4_3CAMTop10 Flashcards by Drew Spargo

How does glucosamine work its magic?

1) decreases chondrocyte breakdown; 2) decreases damage to cartilage matrix; 3) increases formation and repair of cartilage; 4) inhibit cytokine-stimulated production of inflammatory mediators

How well did you know this?

Not at all

Perfectly

What are the uses of glucosamine?

1) mild-moderate knee OA (A); 2) general OA (B); 3) TMJ arthritis (PE); 4) RA - not as effective

How well did you know this?

Not at all

Perfectly

What were the results of the GAIT trial?

glucosamine for knee OA: less effective if older, heavier, or chronic disease (worn-down cartilage and bone-on-bone)

How well did you know this?

Not at all

Perfectly

What are the ADRs of glucosamine?

1) GI upset, 2) heartburn, 3) diarrhea; 4) may increase blood sugar as an amino sugar

How well did you know this?

Not at all

Perfectly

Who is allergic to glucosamine?

those with shellfish allergy - use veggie-based product

How well did you know this?

Not at all

Perfectly

What are sources of glucosamine?

1) marine exoskeletons; 2) in vivo glycoprotein produced by cartilage, synovial space

How well did you know this?

Not at all

Perfectly

What are sources of chondroitin?

1) bovine/pork/shark cartilage; 2) a glycosaminoglycan in cartilage and CT

How well did you know this?

Not at all

Perfectly

How does chondroitin work its magic?

1) inhibits synovial enzymes to decrease cartilage destruction; 2) increases H2O retention and elasticity in cartilage

How well did you know this?

Not at all

Perfectly

What are the uses of chondroitin?

1) arthritis; 2) dry eye

How well did you know this?

Not at all

Perfectly

What is methylsulfonylmethane (MSM)?

an odorless metabolite of DMSO occurring naturally in green plants

How well did you know this?

Not at all

Perfectly

What is the normal dosage for glucosamine/chondroitin?

g/c 500/400 mg/day in 3 divided doses for 3 months; decrease when OA/RA is under control according to weight; do not increase after 3 months if no effect

How well did you know this?

Not at all

Perfectly

How is chondroitin supplied?

as sulfate of HCl form; Mn may be included

How well did you know this?

Not at all

Perfectly

What is the RDA of Managenese?

1.8-2.3 mg/day

How well did you know this?

Not at all

Perfectly

What is the function of Mn in chondroitin?

aids in bone formation

How well did you know this?

Not at all

Perfectly

How much Mn may be supplied in glucosamine/chondroitin products?

> 11 mg/day

How well did you know this?

Not at all

Perfectly

What are the considerations for Mn in chondroitin?

not dangerous if

How well did you know this?

Not at all

Perfectly

How is chondroitin used for cataract surgery?

a viscoelastic agent; also as a preservative medium for cornea transplantation

How well did you know this?

Not at all

Perfectly

What did a 2011 study find regarding chondroitin use for OA?

800 mg QD for 3 months decreased hand pain and morning stiffness; but modest effect if used without glucosamine

How well did you know this?

Not at all

Perfectly

What are the ADRs for chondroitin?

GI upset, nausea, diarrhea

How well did you know this?

Not at all

Perfectly

What are chondroitin’s interactions?

anticoagulants (inc. INR at high doses)

How well did you know this?

Not at all

Perfectly

What are the uses for methylsulfonylmethane?

1) OA, 2) maybe for allergic rhinitis, 3) absorption vehicle for topical preparations

How well did you know this?

Not at all

Perfectly

What are the ADRs for methylsulfonylmethane?

garlic taste in mouth

How well did you know this?

Not at all

Perfectly

What is the dosing regimen for melatonin?

2-3 mg Qday 30-60 min before bedtime; use x4 days after long flight

How well did you know this?

Not at all

Perfectly

How is melatonin supplied?

1) pure form, 2) with valerian (sleep aid), 3) with B6 (Trp synthesis)

How well did you know this?

Not at all

Perfectly

What are ADRs of melatonin?

drowsiness for 6h; vivid dreams but no hangover effect

What are the uses of melatonin?

distrubed sleep-wake cycles (autism, DM, schizophrenia, Alzheimers, Parkinsons, blindness)

What are the sources of melatonin?

1) synthesized from Trp in pineal gland; 2) supplements from synthetic or plant extracts

What are other names for CoQ-10?

1) idebenone; 2) mitoquinone; 3) ubiquinone

What are sources of CoQ-10?

1) dietary chicken, beef; 2) synthetic; 3) in vivo production of ubiquinol esp. in heart, liver, pancreas

What are the uses of CoQ10?

1) CVD, 2) T2DM, 3) migraine, 4) parkinsons, 5) statin myopathy, 6) anti-aging ingredient, 7) sun protection

What is the usual dose for CoQ-10?

100-200 mg/day

What is the CoQ-10 dose in parkinsons?

300-1200 mg/day

Why is CoQ-10 beneficial in statin myopathy?

(conflicting evidence). Statins decrease in vivo production of ubiquinol

How is CoQ-10 supplied?

in various dosage forms with variable F; can buy pure form; range of cost

What are ADRs of CoQ-10?

1) Gi upset, 2) nausea/vomiting, 3) rash, 4) HA, 5) anorexia; 6) heartburn

What are CoQ-10's interactions?

1) can decrease BP; 2) decrease warfarin effect

What are counseling points for high doses of CoQ-10?

1) safe if

What are other names for echinacea?

1) purple coneflower, 2) American coneflower, 3) black susan

What are the sources of echinacea?

it's a North American plant: 1) leaves of E. purpurea, 2) root of E. angustifolia

How does Echinacea work its magic?

immune system modulator

What are the uses of echinacea?

1) common cold, 2) vaginal yeast infection

How is echinacea taken for cold?

as prophylaxis throughout the season or at first symptoms for 7-10 days

How is echinacea taken for vaginal candidiasis?

as an adjuct to antifungal - can reduce recurrence

How does echinacea affect a cold?

decrease symptoms 10-30% but not preventive

What is the dosage of echinacea?

1) 900 mg dried extract, 2) 3-4 mL alcohol tincture at 5x concentration

What substances may be combined with echinacea?

goldenseal and elderberry

What is goldenseal?

a topical antibacterial

What is elderberry?

an immunomodulator

Who is allergic to echinacea?

those with allergic reaction to asteracaea/compositae family (ragweed, chrystanthemums, daisies, marigolds)

What are echinacea's interactions?

decrease effects of immunosuppressants; 1A2 and 3A4 inhibitor

What are the ADRs of echinacea?

1) GI, 2) fever, 3) dizziness, 4) HA, 5) rash

How long can echinacea be used?

safe if less than 12 weeks

How does cranberry work its magic?

prevents bacterial adherence to bladder wall

What is the dosage for cranberry?

300-400 mg BID or 8-16 oz pure juice QD

At what dosage does cranberry have ADRs?

> 8-16 oz/day of juice

What are the hi-dose ADRs of cranberry?

anticoagulant, decreased effect of alkaline drugs (antidepressants and pain meds)

What are the active principles of garlic?

alliin and allicin

What is allicin?

the active biological ingredient; sulfur containing AA derivative in garlic that has a significant odor

What are the uses (PE) for garlic?

1) HTN, 2) atherosclerosis, 3) GI cancers - fresh garlic only; 4) tick bites; 5) tinea

For what conditions does garlic have IE?

1) BPH; 2) colds; 3) corns; 4) pre-eclampsia; 5) prostate cancer; 6) warts

What is the dosage of garlic?

3.6-5.4g allicin; 4g=1 clove of fresh; 8mg oil; 600-1200 mg extract - TID for HTN!

What are the interactions of garlic?

1) may induce CYP450 system - inc. bleeding of anticoags; inc. metabolism of NNRTIs and Pis; 2) EC garlic may be more effective

Who is allergic to garlic?

those with allergy to lily

What are garlic's ADRs?

odor, heartburn, GI upset

What are the sources of ginseng?

roots of: 1) American (WI and Ontario); 2) Panax (Asian and Korean); 3) Siberian (Devil's bush and Eleuthern)

What is an adaptogen?

substance that increases resistance to stress

What is a tonic?

substance that increases well-being and immune function

What are the proposed benefits of ginseng?

1) adaptogen, tonic, energy; 2) T2DM for reduced post-prandial blood sugar; 3) cold/flu prevention

What is the active component of ginseng?

ginsenoside

What is the dose of ginseng?

100 mg extract BID; 1-2g powder Qday x 2-3 weeks

How does ginsenoside content vary among ginseng sources?

Asian = 1.5%; American = 2%

How is ginseng supplied?

powder and extract

What information should be provided in a ginseng supplement?

1) type, 2) plant part, 3) amount, 4) dosage form

What are ginseng's interactions?

1) decreases warfarin effect, 2) stimulants, 3) hypoglycemics

When is ginseng contraindicated?

1) pregnant/breastfeeding; 2) breast cancer; 3) insomnia

What are other names for Ginkgo?

fossil tree, maidenhair tree, silver apricot

How long does the ginkgo tree live?

1000 years

What is the most commonly adulterated top-10 supplement and why?

ginkgo - hard to find

What part of the ginkgo tree is used?

leaf extract (Chinese may use fruit)

What components of ginkgo have a biological effect?

1) flavonol glycosides (antioxidant); 2) terpene lactones (vasodilators)

How does ginkgo work its magic?

1) decreased platelet activation, 2) decreased amyloid effects; 3) increased endothelin; 4) increased prostacycling; 5) increased hippocampal excitability via GABA receptors

What are the uses of ginkgo?

1) age-related memory impairment and cognitive function; 2) PVD; 3) dementia; 4) glaucoma; 5) diabetic retinopathy; 6) PMS; 7) Raynauds; 8) vertigo

What is the dosage of ginkgo?

increased until 120-600 mg/day in divided doses

What are the ADRs of ginkgo?

HA, N/V/D, allergic dermatitis; uncooked seeds/pulp = neurotoxic;

What are the functions of ginkgo seeds?

need to be cooked! Antibacterial and antifungal

What are the interactions of ginkgo?

1) anticoags - increased bleeding; 2) decreased effect of anti-epileptics; 3) variable effects on CYP450 system

4_3CAMTop10 Flashcards

(86 cards)