Chapter 17

Vitamins, OTC Supplements, Antidotes, and Miscellaneous Topics

Medical Foods

• Not FDA approved• Manufacturer may determine that

medical food must have Rx to be dispensed, but no FDA review required

• Used for burn victims, kidney dialysis patients, or patients with CV disease or osteoporosis

Probiotics

• Stimulate the growth of beneficial (“good”) bacteria in the body

• Most common probiotic products and use– acidophilus: diarrhea, vaginitis– Activia: constipation– Align: IBS– Culturelle: diarrhea– Flora-Q: IBS– Lactinex: diarrhea, cold sores

Water Deficits

• Caused by loss of body fluids resulting from disorders such as– vomiting– diarrhea– edema– large urine output– excessive sweating from fever– acute weight loss

Electrolytes

• Compounds that form ions when dissolved in water

• Ions are electrically charged particles• sodium and water = blood volume

and blood pressure = circulatory collapse

Electrolytes

• Na+ - acid-base & water balance, electroactivity

• K+ - acid-base & water balance, nervous system function

• Ca++- bone formation, coagulation, contractility

• Mg++- normal nerve and muscle function

IV Therapy

• An isotonic solution has the same level of each type of particles as the body fluids, e.g. 0.9% NaCl

Enteral Nutrition

• Patients fed through a tube leading to the GI system (stomach or small intestines)

• Preferred method over IV therapy because GI system will remain functional

Parental Nutrition

• Parental nutrition (PN): patient fed through a view

• Total parenteral nutrition (TPN): provides patient with all nutritional requirements through the parental route

Alternative Supplements

• Use of herbs to treat various complaints• Herbs were the original source of many

important drugs• Herbs have served as models for many

synthetic drugs

Safety Issues

• Many people think herbals products are nontoxic and safe, but this is not completely true

• FDA prevents relatively poisonous plants from being on the market, however safety issues still exist

Three Particular Safety Concerns

• One herb may be mistaken for another– Could result in serious side effects or allergic

response

• Potential for interactions with other herbs and drugs

• Patient may try to treat themselves with herbal products and forgo effective treatment

Some Problems With Herbal Supplements

• Lack of regulation and standardization– No FDA quality control– Content of herbal products varies widely

• Accurate information is hard to find• Determining toxicity– Some of the most toxic chemicals are obtained from

plants

Alternative Supplements

• Chamomile- anti-inflammatory, antispasmodic• Chondroitin- arthritis• chromium picolinate- weight loss, improve

insulin metabolism• coenzyme Q10- CHF• dong quai- menstrual cramps• Echinacea- common cold• enada, NADH- mental clarity, fatigue

Alternative Supplements

• Feverfew- migraine prophylaxis• Garlic- HTN and hyperlipidemia• Ginger- antiemetic• Ginkgo- circulatory stimulant• Ginseng- energy • Glucosamine- arthritis • Hawthorn- cardiovascular problems

Alternative Supplements

• Kava- anxiety, psychosis, induces relaxation

• Melatonin- sleep • saw palmetto- prostate • St. John’s wort- depression • Valerian- sleep • Yohimbe- impotence

Poisons and Antidotes

• Children under 6 at high risk of accidental poisoning

• Common drugs that cause the most childhood poisonings– Iron tablets– TCAs– Calcium channel blockers– Opiates– Aspirin– Alcohol

Klor-Con/Potassium Chloride

• Used to prevent or to treat low levels of potassium

• Category C

Folvite/Folic Acid

• B vitamin• Produce & maintain new cells, prevent

changes to DNA• Tx: anemia, folic acid deficiency• Preg. Cat A