Vitamins, Supplements, and Drug Testing Pharm

Vitamin A

- fat soluble

- helps form and maintain healthy teeth, bones, soft tissue, mucous membranes, and tissue in the retina

- *contributes to night vision

- carrots, pumpkins, tomatoes, spinach

Vitamin D

- fat soluble

- *regulates calcium and phosphate

- ultraviolet rays from light, sunlight, and milk

Vitamin E

- fat soluble

- no role in metabolism

- *fights free radical damage

- vegetable oils & nuts

Vitamin K

- fat soluble

- blood clotting

- newborns = Vit K deficient

- deficiency = bleeding

Vitamin C

- water soluble

- promotes healthy teeth & gums

- *has antioxidant properties

- *citrus fruits

Niacin (Vitamin B3)

- water soluble

- helps maintain healthy skin and nerves

- *reduces high cholesterol as medication

- deficiency = pellagra ("rough skin")

Riboflavin (Vitamin B2)

- water soluble

- important for body growth and the production of RBC

- no toxicity

- might help relieve migraine headaches

Thiamin (Vitamin B1)

- water soluble

- carbohydrate metabolism

- alcoholics- Wernike-Korsakoff syndrome (reversible)

Pyridoxine (Vitamin B6)

- water soluble

- metabolism of sugar, fat, and protein

- drug interaction- interferes with levodopa if given alone (Parkinson's)

- important for athletes

- the more protein you eat, the more pyridoxine your body requires

Cyanocobalamin (Vitamin B12) & Folic Acid

- factors in the synthesis of DNA & RBCs

- folic acid deficiency & pregnant = failure of brain to develop and spina befida

- folic acid protects from colorectal cancer

Enteral (GI)

- feeding by tube

- healthy digestive tract cannot ingest sufficient food

- components = amino acids, carbohydrates, fats & electrolytes

Parenteral (IV)

- administered through peripheral vein or central venous catheter

- components = amino acids, dextrose, fat, electrolytes, and vitamins

- monitor blood, urine, and weight

Bupropion-Naltrexone

- works in hypothalamus to control appetite and how the body burns energy (not entirely understood- targets reward system)

- bupropion = inhibits NE and dopamine reuptake

- naltrexone= opioid antagonist

Orlistate

- stops breakdown of fats - not absorbed

- patients need to take multivitamin supplement

- side effects = flatulence

Semaglutide

- human glucagon-like peptide-1 (GLP-1) receptor antagonist

- regulates appetite, blood sugar, and calorie intake

Hydroxycitric acid

- natural weight loss supplements

- blocks fat by inhibiting enzyme that converts carbohydrate to fat

- inc. glycogen which signals brain to stop eating

- caution: people with diabetes, high blood pressure, pregnant women, young children

Gugulipid

- natural weight loss supplements

- lowers LDL cholesterol

- promote weight loss by stimulating thyroid

- caution: low fat diet should be maintained, rash/diarrhea, NEVER take if on cholesterol lowering drugs

Chromium

- natural weight loss supplement

- mineral that regulate blood sugar and insulin

- caution: produces chromosome damage in cells, decreases motor activity in CNS

Ephedra (Ephedrine)

- weight loss supplement

- CNS stimulant

- Caution: FDA has documented 40 deaths and 800 sides effects linked to ephedrine

Caffeine as a weight loss supplement

- weight loss supplement

- side effects overall so bad no not normally taken as weight loss supplement

Are supplements required to meet any FDA requirements?

NO

Creatine

- muscle cells generate work from energy for 2-3 sec --> creatine extends time to 10 sec, with 30-60 sec rest, body can recharge creatine

- improves "power" but not "endurance"

Creatine Caution

- reports of muscle cramping, strains, and pulls

- inc. renal stress/damage

- inc. risk of heat illness- inc. fluid intake

- little research on long term effects

Caffeine

- supplement

- stay alert and improve endurance

- acts as a CNS stimulant

- caution: side effects (nausea, muscle tremor, palpitations, headache), do not combine with ephedrine, acts as diuretic, negates effects of creatine yet some contain both)

Protein

- high protein diets are used for increase muscle mass and strength gains

- caution: inc. risk of certain cancers, inc. Ca2+ excretion and risk of osteoporosis, lead to reduced intakes of vitamins, minerals, and fiber

Glucosamine and Chondroitin

- "The arthritis cure"

- stimulates cartilage cells

- caution: most effective for early arthritis when cartilage is still present, less effective for severe arthritis

Herbal Supplements

- plant derived products

- available without prescription

- cheap

Echinacea

- herbal supplement

- stimulates immune function (inflammation & viral infections)

- drug interactions: opposes effects of immunosuppressant drugs (TB, cancer, HIV)

Ginkgo

- herbal supplement

- improve memory & concentration, erectile dysfunction

- drug interactions: anticoagulants, antipsychotics

St. John's Wort

- herbal supplement

- relieve depression

- drug interactions- induces P450 to metabolize other drugs, reduces digoxin levels, additive to sertonergic drugs

Blood Doping

- prohibited drug

- infusion of blood to produce an increase in the blood's oxygen carrying capacity

- side effects: heart failure, AIDs, embolisms, clotting, hepatitis, dec. CO

- no way to detect if athlete boosted their hemoglobin by doping or training at high altitudes

Erythropoietin (EPO)

- prohibited drug

- naturally produced by the body and stimulates production of RBCs which transport oxygen

- used in cycling, rowing, and distance runners to cheat

- side effects: high BP, thrombosis, heart attack

3 Categories of Prohibited and Restricted Drug Categories

1) short or intermediate acting stimulants and beta-blockers (easily detectable)

2) anabolic agents (more difficult to detect)

3) masking agents/diuretics (relatively easy to detect)

Anabolic steroids effects on behavior

- agression

- property crimes

- irritability

- euphoria

- increased energy

- addiction

- physical dependence