Deck 15: Medications, Diet-Drug Interactions, and Herbal Supplements
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Deck 15: Medications, Diet-Drug Interactions, and Herbal Supplements
1
According to the Dietary Supplement Health and Education Act (DSHEA),
A)herbal supplements must be approved by the FDA.
B)manufacturers of herbal supplements must provide evidence of a product's safety.
C)herbal supplements must be priced less than prescription medications.
D)manufacturers of herbal supplements may make claims about the prevention or treatment of specific diseases.
E)the FDA must show that a supplement is unsafe before it can stop the sale of an herbal supplement.
A)herbal supplements must be approved by the FDA.
B)manufacturers of herbal supplements must provide evidence of a product's safety.
C)herbal supplements must be priced less than prescription medications.
D)manufacturers of herbal supplements may make claims about the prevention or treatment of specific diseases.
E)the FDA must show that a supplement is unsafe before it can stop the sale of an herbal supplement.
E
2
Which population is least vulnerable to the adverse effects of drugs?
A)elderly people
B)pregnant women
C)middle-aged women
D)children
E)infants
A)elderly people
B)pregnant women
C)middle-aged women
D)children
E)infants
C
3
Naturopathic medicine is based on the theory that "like cures like."
False
4
The National Center for Complementary and Alternative Medicine is one of the many institutes that make up the National Institutes of Health.
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5
Which medical abbreviation or term is prohibited on clinical documentation?
A)q.i.d.
B)mcg
C)IU
D)mg
E)0.1 mg
A)q.i.d.
B)mcg
C)IU
D)mg
E)0.1 mg
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6
Aspirin is an example of a(n):
A)OTC drug.
B)generic drug.
C)herbal product.
D)prescription drug.
E)anticonvulsant drug.
A)OTC drug.
B)generic drug.
C)herbal product.
D)prescription drug.
E)anticonvulsant drug.
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7
Which practice can help to reduce the likelihood of the adverse effects of drugs?
A)Request a complete list of all medications and dietary supplements that a patient is taking.
B)Ensure that more than one doctor is overseeing each patient's medication use.
C)Encourage patients to use multiple pharmacies so that more than one pharmacist can monitor their prescriptions.
D)Tell patients that most side effects are temporary and to wait a few days before calling the doctor.
E)Tell patients that herbal supplements do not usually react with prescription medications.
A)Request a complete list of all medications and dietary supplements that a patient is taking.
B)Ensure that more than one doctor is overseeing each patient's medication use.
C)Encourage patients to use multiple pharmacies so that more than one pharmacist can monitor their prescriptions.
D)Tell patients that most side effects are temporary and to wait a few days before calling the doctor.
E)Tell patients that herbal supplements do not usually react with prescription medications.
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8
Physicians who practice integrative medicine may refer patients for complementary therapies while continuing to provide standard treatments.
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9
A high-fiber diet and regular exercise may prevent the need for laxatives.
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10
Health practitioners do not need to be aware of patients' use of complementary and alternative therapies.
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11
An example of guided imagery is when a person tries to reverse the disease process by using mental pictures.
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12
Problems with medications can be reported to the FDA via the:
A)MedWatch website.
B)DSHEA website.
C)NCCAM website.
D)USDA website.
E)NIH website.
A)MedWatch website.
B)DSHEA website.
C)NCCAM website.
D)USDA website.
E)NIH website.
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13
Although many medications can cause nausea, it usually subsides after the first few doses.
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14
Dietary supplements:
A)can be marketed without studies to document their effectiveness and safety.
B)are always hazardous.
C)always contain the quantity of product stated on the label.
D)are approved by the FDA.
E)are more effective than prescription drugs.
A)can be marketed without studies to document their effectiveness and safety.
B)are always hazardous.
C)always contain the quantity of product stated on the label.
D)are approved by the FDA.
E)are more effective than prescription drugs.
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15
The adverse effects of herbs are required to be listed on supplement labels.
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16
OTC drugs:
A)have no side effects.
B)often were first prescription drugs.
C)do not interact with other medications.
D)are the same as generic drugs.
E)usually cost more than prescription drugs.
A)have no side effects.
B)often were first prescription drugs.
C)do not interact with other medications.
D)are the same as generic drugs.
E)usually cost more than prescription drugs.
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17
OTC drugs:
A)require medical supervision.
B)include herbal supplements.
C)include antibiotics.
D)are used to treat self-diagnosed illnesses.
E)are not regulated by the FDA.
A)require medical supervision.
B)include herbal supplements.
C)include antibiotics.
D)are used to treat self-diagnosed illnesses.
E)are not regulated by the FDA.
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18
There are no known interactions between herbal supplements and medications.
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19
Which population group is most prone to drug-drug interactions?
A)infants
B)children
C)the elderly
D)the disabled
E)teenagers
A)infants
B)children
C)the elderly
D)the disabled
E)teenagers
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20
CAM is sometimes used as a buzzword marketing ploy by unscrupulous sellers of worthless treatments.
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21
Methotrexate interferes with the metabolism of:
A)folate.
B)iron.
C)vitamin B12.
D)calcium.
E)vitamin D.
A)folate.
B)iron.
C)vitamin B12.
D)calcium.
E)vitamin D.
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22
Which food has been shown to raise blood levels of a variety of medications?
A)bananas
B)grapefruit juice
C)tomato juice
D)oranges
E)apples
A)bananas
B)grapefruit juice
C)tomato juice
D)oranges
E)apples
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23
Which type of drug may cause unintentional weight gain?
A)antipsychotics
B)antiretrovirals
C)antinauseants
D)antibiotics
E)antihistamines
A)antipsychotics
B)antiretrovirals
C)antinauseants
D)antibiotics
E)antihistamines
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24
Why is it recommended that tetracycline be taken on an empty stomach at least two hours before or after consuming dairy products?
A)Stomach acidity affects calcium absorption.
B)Too much tetracycline will be absorbed, and blood levels will be too high.
C)The combination of tetracycline and calcium will cause tooth enamel to discolor.
D)Too much calcium will be absorbed, and blood levels will be too high.
E)Tetracycline and calcium will bind to each other, reducing the absorption of both.
A)Stomach acidity affects calcium absorption.
B)Too much tetracycline will be absorbed, and blood levels will be too high.
C)The combination of tetracycline and calcium will cause tooth enamel to discolor.
D)Too much calcium will be absorbed, and blood levels will be too high.
E)Tetracycline and calcium will bind to each other, reducing the absorption of both.
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25
The medications most likely to cause nutrient malabsorption are those that:
A)lower blood glucose.
B)control high blood pressure.
C)damage the intestinal mucosa.
D)slow gastric emptying.
E)slow saliva production.
A)lower blood glucose.
B)control high blood pressure.
C)damage the intestinal mucosa.
D)slow gastric emptying.
E)slow saliva production.
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26
The most common adverse effects of herbs include:
A)breathing difficulties.
B)renal failure, seizures, and heart palpitations.
C)nausea, vomiting, and diarrhea.
D)heart attack or stroke.
E)cancer.
A)breathing difficulties.
B)renal failure, seizures, and heart palpitations.
C)nausea, vomiting, and diarrhea.
D)heart attack or stroke.
E)cancer.
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27
Unintentional weight gain can result from the use of:
A)antidepressant medications.
B)antihypertensive medications.
C)sedatives.
D)antinausea medications.
E)anticonvulsant medications.
A)antidepressant medications.
B)antihypertensive medications.
C)sedatives.
D)antinausea medications.
E)anticonvulsant medications.
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28
Which herb is often used for the prevention and treatment of nausea and motion sickness?
A)ginseng
B)ginger
C)kava
D)valerian
E)garlic
A)ginseng
B)ginger
C)kava
D)valerian
E)garlic
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29
Anticonvulsant drugs may increase levels of enzymes that metabolize:
A)vitamins.
B)fats.
C)proteins.
D)minerals.
E)sugars.
A)vitamins.
B)fats.
C)proteins.
D)minerals.
E)sugars.
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30
Which herb has been linked to liver damage?
A)ginseng
B)gingko
C)kava
D)garlic
E)ephedra
A)ginseng
B)gingko
C)kava
D)garlic
E)ephedra
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31
Consistency in herbal supplements is not guaranteed because:
A)no manufacturers have attempted to standardize them.
B)they are natural substances, so there can be no consistency.
C)different growing conditions can affect the plants' chemical composition.
D)the active ingredient in an herb must be isolated to be effective.
E)the active ingredient is usually not identified.
A)no manufacturers have attempted to standardize them.
B)they are natural substances, so there can be no consistency.
C)different growing conditions can affect the plants' chemical composition.
D)the active ingredient in an herb must be isolated to be effective.
E)the active ingredient is usually not identified.
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32
Which statement does not represent a concern about the use of herbal supplements?
A)contamination with toxic metals
B)adulteration with synthetic drugs
C)lack of consistency in ingredients
D)cost compared to benefit
E)lack of consistency of manufacturing
A)contamination with toxic metals
B)adulteration with synthetic drugs
C)lack of consistency in ingredients
D)cost compared to benefit
E)lack of consistency of manufacturing
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33
Which herb has been found to inhibit the action of oral contraceptives?
A)St. John's wort
B)garlic
C)ginseng
D)kava
E)ginger
A)St. John's wort
B)garlic
C)ginseng
D)kava
E)ginger
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34
Meals high in _____ can inhibit the absorption of tricyclic antidepressants due to binding between the dietary component and the drug.
A)acidic foods
B)fiber
C)protein
D)garlic
E)fat
A)acidic foods
B)fiber
C)protein
D)garlic
E)fat
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35
Which substance can alter sodium and potassium concentrations?
A)ephedra
B)diuretics
C)folate
D)ginseng
E)sedatives
A)ephedra
B)diuretics
C)folate
D)ginseng
E)sedatives
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36
Which herb can intensify the action of warfarin (Coumadin)?
A)kava
B)saw palmetto
C)garlic
D)echinacea
E)black cohosh
A)kava
B)saw palmetto
C)garlic
D)echinacea
E)black cohosh
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37
Medications that reduce stomach acid may impair the absorption of:
A)vitamin C.
B)vitamin B12.
C)glucose.
D)proteins.
E)fats.
A)vitamin C.
B)vitamin B12.
C)glucose.
D)proteins.
E)fats.
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38
Megestrol acetate is a(n):
A)appetite enhancer.
B)weight-loss drug.
C)antidepressant.
D)pain reliever.
E)sedative.
A)appetite enhancer.
B)weight-loss drug.
C)antidepressant.
D)pain reliever.
E)sedative.
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39
Feverfew is often taken to treat:
A)liver disease.
B)migraine headaches.
C)sexual dysfunction.
D)hypertension.
E)insomnia.
A)liver disease.
B)migraine headaches.
C)sexual dysfunction.
D)hypertension.
E)insomnia.
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40
Which herb can raise the likelihood of bleeding when used in conjunction with anticoagulant drugs?
A)ginseng
B)ephedra
C)kava
D)valerian
E)ginger
A)ginseng
B)ephedra
C)kava
D)valerian
E)ginger
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41
Supplements of _____ are usually given to patients receiving the antituberculosis drug isoniazid.
A)iron
B)vitamin B6
C)vitamin B12
D)folate
E)calcium
A)iron
B)vitamin B6
C)vitamin B12
D)folate
E)calcium
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42
Use the following case study to answer questions 52-57.
Jose Salazar has been hospitalized following a motor vehicle accident. He has several broken bones, including his left jaw, two ribs on the left side, and a compound fracture of his left leg. According to his medical record, he is 47 years old, his height is 5'9", and his weight is 171 pounds. During the course of his hospital stay, he was diagnosed with a heart arrhythmia. His current medications include lovastatin to lower his cholesterol, an MAO inhibitor to treat depression, and an analgesic to treat his pain. Mr. Salazar's wife also reports that he takes several herbal products including yohimbe, kava, valerian, and St. John's wort.
Before leaving the hospital, Mr. Salazar will need nutrition education on:
A)how to use a blender.
B)food-medication interactions.
C)food safety.
D)weight loss.
E)kidney function testing.
Jose Salazar has been hospitalized following a motor vehicle accident. He has several broken bones, including his left jaw, two ribs on the left side, and a compound fracture of his left leg. According to his medical record, he is 47 years old, his height is 5'9", and his weight is 171 pounds. During the course of his hospital stay, he was diagnosed with a heart arrhythmia. His current medications include lovastatin to lower his cholesterol, an MAO inhibitor to treat depression, and an analgesic to treat his pain. Mr. Salazar's wife also reports that he takes several herbal products including yohimbe, kava, valerian, and St. John's wort.
Before leaving the hospital, Mr. Salazar will need nutrition education on:
A)how to use a blender.
B)food-medication interactions.
C)food safety.
D)weight loss.
E)kidney function testing.
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43
Grapefruit juice can increase the physiological effects of some drugs by:
A)affecting kidney excretion.
B)decreasing blood concentration of some drugs.
C)inactivating certain drugs.
D)altering the action of certain drugs.
E)inactivating enzymes that metabolize drugs.
A)affecting kidney excretion.
B)decreasing blood concentration of some drugs.
C)inactivating certain drugs.
D)altering the action of certain drugs.
E)inactivating enzymes that metabolize drugs.
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44
The anticonvulsants phenobarbital and phenytoin increase levels of the liver enzymes that metabolize:
A)folate.
B)vitamin B6.
C)vitamin B12.
D)iron.
E)vitamin D.
A)folate.
B)vitamin B6.
C)vitamin B12.
D)iron.
E)vitamin D.
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45
People taking MAO inhibitors should restrict their intake of:
A)tomato sauce.
B)cheddar cheese.
C)cottage cheese.
D)white wine.
E)red wine.
A)tomato sauce.
B)cheddar cheese.
C)cottage cheese.
D)white wine.
E)red wine.
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46
The one characteristic that all alternative therapies have in common is:
A)their effectiveness.
B)research into their safety.
C)a lack of evidence about their effectiveness.
D)the absence of any interactions with mainstream medical care.
E)consistent prescription drug interactions.
A)their effectiveness.
B)research into their safety.
C)a lack of evidence about their effectiveness.
D)the absence of any interactions with mainstream medical care.
E)consistent prescription drug interactions.
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47
People taking lithium are advised to maintain a consistent intake of _____ from day to day in order to maintain stable lithium blood levels.
A)calcium
B)zinc
C)sodium
D)alcohol
E)potassium
A)calcium
B)zinc
C)sodium
D)alcohol
E)potassium
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48
Use the following case study to answer questions 52-57.
Jose Salazar has been hospitalized following a motor vehicle accident. He has several broken bones, including his left jaw, two ribs on the left side, and a compound fracture of his left leg. According to his medical record, he is 47 years old, his height is 5'9", and his weight is 171 pounds. During the course of his hospital stay, he was diagnosed with a heart arrhythmia. His current medications include lovastatin to lower his cholesterol, an MAO inhibitor to treat depression, and an analgesic to treat his pain. Mr. Salazar's wife also reports that he takes several herbal products including yohimbe, kava, valerian, and St. John's wort.
In order to avoid a food-medication interaction with his MAO inhibitor, Mr. Salazar will need to avoid drinking:
A)beer.
B)cola beverages.
C)tea.
D)grapefruit juice.
E)caffeine.
Jose Salazar has been hospitalized following a motor vehicle accident. He has several broken bones, including his left jaw, two ribs on the left side, and a compound fracture of his left leg. According to his medical record, he is 47 years old, his height is 5'9", and his weight is 171 pounds. During the course of his hospital stay, he was diagnosed with a heart arrhythmia. His current medications include lovastatin to lower his cholesterol, an MAO inhibitor to treat depression, and an analgesic to treat his pain. Mr. Salazar's wife also reports that he takes several herbal products including yohimbe, kava, valerian, and St. John's wort.
In order to avoid a food-medication interaction with his MAO inhibitor, Mr. Salazar will need to avoid drinking:
A)beer.
B)cola beverages.
C)tea.
D)grapefruit juice.
E)caffeine.
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49
Which side effects might be expected from long-term use of corticosteroids?
A)weight gain, muscle wasting, bone loss, hyperglycemia
B)weight loss, hypertension, bone loss, hypoglycemia
C)weight gain, high cholesterol, bone loss, hypoglycemia
D)weight loss, muscle wasting, kidney failure, hyperglycemia
E)weight loss, kidney failure, excessive bone growth
A)weight gain, muscle wasting, bone loss, hyperglycemia
B)weight loss, hypertension, bone loss, hypoglycemia
C)weight gain, high cholesterol, bone loss, hypoglycemia
D)weight loss, muscle wasting, kidney failure, hyperglycemia
E)weight loss, kidney failure, excessive bone growth
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50
With the medications Mr. Salazar is taking, he should be advised to stop taking _____, because of the potential of this herb to suppress the effects of some drugs.
A)yohimbe
B)kava
C)St. John's wort
D)valerian
E)ginseng
A)yohimbe
B)kava
C)St. John's wort
D)valerian
E)ginseng
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51
Use the following case study to answer questions 52-57.
Jose Salazar has been hospitalized following a motor vehicle accident. He has several broken bones, including his left jaw, two ribs on the left side, and a compound fracture of his left leg. According to his medical record, he is 47 years old, his height is 5'9", and his weight is 171 pounds. During the course of his hospital stay, he was diagnosed with a heart arrhythmia. His current medications include lovastatin to lower his cholesterol, an MAO inhibitor to treat depression, and an analgesic to treat his pain. Mr. Salazar's wife also reports that he takes several herbal products including yohimbe, kava, valerian, and St. John's wort.
Because Mr. Salazar is taking lovastatin, he should be counseled to avoid:
A)apple juice.
B)grapefruit juice.
C)green leafy vegetables.
D)milk.
E)orange juice.
Jose Salazar has been hospitalized following a motor vehicle accident. He has several broken bones, including his left jaw, two ribs on the left side, and a compound fracture of his left leg. According to his medical record, he is 47 years old, his height is 5'9", and his weight is 171 pounds. During the course of his hospital stay, he was diagnosed with a heart arrhythmia. His current medications include lovastatin to lower his cholesterol, an MAO inhibitor to treat depression, and an analgesic to treat his pain. Mr. Salazar's wife also reports that he takes several herbal products including yohimbe, kava, valerian, and St. John's wort.
Because Mr. Salazar is taking lovastatin, he should be counseled to avoid:
A)apple juice.
B)grapefruit juice.
C)green leafy vegetables.
D)milk.
E)orange juice.
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52
What advice should be given to Mr. Salazar regarding his use of herbal products?
A)He should stop taking them completely.
B)He should look up the side effects of each herbal product he takes so he can be aware of them.
C)He should never take more than one herbal product at a time.
D)Herbal products should never be taken at the same time he takes his prescription medications.
E)Each time he visits his physician, he should bring a list of all prescription medications and herbal products he regularly takes.
A)He should stop taking them completely.
B)He should look up the side effects of each herbal product he takes so he can be aware of them.
C)He should never take more than one herbal product at a time.
D)Herbal products should never be taken at the same time he takes his prescription medications.
E)Each time he visits his physician, he should bring a list of all prescription medications and herbal products he regularly takes.
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53
Which food should not be eaten in a tyramine-controlled diet?
A)tomatoes
B)liver
C)cucumbers
D)pork sausage
E)beef
A)tomatoes
B)liver
C)cucumbers
D)pork sausage
E)beef
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54
One of the problems with determining the effectiveness of an herbal remedy is:
A)the lack of a consistent supply of herbs.
B)the fact that different samples of an herb can have different chemical compositions.
C)inconsistent labeling of supplements.
D)differing opinions about the best method for testing herbs.
E)the inability of testing agencies to collect appropriate samples.
A)the lack of a consistent supply of herbs.
B)the fact that different samples of an herb can have different chemical compositions.
C)inconsistent labeling of supplements.
D)differing opinions about the best method for testing herbs.
E)the inability of testing agencies to collect appropriate samples.
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55
People taking MAO inhibitors should avoid foods containing:
A)tyramine.
B)phenylalanine.
C)tryptophan.
D)starch.
E)high amounts of fat.
A)tyramine.
B)phenylalanine.
C)tryptophan.
D)starch.
E)high amounts of fat.
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56
Despite the popularity of _____, its benefits for treating the common cold have not been supported by some clinical studies.
A)ginseng
B)St. John's wort
C)echinacea
D)garlic
E)ephedra
A)ginseng
B)St. John's wort
C)echinacea
D)garlic
E)ephedra
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57
Individuals using warfarin are advised to:
A)avoid all foods containing vitamin K.
B)take a vitamin K supplement.
C)consume consistent amounts of vitamin K daily.
D)avoid green, leafy vegetables.
E)avoid acidic foods.
A)avoid all foods containing vitamin K.
B)take a vitamin K supplement.
C)consume consistent amounts of vitamin K daily.
D)avoid green, leafy vegetables.
E)avoid acidic foods.
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58
The drug warfarin is structurally similar to:
A)vitamin C.
B)vitamin K.
C)vitamin D.
D)vitamin E.
E)vitamin B12.
A)vitamin C.
B)vitamin K.
C)vitamin D.
D)vitamin E.
E)vitamin B12.
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59
Which form of alternative medicine proposes that a person's "life force" can foster self-healing?
A)homeopathic medicine
B)naturopathic medicine
C)bioelectrical medicine
D)chiropractic medicine
E)acupuncture medicine
A)homeopathic medicine
B)naturopathic medicine
C)bioelectrical medicine
D)chiropractic medicine
E)acupuncture medicine
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60
Which herbal product taken by Mr. Salazar may be causing his heart arrhythmia?
A)yohimbe
B)kava kava only
C)St. John's wort
D)valerian only
E)both valerian and kava kava
A)yohimbe
B)kava kava only
C)St. John's wort
D)valerian only
E)both valerian and kava kava
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61
Match between columns
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62
Match between columns
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63
Match between columns
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64
Which alternative therapy involves the alleged curative power of "energy"?
A)qi gong
B)massage therapy
C)biofeedback training
D)faith healing
E)chiropractic medicine
A)qi gong
B)massage therapy
C)biofeedback training
D)faith healing
E)chiropractic medicine
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65
Match between columns
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66
A complementary and alternative medicine that is classified as a biologically based therapy is:
A)dietary supplements.
B)chiropractic medicine.
C)massage therapy.
D)reflexology.
E)acupuncture.
A)dietary supplements.
B)chiropractic medicine.
C)massage therapy.
D)reflexology.
E)acupuncture.
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67
A patient is taking an MAO inhibitor and is on a tyramine-controlled diet. Which food should be avoided?
A)American cheese
B)peanuts
C)soy sauce
D)spinach
E)beef
A)American cheese
B)peanuts
C)soy sauce
D)spinach
E)beef
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68
Match between columns
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69
The nurse recognizes that a patient placed on the anticoagulant drug warfarin will need:
A)supplements of vitamin K.
B)a high-kcalorie diet.
C)education regarding diet-drug interactions.
D)education regarding increasing iron intake.
E)education regarding monitoring fluid input and output.
A)supplements of vitamin K.
B)a high-kcalorie diet.
C)education regarding diet-drug interactions.
D)education regarding increasing iron intake.
E)education regarding monitoring fluid input and output.
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70
Match between columns
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71
Which alternative therapy is a form of traditional Chinese medicine?
A)bioelectromagnetic therapy
B)acupuncture
C)chiropractic
D)therapeutic touch
E)homeopathic medicine
A)bioelectromagnetic therapy
B)acupuncture
C)chiropractic
D)therapeutic touch
E)homeopathic medicine
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72
Match between columns
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73
Drugs that reduce cholesterol levels might also interfere with:
A)urinary function.
B)stomach pH.
C)fat soluble vitamin absorption.
D)red blood cell formation.
E)hemoglobin concentration.
A)urinary function.
B)stomach pH.
C)fat soluble vitamin absorption.
D)red blood cell formation.
E)hemoglobin concentration.
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74
Match between columns
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75
Reduced stomach acidity may affect the absorption of which drug?
A)methotrexate
B)ephedra
C)lanoxin
D)leucovorin
E)isoniazid
A)methotrexate
B)ephedra
C)lanoxin
D)leucovorin
E)isoniazid
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76
Which CAM is biologically based?
A)ayurveda
B)meditation
C)prayer
D)aromatherapy
E)refexology
A)ayurveda
B)meditation
C)prayer
D)aromatherapy
E)refexology
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77
Match between columns
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78
Match between columns
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79
Which drug prevents cancer cells from obtaining folate?
A)methotrexate
B)ephedra
C)coenzyme Q
D)leucovorin
E)isoniazid
A)methotrexate
B)ephedra
C)coenzyme Q
D)leucovorin
E)isoniazid
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80
Which drug is used to treat tuberculosis?
A)methotrexate
B)ephedra
C)lanoxin
D)leucovorin
E)isoniazid
A)methotrexate
B)ephedra
C)lanoxin
D)leucovorin
E)isoniazid
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