80: RXPrep: Dietary Supplements, Natural & Complementary Medicine

What are some differences of supplements vs drugs?

Supplement safety is manufacturer's responsibilitySupplements cannot claim to treat, cure or mitigate a condition.

What are the four areas of concern of supplements?

Interaction with prescription drugsIncreased bleeding riskCardiotoxicityHepatotoxicity

Concerns with St. John's Wort

DDI - CYP inducerSerotonergicPhotosensitivityLower seizure threshold

Supplements that increase bleeding risk

5 Gs": garlic, ginger, ginkgo, ginseng, glucosamineFish oils (High dose)Vitamin EDong QuaiWillow bark (salicylate)

Supplements with risk of hepatotoxicity

Black cohoshChaparralKavaGreen tea "extracts

Supplements that are cardiotoxic

YohimbeEphedra

Supplements commonly used for anxiety

ValerianSt. John's wortKavaPassionflowerChamomile

Supplements commonly used for ADHD

Fish oil

Supplements commonly used for cold sores (aphthous ulcers/canker sores)

L-lysine

Supplements commonly used for colds and flu

ZincEchinaceaVitamin C

Supplements commonly used for dementia / memory

GinkgoVitamin E

Supplements commonly used for Depression

ValerianSt. John's wortSAMe (S-adenosyl-L-methionine)

Supplements commonly used for Diabetes

Alpha lipoic acidCinnamonChromium

Supplements commonly used for Dyslipidemia

GarlicRed yeast ricePlant sterolFish oilFibers

Supplements commonly used for Dyspepsia

CalciumMagnesium

Supplements commonly used for energy / weight loss

Bitter orange (synephrine component)CaffeineGuarana, green tea powder (caffeine)

Supplements commonly used for erectile dysfunction

GinsengL-arginineYohimbe

Supplements commonly used for HF, heart health

Coenzyme Q10HawthornFish oil

Supplements commonly used for HTN

Coenzyme Q10Fish oilGarlicL-arginine

Supplements commonly used for GI health

ProbioticsFibersChamomile

Supplements commonly used for Inflammation

Fish oilFlax seeds/oilTurmeric

Supplements commonly used for insomnia / sleep

MelatoninValerianChamomile

Supplements commonly used for Liver disease

Milk thistle

Supplements commonly used for Menopause

Black cohoshEvening primrose oilSoy, red clover

Supplements commonly used for migraine prophylaxis

FeverfewButterburMagnesiumRiboflavin (B2)

Supplements commonly used for motion sickness

GingerPeppermint

Supplements commonly used for osteoarthritis

TurmericGlucosamineChondroitinSAMe

Supplements commonly used for osteoporosis

CalciumVitamin DSoy

Supplements commonly used for prostate health

Saw palmettoLycopene

Supplements commonly used for skin conditions

Tea tree oil

Supplements commonly used for UTI

ProbioticsCranberry

Supplements commonly used for weight loss

Garcinia cambogia

Vitamin A

Retinol

Vitamin B1

Thiamine

Vitamin B2

Riboflavin

Vitamin B3

Niacin

Vitamin B6

Pyridoxine

Vitamin B9

Folic Acid

Vitamin B12

Cyanocobalamin

Vitamin C

Ascorbic acid

Wernicke's is a ___________ deficiency. What are the symptoms?

ThiamineMental confusionVision changesAtaxiaTremor

Korsakoff syndrome

As symptoms of Wernicke's fade, Korsakoff syndrome/psychosis tends to develop which is permanent neurological damage.

Anticonvulsants can contribute to ________________ deficiency

calcium; supplement with calcium + vit D is required for most patients.

What supplementation is recommended for all prescription medications for low bone density?

Calcium Vitamin D

AAP recommends for exclusively breastfed infants or babies drinking < 1L baby formula

400IU vitamin D QdayPoly-Vi-Sol acceptable

What supplementation do older children who do not drink at least of 4 cups of vitamin D fortified milk need?

Vitamin D

Folic acid recommendation

400 mcg: childbearing age600 mcg: 1 month before pregnancy

Concerns with Vitamin E

CVD risk if > 400IU

How much iron do breastfed 4 - 6mo. babies need?

1mg/kg/day

What nutrient is depleted with acetazolamide?

CaK

What nutrient is depleted with antiepileptic drugs?

Ca

What nutrient is depleted with amphotericin B?

MgK

What nutrient is depleted with isoniazid?

B6

What nutrient is depleted with loop diuretics?

K

What nutrient is depleted with metformin

B12

What nutrient is depleted with MTX

Folate

What nutrient is depleted with Orlistat

B-caroteneFat soluble vitamins

What nutrient is depleted with PPI?

MgB12 (> 2yrs tx)

What nutrient is depleted with sulfamethoxazole?

Folate

What supplement is recommended in alcoholics?

B1Folate

What supplement is recommended in microcytic anemia?

Ferrous sulfate

What supplement is recommended in macrocytic anemia?

B12Folate

What supplement is recommended in pregnancy?

FolateCaVitamin DPyridoxine (for nausea)

What supplement is recommended in osteopenia/osteoporosis, osteomalacia

CaVitamin D

What supplement is recommended in CKD?

Vitamin D

What supplement is recommended in scurvy?

Vitamin C

Is it legal to market CBD as a food/dietary supplement?

No, it is currently available as a prescription drug

Homeopathy

Based on "the law of similars" or the concept that "like is cured by like." This is the belief that giving very small amounts of a substance, which in its undiluted form causes similar symptoms of the illness, will protect the patient or cure them of the illness.