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Vitamins & Herbals
Vitamins/herbal - Trade Name/Use/Dosing/Notes
37
Pharmacology
Graduate
02/22/2011

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Cards

Term
Vitamin A
Definition
Other Names: Retinol, Beta-carotene
Uses: Eyesight, Aging
Dosing: <10,000 IU daily - <5,000 IU if pregnant

Notes:
Term
Vitamin B1
Definition
Other Names: Thiamine
Uses: Alcohol Dependency
Term
Vitamin B2
Definition
Other Names: Riboflavin
Uses: Migraines, Cataracts
Notes: Diarrhea (large doses)
Term
Vitamin B3
Definition
Other Names: Niacin
Uses: Increases HDL, Decreases TG
Dosing: 1-3g daily
Notes: Flushing/itching/headache: >50mg
Liver toxicity: >1.5g niacin
Term
Vitamin B5
Definition
Other Names: Pantothenic Acid
Uses: Stamina
Notes: Royal Jelly (bees)
Term
Vitamin B6
Definition
Other Names: Pyridoxine
Uses: Nausea/vomiting (pregnancy)
Notes: Need adequate folic acid
Sensory neuropathy at high doses (>1g)
Term
Vitamin B9
Definition
Other Names: Folic Acid
Uses: Neural tube defects, decreases side effects of methotrexate
Dosing: 400mcg QD
Notes: May mask pernicious anemia
Replenish in chronic alcoholics
Term
Vitamin B12
Definition
Other Names: Cyanocobalamin
Uses: Pernicious anemia
Notes: Consider folate use (masks B12 deficiency)
PO equivalent to IM
Replenish in chronic alcoholics
Term
Vitamin C
Definition
Other Names: Ascorbic Acid
Uses: Common cold, iron absorption
Dosing: <2g QD
Notes: Kidney Stones (>1g QD)
Term
Vitamin D
Definition
Other Names: Ergocalciferol (D2)
Cholecalciferol (D3)
Uses: Osteoporosis
Fall prevention
Dosing: 400 IU 0-12 months
600 IU 1-70 y
800 IU >70 y
(may need more)
Notes:
Term
Vitamin E
Definition
Other Names: Alpha-tocopherol
Uses: Dementia, AMD, Tardive Dyskinesia, CVD/scarring
Dosing: <400 IU/Day (unhealthy)
Notes: >800 IU/Day increases bleeding risk
Term
Vitamin K
Definition
Other Names: Phytonadione
Uses: Bleeding (related to warfarin)
Notes: Counteracts warfarin, found in green leafy veggies
Term
Calcium
Definition
Uses: Osteoporosis, antacid
Dosing: 1000-1200mg/Day
Notes: No more than 500mg at a time.
Calcium Carbonate: inexpensive/less pills/acid dependent
Calcium citrate: expensive/large pills/more pills/acid independent
Term
Iron
Definition
Uses: Anemia
Notes: Constipation, Vitamin C helps absorption
Separate: Biphosphates/levodopa/methyldopa/antibiotics
Term
Lutein
Definition
Uses: Antioxidant, Eye health
Notes: Food is the best source
Term
Lycopene
Definition
Uses: Antioxidant
Notes: Better availability in heat-processed food
Term
Magnesium
Definition
Uses: Constipation, Pre-eclampsia, Headaches/PMS
Notes: AE: diarrhea
Term
Zinc
Definition
Uses: Common Cold
Notes: Avoid nasal gel
Beware of cadmium exposure
Term
Bitter Orange
Definition
Uses: Weight loss, athletic performance
AE's: Prolongs QT interval
Potential Cardiac Effects
Counseling Points: Related to ephedrine
Banned by many sports organizations
Term
Black Cohosh
Definition
Uses: Menopause
Contraindicated in: pregnancy (causes uterine contractions)
Efficacy: Modest
AE's: Reports of liver damage (if long-term use; check LFTs periodically)
Counseling Points: Doesn't stimulate estrogen-dependent tumors
Doesn't work for hot flashes in breast cancer survivors
Takes several weeks to take effect
Term
Echinacea
Definition
Uses: Common Cold
Contraindicated in: asthma, ragweed allergy, atopy, allergic rhinitis
Efficacy: limited, may decrease cold duration/severity by 10-30%
AE's: Well tolerated
Counseling Points: No standardization
Likely safe, likely ineffective
Term
Ephedra - BANNED
Definition
Uses: Weight loss, athletic performance
AE's: MI, Arrhythmia, Stroke, Psychosis, Seizures, Death
Counseling Points: Do not recommend
Term
Fish Oil
Definition
Uses: Cholesterol (dec. TG's, may inc. LDL)
Efficacy: Good
AE's: Fishy Burp, halitosis, heartburn, loose stool
Counseling Points: Take with meals or freeze caps to minimize AE's
May inhibit platelet aggregation
Contamination concerns
Term
Flaxseed
Definition
Uses: Menopause(40g/day), Cholesterol, HTN, Constipation
Efficacy: Weak evidence
AE's: bloating, flatulence, diarrhea
Counseling Points: 40g has high fat content and ~200 calories
Term
Garlic
Definition
Uses: HTN, Cholesterol
Efficacy: Limited (decreases SBP 7-8%)
None (recent studies)
AE's: Heartburn, flatulence, breath and body odor
Counseling Points: Odorless garlic doesn't work as well
Interacts with warfarin, antiplatelet agents, anticoagulants.
Induces 3A4 at high doses.
Term
Gingko
Definition
Uses: Dementia
Efficacy: Mild to moderate. Recent trials: not effective.
AE's: GI complaints, bleeding (stop 2 weeks before surgery)
Counseling Points: Ginkgotoxin can cause seizures (found in seeds)
Interacts with anticoagulants and antiplatelet agents (increased bleeding)
Takes 6-8 weeks to see improvement
Term
Ginseng
Definition
Uses: Common cold, Cognitive function, Sexual function, General well-being
Efficacy: ??
AE's: Headache, Insomnia
Counseling Points: Interacts with:
warfarin (increases clotting)
anticoagulants (increases bleeding)
loop diuretics (diuretic resistance)
Bitter orange (prolongs QT interval)
Term
Glucosamine/Chondroitin
Definition
Uses: Osteoarthritis
Efficacy: Mixed results
AE's: Mild GI upset
Counseling Points: Derived from exoskeleton of shellfish (not meat); or produced synthetically
Allergy issues
Sulfate salt used most in RCTs
Term
Goldenseal
Definition
Uses: Common Cold
Contraindicated in:
nursing mothers
Efficacy: none
AE's: Well tolerated
Counseling Points: Accumulation of active ingredient in breast milk may cause kernicterus in newborns
Term
Hoodia
Definition
Uses: Weight loss
Efficacy: Possibly effective but products of questionable quality
AE's: Well tolerated
Counseling Points: More is being sold than there are plants in existence
Term
Melatonin
Definition
Uses: Insomnia
Efficacy: Good
Counseling Points: Regulates circadian rhythms. High doses may inhibit ovulation.
Term
Red Clover
Definition
Uses: Menopause
Efficacy: Negligible
AE's: Headache
Counseling Points: Avoid if taking tamoxifen or history of breast cancer.
Increased risk of bleeding with antiplatelet agents or anticoagulants
Term
SAMe
Definition
Uses: Depression
Efficacy: Modest in limited number of RCTs
AE's: Well tolerated
Counseling Points: Increases serotonin (serotonergic effects). Issues with product quality and cost.
Term
Saw Palmetto
Definition
Uses: BPH
Efficacy: Similar to 5-alpha reductase inhibitors. Inferior to alpha-1 blockers.
AE's: Dizziness, HA, GI complaints
Counseling Points: Takes 1-2 months to see improvement.
Term
Soy
Definition
Uses: Menopause
Cholesterol "reduces the risk of heart disease" (protein)
Osteoporosis, Diabetes
Efficacy: Modest benefit -- takes up to 2 months to work
AE's: Well tolerated
Counseling Points: Protein from foods better than supplements (safer, more evidence).
Avoid if taking tamoxifen or history of breast cancer.
"Unopposed phytoestrogens" probably OK; use food sources instead of supplements
Term
St. John's wort
Definition
Uses: Depression
Efficacy: Effective for mild/moderate depression
AE's: Nausea, Insomnia, Vivid dreams, restlessness, fatigue, dry mouth, photosensitivity
Counseling Points: Similar to SNRI's.
Takes 3-4 weeks for maximal effect; taper when discounting.
Induces 3A4; benzos, oral contraceptives, protease inhibitors, warfarin
Term
Valerian
Definition
Uses: Insomnia
Efficacy: Looks good but more trials needed
AE's: HA, nervousness, excitability, hepatotoxicity (rare)
Counseling Points: Benzo-like effects at GABA receptors.
Taper when discontinuing.
May inhibit 3A4.
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