Nutritional Supplements and Alternative Medicines

Copyright © 2012, 2009, 2003 by Saunders, an imprint of Elsevier Inc. All rights reserved.

CHAPTER 19

Nutritional Supplements and Alternative Medicines

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LEARNING OBJECTIVES Discussing medical indications for nutritional

supplements. Identifying fat-soluble and water-soluble

vitamins. Identifying minerals that are used as

supplements and for electrolyte replacement. Discussing common home remedies used as

alternative medicinal forms. Describing the use of herbal medicines.


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LEARNING OBJECTIVES (CONT’D.) Understanding over-the-counter (OTC)

nutritional supplements and their interactions with therapeutic prescription medications.

Describing cultural differences and the use of herbals and alternative medicines.

Providing patient education for compliance with medications used as nutritional supplements and alternative medicines.


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Intellectual impairment

Muscle wasting Obesity Emaciation Loss of hair Delayed healing of

wounds

NUTRITIONAL IMBALANCECOMMON SIGNS AND SYMPTOMS Nonspecific complaints Abnormal bone function Neurological damage Inability to build, repair

tissue Change in energy level


NOURISHMENTThe human body requires food, and especially vitamins, that are not produced by the body.

Vitamins are normally obtained from fluids and plant and animal products that we ingest.

Nutrients might be “natural,” but they can still have side effects on the human body when:

introduced in large amounts taken indiscriminatelyinteracting with other supplements or drugs


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COMMON SIDE EFFECTS OF VITAMINS, MINERALS, AND HERBS Irritability Anorexia Headaches, flushing Indigestion, nausea, diarrhea, constipation Abdominal cramping and pain Discolored stools Insomnia Hypotension


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VITAMINS General term for number of organic

substances or nutrients necessary for normal: growth development metabolism release of energy from food

Needed in trace amounts; required amounts vary in children, elderly, pregnant, or lactating women


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VITAMINS Most American diets contain adequate vitamin

amounts. Fat-soluble vitamins are stored for long periods.


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VITAMINS: PATIENT EDUCATION FOR COMPLIANCE Vitamin supplements - taken in addition to

dietary sources; could be useful during certain times in life cycle Healthy, nonsmoking, nonpregnant adults do not

need vitamin supplements. Fortified/enriched foods have synthetic

vitamins added during processing.


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VITAMINS: PATIENT EDUCATION FOR COMPLIANCE Overcooking vegetables leads to vitamin loss. Over-the-counter vitamins typically have lower

vitamin content than prescription vitamins. Humans need 10 to 15 minutes of sunlight

exposure per day, 3 times a week, for normal absorption of vitamin D.


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VITAMINS Vitamin A highly teratogenic


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FAT-SOLUBLE VITAMINS


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WATER-SOLUBLE VITAMINS


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WATER SOLUBLE VITAMINS


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VITAMINS


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MINERALS Inorganic solid substances Usually component of earth’s crust Needed in small amounts for body to function

normally 4% of body weight Mineral supplements are needed during rapid

growth periods, for clinical situations (anemia), or during certain drug therapies (diuretics)


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MINERALS Acid—hydrogen ion released in a solution,

reacts with metal to form saltspH < 7

Base—combines with hydrogen to form saltpH > 7 or alkaline

Salt—any compound of acid and base


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MINERALS Electrolytes can conduct electrical charge, form

charged particles (ions). Water = solvent; electrolytes = solute Together they form an isotonic (0.9%) salt

solution.


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MAJOR MINERALS Calcium (Ca+)

needed for bone and tooth formation, muscle contraction and relaxation, blood clotting, nervous system transmission, insulin secretion

calcium carbonate (Tums) and Os-Cal good sources postmenopausal women need vitamin D for

effective calcium absorption


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MAJOR MINERALS Phosphorus (P+)

needed for bone and tooth formation, energy helps in storage of fats and metabolism


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MAJOR MINERALS Magnesium (Mg+)

helps synthesize proteins, stimulates muscle contraction and nerve transmission, activates enzymes, aids in bone formation

supplements found in combinations with other minerals (calcium)

Slow Mag, MOM, Epsom salts


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MAJOR MINERALS Sodium (Na+)

regulates body fluid and acid-base balance found in table salt


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MAJOR MINERALS Potassium (K+)

maintains cell structure by regulating levels of intracellular fluid

regulates muscle function, especially cardiac muscle

K-Lyte or K-Dur Chloride (Cl-)

serves as buffer, enzyme activator, component of gastric HCl


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TRACE MINERALS Iron (Fe+)

essential component of blood hemoglobin; used in antibody formation

ferrous sulfate darkens stools, causes constipation liquid iron preparations should be ingested through

a straw to prevent tooth discoloration never mix iron and antacids


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TRACE MINERALS (CONT’D.) Zinc (Zn+)

essential component of DNA and RNA necessary for sexual development, wound healing,

normal taste and smell Fluorine/Fluorides (Fl)

protect against dental caries, contribute to bone formation

present in fluorinated water, tea, seafood do not take fluoride drops with milk or dairy

products


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USE OF MINERAL SUPPLEMENTS Take with care and only under physician

advice. A healthy person who eats a balanced diet will

obtain sufficient minerals to counteract normal losses of minerals.

Excessive amounts could easily become toxic, causing: hair loss changes in blood, muscles, blood vessels


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ALTERNATIVE MEDICINES Products lacking scientific evidence of safety

and efficacy some herbal preparations copper bracelets for arthritis

Complementary medicine—alternative techniques proven effective by scientific research acupuncture massage therapy biofeedback


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HOME AND FOLK REMEDIES Treatment devised at home without

professional medical advice Passed down from generation to generation Questionable therapeutic valueMany home and folk remedies coexist with modern pharmacological therapy.

In the United States, most cultural groups use some form of complementary or alternative therapies.


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HOME AND FOLK REMEDIES


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SAFETY AND REGULATION OF HERBAL SUPPLEMENTS Considered dietary supplements; not regulated

by FDA Always ask patients about their use of herbal

supplements Instruct patients to purchase herbs from a

reputable source Inform physician of herbal therapy to avoid

drug interactions


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LEADING USES FOR HERBAL PRODUCTS

• Different parts of the herb are used for medicinal purposes.


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EXAMPLES OF HERBS WITH A POTENTIAL FOR TOXIC EFFECTS

Nutritional Supplements and Alternative Medicines

Education

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