Herbal & Dietary Supplements
This 1994 legislation created a regulatory category where products do not require pre-market proof of safety or efficacy.
What is the Dietary Supplement Health and Education Act (DSHEA)?
These omega-3 fatty acids found in fish oil compete with arachidonic acid, reducing inflammatory mediator production.
What are EPA and DHA?
This class of drugs requires activation in an acidic environment before covalently binding its target.
What are proton pump inhibitors (PPI)?
This drug forms a negatively charged paste that binds to positively charged proteins in ulcer craters.
What is Sucralfate?
This antidiarrheal slows GI transit by acting on peripheral opioid receptors without significant CNS effects.
What is Loperamide?
This supplement reduces. recurrent UTIs primarily by preventing bacterial adhesion to the bladder wall, not by killing bacteria.
What is Cranberry?
This herbal supplement increases phagocytosis and cytokine release, explaining its use in upper respiratory infections.
What is Echinacea?
This pharmacologic property explains why PPIs are dosed before meals rather than at bedtime.
What is the need for active proton pumps (meal stimulated acid secretion)?
This prostaglandin analog increases both mucus and bicarbonate secretion in the stomach.
What is Misoprostol?
This stool softener works via surfactant activity rather than stimulating motility or osmotic effects.
What is Docusate?
This supplement has SSRI-like activity via inhibition of serotonin, norepinephrine, and dopamine reuptake.
What is St. John's Wart?
This supplement's anti-nausea effect is partly due to antagonism of 5-HT3 receptors in the GI tract.
What is Ginger?
This H2 blocker related mechanism explains why blocking histamine also partially reduces gastrin and acetylcholine mediated acid secretion.
What is downstream signaling convergence at the parietal cell?
This adverse effect limits the use of Misoprostolin women of childbearing potential.
What is uterine contraction leading to miscarriage/abortion?
This IBS-D antibiotic improves symptoms by altering gut microbiota with minimal systemic absorption.
What is Rifaximin?
A patient on warfarin starts a supplement for osteoarthritis and later presents with increased INR; the supplement is also derived from shellfish and may affect glucose levels.
What is Glucosamine?
This supplement may weakly inhibit HMG-CoA reductase and also has antiplatelet effects, increasing bleeding risk.
What is Garlic?
A hopitalized patient on clopidogrel develops GI bleed requiring acid suppression; this PPI is preferred due to minimal CYP2C19 interaction.
What is Pantoprazole?
This combination priciple in H. pylori therapy directly addresses the organism's ability to rapidly develop resistance.
What is use of multiple antibiotics (triple/quadruple therapy)?
This IBS-C drug increases intestinal secretion by activating guanylate cyclase-C receptors.
What is Linaclotide or Plecanatide?
This supplement is often marketed for "energy" but may increase cortisol, affect insulin sensitivity and cause tachycardia.
What is Ginseng?
A patient taking this supplement for memory may experience increased bleeding risk due to inhibition of platelet activating factor.
What is Ginko Biloba?
Long-term PPI use increases infection risk due to loss of this normal physiologic gastric function.
What is acid-mediated bacterial barrier/protection against colonization?
This OTC agent both coats ulcers and has antibacterial activity, while causing a harmless but alarming stool discoloration.
What is Bismuth Subsalicylate?
This prokinetic drug enhances gastric emptying by antagonizing dopamine receptors, theraby increasing cholinergic activity.
What is Metoclopramide?