietary supplements may show a benefit in DM?

Cinnamon, Chromium

What dietary supplement may be used for menstrual cycle/menopause sxs and may inc bleeding in patients taking Warfarin?

Evening primrose oil

What dietary supplement may be used for menstrual cycle/menopause sxs and should be d/c if patients begin to have liver disorders or liver failure symptoms?

Black cohosh

What dietary supplements are used for cardiac and HTN?

Garlic, Hawthorn

What dietary supplements used for GI symptoms?

Slippery elm, Licorice root, Marshmallow, Aloe vera, Bromelain

Pts w/ a pineapple allergy should be careful if using what herbal med?

Bromelain

What herb has a thermogenic effect when applied to the skin, which increases local circulation and raises body temp?

*found in cayenne pepper

Capsaicin

What does capsaicin reduce?

Substance P (chemical that carries pain messages to the brain, in your body)

What herb is said to improve BPH?

Saw palmetto

What vitamin do vegans need to supplement?

Vitamin B12

T/F: Medicare will pay for obesity counseling if it is coordinated by a PCP

True

What antibody is produced after the immune system perceives an ordinary food as a harmful substance?

IgE

*attaches to mast cells

What antibodies should be tested when evaluating food allergies?

IgE & IgG