Long Exam 3_ GI- - Nutraceuticals.pdf

ingredients garlic organosulfurs S-allylcysteine MOA inhibits HMG-CoA reductase - involved in cholesterol biosynthesis antiplatelet, enhanced fibrinolytic clinical use atherosclerosis BP reduction (mild hypertension) adverse effects nausea hypotension allergy bleeding breath and body odor dosage 600...

ingredients garlic organosulfurs S-allylcysteine MOA inhibits HMG-CoA reductase - involved in cholesterol biosynthesis antiplatelet, enhanced fibrinolytic clinical use atherosclerosis BP reduction (mild hypertension) adverse effects nausea hypotension allergy bleeding breath and body odor dosage 600-900mg/day powdered - equiv. to 1 clove raw garlic 1 bulb: 1.8% alliin other notes standardized to allicin or alliin 600-1800mg/day aged garlic extract enteric-coated forms preferred milk thistle silymarin isomers - silybun (50-70): poor oral - silychristin - silydianin melatonin serotonin derived from pineal gland antioxidant potential IV: reduce HCV RNA and ALT anti-inflammatory liver-protective - 2100mg/day for 1 yr reduced fibrosis and stiffness induce lactation (inc. prolactin; generally not recommended) jet lag and sleep aid px who develop insomnia from beta blockesr improve morning alertness and quality of sleep reduce periperative anxiety in adults standardized to contain 70-80% silymarin next day drowsiness,fatigue, dizziness, headache, irritability rare: transient depression or dysphoria may decrease prolactin may affect BP in both jetlag: 0.5-5mg at desired bedtime - 5mg: faster onset of sleep - lower: better sleep quality immediate release is preferred dark room environment daylight exposure in new timezone better than placebo in helping patients fall asleep faster and better - esp, when traveling across >=5 time zones - symptoms reduced when taken close to bedtime - more effective in east-bound travel insomnia: 0.3-10mg - immediate release once a night - lowest effective dose first then may be repeated in 30 mins - max: 10-20mg - sustained release can also be used (but more mahal) glucosamine CoQ10/ubiquinone cartilage nutrient (from crabs may increase supple of necessary and other crustaceans) glycosaminoglycan building blocks found in mitochondria of many organs CoQ10: brain, drain, pain manifestations after ingestion: ubiquinal predominates statins: inhibit HMG CoA reductase - also required for CoQ10 synthesis pain management associated w/ knee osteoarthritis Parkinson's heart (heart failure, ischemia) - antioxidant for ischemia - LipA, HDL, exercise tolerance - small reduciton in cardiac deaths and reinfarction oral: well-tolerated mild diarrhea, crampingm nausea cross allergenicity - unlikely if properly manufactured avoid combination with warfarin 500mg 3x/day OR 1500mg/day generally well tolerated low incidence: GI upset, diarrhea, nausea, heartburn, and anorexia maculopapular rash, thrombocytopenia, irritability, dizziness, headache insufficiency: 30mg/day cardiac support: 100-600mg.day in 2-3 divided doses improvement may be observed 1-2 mos later may decrease effects of warfarin - similar structure to vitamin K saw palmetto hexane liposterolic extract gingko biloba leaf extract standardized to contain - 24% flavone genesis - 6% terpene lactones inhibits 5a reductase conversion of testosterone to DHT inhibit prostatic GFs blockade of a1 adrenoreceptors inhibition of inflammatory mediators benign prostate hyperplasia no adverse effect to the PSA levels alzheimer's/vascular/mixed dementia - utilizes the formulation of EGb761 - can be single parent or addon to conventional - not for prevention nausea, headache, stomach upset, diarrhea, dementia: 240mg daily divided into 2 doses allergy, anxiety, insomnia possible bleeding complications - avoid use w/ anticoagulants or antiplatelets possible seed contamination from some herbal formilations - may contain uncooked seeds: epileptogenic - avoid giving to ppl w/ seizure disorders chronic schizophrenia when combined w/ standard treatment - clozapine, halperidol, olanzapine available forms: - glucosamine sulfate - glucosamine hydrochloride (inferior) 160mg PO 2x/day can be given alongside long-term statin therapy