Term
What is the primary goal of diabetes treatment?
|
|
Definition
| To prevent long-term complications |
|
|
Term
| What is important in diabetic treatment? |
|
Definition
Tight control of blood glucose level
Control blood pressure and blood lipids |
|
|
Term
| Where is insulin synthesized? |
|
Definition
| The pancreas by beta cells in islets of Langerhans |
|
|
Term
What is insulin composed of?
|
|
Definition
A (acidic) chain & B (basic) chain
|
|
|
Term
| What is the precursor of insulin? |
|
Definition
|
|
Term
| What is proinsulin composed of? |
|
Definition
Consists of insulin + peptide loop that connects A & B loops (called connecting peptide, C-peptide)
|
|
|
Term
| How is proinsulin converted to insulin? |
|
Definition
C-peptide is clipped from proinsulin molecule by enzymes
|
|
|
Term
| What could you measure to determine if pancreas producing its own insulin? |
|
Definition
|
|
Term
What stimulates insulin release?
|
|
Definition
Rise in blood glucose
Sympathetic nervous system |
|
|
Term
Beta2 adrenergic receptors _________ insulin release. Alpha adrenergic receptors ________ insulin release.
|
|
Definition
|
|
Term
| Insulin stimulates cellular transport/uptake of _________________. |
|
Definition
Glucose
Amino acids
Nucleotides
Potassium
|
|
|
Term
Insulin promotes the synthesis of what complex organic molecules?
|
|
Definition
Glucose converted to glycogen
Amino acid assembled into protein
Fatty acids added to trigylcerides
|
|
|
Term
| What insulins can be given subcutaneously? |
|
Definition
|
|
Term
| How is insulin manufactured? |
|
Definition
Via recombinant DNA technology
|
|
|
Term
How was insulin provided before recombinant DNA technology?
|
|
Definition
| beef & pork pancreas insulin |
|
|
Term
Most insulins are available only in ____________.
|
|
Definition
|
|
Term
| What is the onset, peak, and duration of rapid acting insulin? |
|
Definition
Onset of 10-30min
peak 30min-3hrs
duration of 3-6hrs |
|
|
Term
| What are the rapid acting insulins? |
|
Definition
Insulin lispro (Humalog®)
insulin aspart (NovoLog®)
insulin glulisine (Apidra®)
|
|
|
Term
| What is the onset, peak, and duration of short duration slower acting insulins? |
|
Definition
Onset of 30-60min
peak 1-5hrs
duration 6-10hrs |
|
|
Term
| What are the short duration slower acting insulins? |
|
Definition
Regular insulin (Humulin R®, Novolin R®)
|
|
|
Term
| What type of insulin is used in insulin pumps? |
|
Definition
Regular insulin (Humulin R®, Novolin R®)
|
|
|
Term
___________ is available in U-500
|
|
Definition
|
|
Term
_______ insulin is available w/o a prescription.
|
|
Definition
U-100 Regular insulin (Humulin R®, Novolin R®)
|
|
|
Term
| ___________ can be mixed with regular insulin. |
|
Definition
|
|
Term
| What type of insulin can be given IV? |
|
Definition
|
|
Term
| What are the characteristics of NPH insulin? |
|
Definition
suspension (cloudy)
Can be mixed w/short-acting insulin
Administered b.i.d.
|
|
|
Term
| What is the onset, peak, and duration of NPH insulins? |
|
Definition
Onset 1-2hrs
peak 1-5hrs
duration 16-24hrs |
|
|
Term
| What are the NPH insulins? |
|
Definition
NPH (Humulin N®, Novolin N®)
|
|
|
Term
| What is the onset, peak, and duration of insulin detemir (Levemir®)? |
|
Definition
Onset 6-8min
peak 12-24hrs
duration varies on dose (12-24hrs)
|
|
|
Term
| What are the intermediate duration insulins? |
|
Definition
NPH (Humulin N®, Novolin N®)
insulin detemir (Levemir®) |
|
|
Term
| What insulins can Insulin lispro (Humalog®) be mixed with? |
|
Definition
|
|
Term
| What insulin is long acting? |
|
Definition
Insulin glargine (Lantus®)
|
|
|
Term
| What is the onset, peak, and duration of Insulin glargine (Lantus®)? |
|
Definition
Onset 70min
no peak
24hr duration
|
|
|
Term
| What are the characteristics of Insulin glargine (Lantus®)? |
|
Definition
Clear
Usually given at bedtime
|
|
|
Term
What are the premixed combinations available of NPH/regular insulins?
|
|
Definition
|
|
Term
| What is drawn up first when mixing insulins? |
|
Definition
|
|
Term
| What are the characteristics of insulin pumps? |
|
Definition
• Delivers a basal infusion of short-acting insulin (Simulates the pancreas)
• Can give mealtime bolus
• Insulin administered via subcut catheter, usually on abdomen (Site changed every 1-3 days)
|
|
|
Term
| What are the complications of insulin? |
|
Definition
• Hypoglycemia
• Lipodystrophies (Lipoatrophy,
Lipohypertrophy)
• Allergic reactions
• Drug interactions
|
|
|
Term
| What drug interactions can occur with insulin? |
|
Definition
• hypoglycemic agents (BB, other diabetic drugs)
• Hyperglycemic agents (Loop diuretics, steroids)
• Beta Blockers (selective - hyperglycemia, nonselective - masks hypoglyecemia) |
|
|
Term
| When are oral DM drugs used? |
|
Definition
Used in conjunction with & after failure of diet & exercise
|
|
|
Term
| What main 2 ways do oral DM drugs work? |
|
Definition
• Drive blood glucose down
• Impair of postprandial rise in blood glucose
|
|
|
Term
| What oral DM drugs drive blood glucose down? |
|
Definition
Sulfonylureas, glitazones, glinides
|
|
|
Term
What oral DM drugs impair the postprandial rise in blood glucose?
|
|
Definition
Biguanides, alpha-glucosidase inhibitors
|
|
|
Term
| What are the characteristics of Biguanides? |
|
Definition
• metformin (Glucophage®)
• ▼liver glucose production in liver, ▲tissue response to insulin
(Does not actively ▼blood glucose=little risk of hypoglycemia)
• Drug of choice for initial therapy
• Is excreted unchanged by kidneys so use caution in renal insufficiency
• As effective as insulin in gestational DM
• Also used for PCOS to stimulate ovulation
• Available as combination w/several other oral anti-diabetic drugs
|
|
|
Term
| What are the Biguanide side effects and interaction? |
|
Definition
• Major side effects are GI (Usually improve over time)
• Can ▼absorption of B12 & folic acid (caution in women of child bearing age)
• Wt loss/appetite suppression
• Can cause lactic acidosis (Is potentially fatal [50% mortality])
• Avoid/caution w/ETOH, cimetidine (Tagamet®), renal failure, heart failure, liver disease
• Must be discontinued 48hrs before & after contrast d/t to risk of lactic acidosis & acute renal failure |
|
|
Term
| What are the characteristics of sulfonylureas? |
|
Definition
• glipizide (Glucotrol®), glyburide (Micronase®, DiaBeta®), glimepiride (Amaryl®)
• Promote insulin secretion by pancreas & ▲tissue response to insulin
• Have 2 generations (all those listed are 2nd)
1st may cause CV toxicity
2nd are more potent
2nd have less drug-drug interactions
|
|
|
Term
| What are the side effects of sulfonylureas? |
|
Definition
• Primary adverse effect is hypoglycemia, esp. w/kidney & liver disease d/t accumulation
• Not safe or effective in pregnancy
• Avoid in breastfeeding-can create hypoglycemia in infant
• Disulfiram-like reaction when taken w/ETOH
|
|
|
Term
| What are the drug interactions of sulfonylureas? |
|
Definition
• ▲ hypoglycemia (NSAIDs, Sulfonamide abx, ETOH, cimetidine (Tagamet®)
• Beta-adrenergic blocking agents (▼benefits of sulfonylurea b/c BB suppresses insulin release, masks s/s of hypoglycemia)
|
|
|
Term
| What are the characteristics of glinides? |
|
Definition
• AKA meglitinides
• repaglinide (Prandin®), nateglinide (Starlix®)
• Promote insulin secretion by pancreas
• Same mechanism as sulfonylureas
• Have fast onset & short duration (Prandin® peaks in 1˚, duration of 4˚, Starlix® peaks in 30 min, duration of 2˚)
• Major deterrent is cost ($70-90 vs. $10 for sulfonylurea)
|
|
|
Term
| What are the characteristics of Thiazolidinediones (Glitazones)? |
|
Definition
• AKA TZDs
• rosiglitazone (Avandia®), pioglitazone (Actos®)
• ▼insulin resistance=▲glucose uptake by cells & ▼liver glucose production
• Takes several wks for maximal benefit
• Can cause hypoglycemia only in presence of excess insulin
• Caution w/heart failure pts b/c causes fluid retention & edema (Effect ▲when given w/insulin)
• Avandia® now has black box warning (Linked to ▲risk of heart disease, MI, CHF, Can only get from company under special situations)
• Actos® linked to bladder CA
|
|
|
Term
| What are the characteristics of Alpha-Glucosidase Inhibitors? |
|
Definition
• acarbose (Precose®), miglitol (Glyset®)
• Act in intestine to delay carbohydrate absorption
• Taken w/meals
• Minimal amt is absorbed as active drug = minimal systemic effects
• Main side effects are GI
• Does not cause hypoglycemia if given alone
|
|
|
Term
| What are the characteristics of gliptins? |
|
Definition
• 1st & only drug in class is sitagliptin (Januvia®)
• Enhance actions of incretin hormones
(Stimulate glucose-dependent release of insulin, Suppress postprandial release of glucagon)
• Well tolerated w/few side effects
• Little risk of hypoglycemia
• No known drug interactions or contraindications
|
|
|
Term
| What are the injectable DM drugs? |
|
Definition
Amylin mimetics-pramlintide (Symlin®)
Incretin mimetics-exenatide (Byetta®)
|
|
|
Term
| What are the characteristics of amylin mimetics-pramlintide (Symlin®)? |
|
Definition
• Complements effects of insulin in Type I or II
• Synthetic analog of amylin (peptide hormone made in pancreas & released w/insulin
• Can cause severe hypoglycemia when given w/insulin
• Nausea common
• Reduces postprandial glucose levels by delaying gastric emptying & suppressing glucagon secretion (Can delay absorption of oral drugs)
• Also acts in brain to ▲sense of satiety
• Given subcut at mealtime
• Metabolized by kidney instead of liver
|
|
|
Term
What are the characteristics of incretin mimetics-exenatide (Byetta®)?
|
|
Definition
• Improves glucose control in pts on metformin or sulfonylureas
• Action same as Symlin® & also stimulates glucose-dependent release of insulin & suppresses appetite (Can also delay absorption of oral drugs)
• N/V/D common
• Hypogylcemia when given w/sulfonylurea
• Given subcut before meals
• Excreted unchanged in urine
• Long term effects not yet known
|
|
|
Term
|
Definition
| promotes breakdown of glycogen into glucose, ▼conversion of glucose to glycogen, & stimulates biosynthesis of glucose |
|
|
Term
| How long does it take glucagon to work? |
|
Definition
|
|
Term
| Which is preferred by IV, glucose or glucagon? |
|
Definition
|
|
Term
Hypokalemia is usually caused by ___________.
|
|
Definition
|
|
Term
| Why are potassium salts preferred to treat hypokalemia? |
|
Definition
| because chloride deficiency frequently coexists with hypokalemia |
|
|
Term
| What treatment is used in mild hypokalemia? |
|
Definition
|
|
Term
| What treatment is used in severe hypokalemia or a patient who cannot take meds PO? |
|
Definition
|
|
Term
| What are the characteristics of oral potassium chloride? |
|
Definition
• Causes abdominal discomfort, N/V/D
• Sustained-release version has fewer GI effects
|
|
|
Term
| What must be kept in mind when administering IV potassium chloride? |
|
Definition
Must be diluted and infused slowly
|
|
|
Term
| What are the contraindications to potassium use? |
|
Definition
Avoid in patients who are predisposed to hyperkalemia (Severe renal impairment, use of potassium-sparing diuretics, hypoaldosteronism)
|
|
|
Term
| What is the main complication of hypokalemia and what can be done to minimize its effects? |
|
Definition
hyperkalemia (Assess renal function and changes in ECG)
|
|
|
Term
| What are the signs of hypokalemia? |
|
Definition
Alkalosis
Shallow respirations
Irritability
Confusion
Weakness
Arrhythmias
Lethargy
Thready pulse
▼ intestinal motility
|
|
|
Term
| What are the treatment options for hyperkalemia? |
|
Definition
• Withhold foods that contain potassium
• Withhold medicines that promote potassium accumulation
• Counteract potassium-induced cardiotoxicity
• Lower extracellular levels of potassium (Calcium gluconate, Infusion of glucose and insulin)
• If acidotic – infusion of sodium bicarbonate
|
|
|
Term
| What are the s/s of hyperkalemia? |
|
Definition
Muscle cramps -> weakness -> paralysis
Drowsiness
▼ BP
EKG changes
Dysrhythmias
Abd. cramping
Diarrhea
Oliguria |
|
|
Term
|
Definition
Organic compounds required in minute amounts for growth and maintenance of health.
|
|
|
Term
Vitamins _______ serve as a source of energy.
|
|
Definition
|
|
Term
| What are vitamins used for? |
|
Definition
Essential for energy transformation and regulation of metabolic processes
|
|
|
Term
| Several vitamins are __________ in native form. |
|
Definition
|
|
Term
| Recommended dietary allowances (RDAs) for vitamins are set by the ___________________________________. |
|
Definition
| Food and Nutrition Board of the National Academy of Sciences |
|
|
Term
|
Definition
| average daily dietary intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy individuals in a particular life-stage or gender group. |
|
|
Term
_________________ for a vitamin is the highest average daily intake that can be consumed by nearly everyone without a significant risk for adverse effects.
|
|
Definition
| The Tolerable Upper Intake Limit (UL) |
|
|
Term
| An index of safety—not a recommendation to exceed the RDA |
|
Definition
| The Tolerable Upper Intake Limit (UL) |
|
|
Term
_______________ is the level of intake that will meet nutrition requirements for 50% of the healthy individuals in any life-stage or gender group.
|
|
Definition
| Estimated Average Requirement (EAR) |
|
|
Term
| What are the fat-soluble vitamins? |
|
Definition
|
|
Term
| What are the water-soluble vitamins? |
|
Definition
• Vitamin C
• Vitamin B complex—thiamin, riboflavin, niacin, pyridoxine, pantothenic acid, biotin, folic acid, cyanocobalamin
|
|
|
Term
| What are the characteristics of vitamin A (retiniol)? |
|
Definition
• Multiple functions in the eyes
• Sources-dairy, meat, fish oil, fish, darkly colored carotene-rich fruits/veggies (carrots, cantaloupe, mangoes, spinach, tomatoes, pumpkins, sweet potatoes)
• Toxicity - Birth defects, liver injury, bone-related disorders
• Deficiency causes:
Night blindness
Xerophthalmia (dry eye)
Keratomalacia (dry & soft cornea)
Blindness
• Therapeutic uses - Only indication is to prevent/correct deficiency
|
|
|
Term
| What are the characteristics of vitamin D? |
|
Definition
• Regulates calcium and phosphorus
• Deficiency causes rickets or osteomalacia (Vit D used to treat these & hypoparathyroidism)
• May decrease risk of breast & colorectal CA, DMI
• Natural food sources-shiitake mushrooms & oily fish (salmon, tuna)
• Have fortified food sources and sunlight
• S/S of toxicity occur 2˚ hypercalcemia
• Supplements usually given PO w/1 exception-calcitriol
|
|
|
Term
| What are the characteristics of vitamin E? |
|
Definition
• Antioxidant properties
• Sources—fresh greens, seeds, oils, nuts, whole-grain products
• Toxicity may increase risk for bleeding, increase risk of heart failure & cancer progression
• Deficiency rare - Mostly in people w/inborn deficiency of protein required for Vit E secretion & transport or those w/fat malabsorption syndrome (Results in neurologic deficits)
|
|
|
Term
| What are the characteristics of vitamin K? |
|
Definition
• Action required for synthesis of prothrombin and other clotting factors
• Present in wide variety of foods-greens, tomatoes, blueberries
• Deficiency produces bleeding (Results from reduced absorption)
• All newborns deficient –at risk for intracranial hemorhage
• Adverse effects - Hypersensitivity reaction when given IV-shock, resp/cardiac arrest & hyperbilirubinemia in parenteral administration to newborns
• Therapeutic use - Warfarin overdose
|
|
|
Term
| What are the characteristics of vitamin D (Ascorbic Acid)? |
|
Definition
• Action required for production of collagen and other compounds that bind cells together
• Part of the biochemical reaction for the synthesis of adrenal steroids
• Sources - Citrus fruits/juices, tomatoes, potatoes, strawberries, melons, spinach, broccoli
• Has antioxidant properties
• Facilitates iron absorption
• Deficiency can lead to scurvy
• Excessive doses can cause nausea, abd cramps, diarrhea
• Only established indication is prevent/treat scurvy
|
|
|
Term
|
Definition
Niacin (nicotinic acid)
Riboflavin (vitamin B2)
Thiamin (vitamin B1)
Pyridoxine (vitamin B6)
Cyanocobalamin (vitamin B12)
Folic acid
|
|
|
Term
| What are the characteristics of Niacin (Nicotinic Acid)? |
|
Definition
• High doses treat ▲ cholesterol
• Present in many foods naturally & enriched (Liver, poultry, fish, potatoes, peanuts, cereal)
• Deficiency
-Pellagra – dermatitis characterized by scaling and cracking of the skin in areas exposed to the sun
-GI disturbances
-CNS - Irritability, insomnia, memory loss, anxiety, and dementia
• Adverse effects
-Very low toxicity
-High doses can cause vasodilation (flushing, dizziness, nausea)
-Toxicity more in regards to use for cholesterol
|
|
|
Term
| What are the characteristics of Riboflavin (Vitamin B2)? |
|
Definition
• Involved in numerous enzymatic reactions
• First, must be changed to active forms flavin adenine dinucleotide (FAD) or flavin mononucleotide (FMN)
• Sources-milk, yogurt, cheese, bread, fortified cereals, organ meats
• Therapeutic uses
-Riboflavin deficiency
-Migraine headache prevention in high doses
|
|
|
Term
| What are the characteristics of Thiamin (Vitamin B1)? |
|
Definition
• Actions
-Coenzyme for carbohydrate metabolism
-Requirements increased slightly during pregnancy and breast-feeding
• Sources-enriched/fortified products, whole grain products, pork
• Deficiency
-Beriberi - Wet beriberi-fluid accumulation in legs, palpitations, ECG changes, circulatory collapse & death; slow recovery - Dry beriberi-neuro & motor deficits; quick recovery
-Wernicke-Korsakoff syndrome (Most common in alcoholics; serious disorder of CNS; can result in irreversible brain damage)
|
|
|
Term
| What are the characteristics of Pyridoxine (Vitamin B6)? |
|
Definition
• Coenzyme in the metabolism of amino acids and proteins
• Must first be converted to its active form – pyridoxal phosphate
• Sources-fortified breakfast cereals, meat, fish, poultry, starchy vegetables, noncitrus fruits
• Deficiency
-May result from poor diet, isoniazid use, inborn errors of metabolism
-Symptoms (Seborrheic dermatitis, microcytic anemia, peripheral neuritis, convulsions, depression, confusion)
• Dietary deficiency rare in U.S. except for alcoholics
• Extremely large doses may cause ataxia & numbness of feet/hands
|
|
|
Term
| What are the characteristics of Cyanocobalamin (Vitamin B12) and Folic Acid? |
|
Definition
• Both essential factors in the synthesis of DNA
• Deficiency of either manifests as megaloblastic anemia
• Cyanocobalamin can also produce neurologic damage
• B12 helps convert folic acid into active form
• Absence of folic acid underlies abnormalities seen w/B12 deficiency
|
|
|
Term
| What are the characteristics of Cyanocobalamin (Vitamin B12)? |
|
Definition
• Must obtain from animal sources-the B12 we produce is unavailable from absorption
-Liver, dairy products good sources
• Deficiency-usually caused by impaired absorption
• Adverse effects-may cause hypokalemia
|
|
|
Term
| What are the characteristics of folic acid? |
|
Definition
• Food folate versus synthetic folate
-Synthetic form is more stable
-FDA ordered synthetic folate to be added to all enriched grain products
-Sources-liver, peas, lentils, oranges, whole grain products, asparagus, beets, broccoi, spinach
• Deficiency of folic acid during pregnancy can impair CNS development
-Can result in neural tube defects, anencephaly, spina bifida
-Important for any woman who may become pregnant to take additional folic acid
• May protect against colorectal ca
• Deficiency usually caused by poor diet, malabsorption, alcoholism
|
|
|
Term
| “vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites” intended to supplement the diet |
|
Definition
|
|
Term
| What are the characteristics of Black Cohosh? |
|
Definition
• Cimicifuga racemosa
• Used to treat symptoms of menopause
• MOA unknown
• Effectiveness
-Some studies have shown it to be as effective as estrogen
-Has not been evaluated for long-term use
• Adverse effects
-GI most common, rash, headache, dizziness, wt gain, cramps
• May potentiate hypotensive & hypoglycemic effects of other drugs
|
|
|
Term
| What are the characteristics of Coenzyme Q-10? |
|
Definition
• Potent antioxidant in the body; participates in production of ATP at the mitochondrial level
• Therapeutic uses
-Mitochondrial encephalomyopathies, CHF, and myopathies due to HMG-CoA reductase inhibitors (statins)
• Effective in situations of documented deficiency; little evidence of improving the above
• High doses may produce GI s/s
• Structurally similar to vitamin K, so watch with coumadin
|
|
|
Term
| What are the characteristics of Echinacea? |
|
Definition
• Echinacea angustifolia, E. purpurea, E. pallida
• Used orally and topically
-Produces antiviral, anti-inflammatory, and immunostimulant effects
-Widely taken, but effectiveness is highly questionable
• Adverse effects rare-unpleasant taste most common
-Rarely can cause allergic reaction
• Interactions
-May interfere with immunosuppressant drugs
|
|
|
Term
| What are the characteristics of Flaxseed? |
|
Definition
• Used to treat dyslipidemia and constipation
• Soluble plant fiber
• Seems to decrease total cholesterol and LDL, similar to other fiber products
• Adverse effects are GI-related (bloating, cramping, etc.)
• Should be taken 1 hour before or 2 hours after other medications
|
|
|
Term
| What are the characteristics of Garlic? |
|
Definition
• Used primarily for cardiovascular system effects
-To reduce levels of TG and LDL and raise HDL
• Also used to reduce blood pressure, suppress platelet aggregation, increase arterial elasticity, and decrease formation of atherosclerotic plaque; antimicrobial and anticancer effects
• Effectiveness-can produce favorable effects on lipids & B/P depending on quality of preperation
• Adverse effects-bad taste & breath; may produce GI s/s
• Has antiplatelet effects
|
|
|
Term
| What are the characteristics of ginger root? |
|
Definition
• Primary uses
-To treat vertigo
-To suppress nausea and vomiting caused by motion sickness or morning sickness; to suppress post-op nausea and vomiting
-For cancer chemotherapy
• Can be effective but takes up to 3 days
• Well tolerated-huge doses can cause CNS depression & dysrhythmias, GI s/s
• Can suppress platelet aggregation
|
|
|
Term
| What are the characteristics of Ginkgo Biloba? |
|
Definition
• Used to improve age-related memory impairment & senile dementia but proof lacking
• Is effective increasing pain-free walking distance in those w/peripheral arterial disease
• Well tolerated-can cause GI s/s, headache, dizziness
• Can suppress coagulation; may promote seizures
|
|
|
Term
| What are the characteristics of Glucosamine? |
|
Definition
• Is glucose w/amino group attached
• Used to treat OA of knee, hip, wrist
• Effective in form of glucosamine sulfate but not glucosamine hydrochloride
• Adverse effects-GI
• Is made w/shellfish so use caution if allergic
• May increase bleeding risk
|
|
|
Term
| What are the characteristics of green tea? |
|
Definition
• Use to lose weight, improve mental clarity, prevent CA of stomach, skin, bladder, breast
• May be effective in wt loss & clarity d/t caffeine
• Adverse effects r/t caffeine
• Contains small amt of Vitamin K
• Use caution w/stimulants & vasodilators
|
|
|
Term
| What are the characteristics of probiotics? |
|
Definition
• Composed of bacteria and/or yeast
• Replace natural flora
• Effectiveness varies by product
• Are well tolerated-may cause flatulence & bloating
• May be altered by antibiotics/antifungals
|
|
|
Term
| What are the characteristics of Saw Palmetto? |
|
Definition
• Used to relieve urinary s/s associated w/BPH
• Conflicting results regarding effectiveness
• Well tolerated
• Has antiandrogenic effect; avoid in pregnant women (category X)
|
|
|
Term
| What are the characteristics of St. John’s Wort? |
|
Definition
• Widely used to treat depression
• Limited clinical studies show St. John’s wort is useful for mild to moderate depression – not severe depression
• No prescription needed in United States
• May cause skin reactions, CNS effects, GI s/s
• Interacts adversely with many drugs
-Induction of cytochrome P450 enzymes
-Induction of P-glycoprotein
-Intensification of serotonin effects
|
|
|
Term
What are the harmful supplements and their effects?
|
|
Definition
• Comfrey - Contains pyrrolizidine alkaloids that are associated with veno-occlusive disease
• Kava - Can result in severe hepatic damage
• Ma huang (ephedra) - Can elevate BP and stimulate the heart and CNS
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|
