صفحه 1:
ad
طدا ©:
3
صفحه 2:
Werbd Products
صفحه 3:
(© weds)
@lercraive cred Cowplewediary سر زا
رت مه و مت رت سا
تور Mel و ا رک ۱4۳
دل وصاعهت اعد رن ل »)سس ات ارت
صفحه 4:
اه عط مسب
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صفحه 5:
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eee tae a eae ec
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Ce eee COC ae ee OG ae
— Due ول wil be Dov Od.
صفحه 6:
Weekly Quiz
* Every week there will be a brief (~5 questions)
quiz. The time allowed will be 10-15 min.
* quiz will be based on lecture material
presented in the previous class.
* You can drop one quiz with the lowest score.
¢ There will be no “make-up” quiz if you are
absent.
* At least a 70% on all possible quiz points and a
“pass” on the research paper will be needed to
get credit for this credit/no credit course.
صفحه 7:
میا مت مات وت دا مت
سس همست
- The Review oP Oot Products. Paris und Orwpeterus
Pubtchiay Brow, Gt. bovis DO. COOR. @vatcble of he DO
®ovkstore. lev writible اما ادن the OW ot
1 ااال
"4 ا Vick Dye cleared
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Carey beeen nod ole no On contac he Tae ee a
0 انس (
SIONS Nae nse en PR rerio RN eae ca Des Cat
board. $990 /peur. Oulu wauiable at OO at
۱ nce asc Caaf
صفحه 8:
بت
el ka og اوه
ارس رم مه مامتها aS
۳0
Bel eco RCN a ea ل Ua
۱ crag Ao lcac acer)
Clevier — exceledt.
999
- ۳ )90 حاصباا 9 علفظ) امهنهانل)
Op O. Okxvedhd, et d. 92009۰ BBC Press. ۰
صفحه 9:
۱ (ae)
يي es Cae A Be تب یم تن
Carr Le ad CN as NT ae
Gpriager Orrkry. GOOS. Exophusis va therapeutics wi
Laces ee cree a el)
— Octed Therapeutics Pocket Gude, On editva. Krish, OL et
RE Cn cece LO 12 222 ca
Rema Reiner cac cat ac cin cae emcee heehee)
صفحه 10:
Certodicus un Oewsteters va Werbd Products
۱ Vaan (le A Cr Nea oR hrc ca]
CON At ROUSSE ص
(Pousrdatiod; PO Box 2 يدل
۹
صفحه 11:
مات متا هت ۱۱
] ee ee aT
Pee he aed lee ee ed ete ede
$00 hr. The subsoripton wil ub provide pou were i Die Dorel Produce
Ts Oe ed ea ae ee an
او A ag (O.O0) ie
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ا ا ا ا ا ا ا
تمه تا ها
ات با دس مت ماس با
مد میمصت همم دا ی ما مهتم سس
a MEL ean مر ام مه
stes oP terest. ها هم مس یه مس
ولو یت :مه
صفحه 12:
OxePul Ietercet Orb sites
© OP Pe oP Ottery Guppleweuts, ONL. Oucdated by DOLE,
their wissivs ts to prowote research and provide vbevive
یمیمص Lick to 10106 dacbose ot
soiedPic fiercture vo dietary supplewedts ond vier dotboses. Ose
eee ee ددم
۱۱ Werbdl Product Ossoriatos. Trade Ossvcrica wit
DO ا ا ا ااا
يال ان ميا rePereues va kerbub. Ont
ows up to te, however. OsePul yevercl site.
مت ما
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ie a وله نم
یم رو LIT
صفحه 13:
(irae RCo ira ara OW OO ecard
*Dietary Supplement/Food Label News from the FDA
http://www.cfsan.fda.gov/~dms/infonet.html
*Nutrition News Focus
http://www.NutritionNewsFocus.com
*Arbor Clinical Nutrition Updates (Dr. Tony Heilman)
http://arborcom.com
صفحه 14:
1000 year
old
“Patterson
۱۵
Native
American
bundle of
6 1مصنمت0
روت
HerbalGram
2002;55:35-41
صفحه 15:
car Amara ca
* sales of about $14 billion $ in USA for dietary
ity ojo) Keveelevaunc}
¢ sales of about 5 billion $ in USA for botanicals
٠ Mass market herbal sales increased
dramatically in the 1990s but have dropped in
recent years. Total sales from all channels have
generally shown a slow increase.
* In 1990 5.8% used “alternative medicines”
* In 2002, 25.2% used “alternative medicines”
٠ most do not tell their “traditional” provider
what they are taking and many take alternative
and complementary products together with
alopathic drugs
ref. Eisenberg et al. JAMA 1998;280:1569-1575; HerbalGram 2006;71:64.
صفحه 16:
@avtker Gavep vu Public Ose oP
CT ance DAC abi ctcd
۱۳5 2۱0۵ یی
دا ل ل ل ا
۱ aca cd
۵
2 report ed OOO wediciues were
Drvery nica ناجم دراك"
Se MTN Ma tA CAML CAGhS|
AI oe وا ار تفت S NI CAShS| ل
۱2 2 did «vt tell OO ۹۹2۵ OO revowweuded)
SON AS te CMO BR es Sofie ae = (eID)
صفحه 17:
Dietary Supplement Education Alliance Survey
04 63 0 11 nky:)|
July 2001
*N=1022
*59% take dietary supplements on a regular basis
°46% take multivitamins
°23% take herbal and specialty products (15%
botanicals, 8% non botanical supplements)
°95% indicate satisfaction; 75% very satisfied or
extremely satisfied
°25% wrong about expecting immediate results from
herbals
*Only 49% consult with health care providers about
taking sunvlements
صفحه 18:
4
3561
3259 (92)
533 (15)
2081 (58)
2219 (62)
463 (13)
511 14.4)
3
3919
3533 (90)
504 (13)
1678 (43)
2263 (68)
111017
159 017[
Table 1. Enrollees in CHS Study*
Total enrolled: 5849
White. 4925 (84)
Black: 924 (16)
Male: 2478 (42)
Female: 3371 (58)
Study period 1 2
Total users 4373 4351
Rx users 3994 (91) 3891 (89)
CAM users 278 (6) 295 (7)
Vitamin/mineral | 1713 (39) 1707 (39)
users
OTC users. 2635 (60) 2720 (63)
Rx plusCAM 238 (5) 243 (6)
Rx, CAM, OTC | 264 (6) 270 (6.2)
* The number in parentheses is the percent of the enrolled
Elmer et al. Ann Pharmacother (in press for Oct 07)
Elmer et al n Pharmacother. 2007;40:1617-24
صفحه 19:
كت
رجا دنتسه 20 را صدلا گ كص الكت عاناة1
Bilhary
Lysine
ملام مم
Stakeatilage
صفحه 20:
Sales of Overthe Counter
Herbal Medicines (8)
Distrbution ofthe $4.96 Billion European Market for Overshe-Counter
Medicines in 2003
milion in sales was divided among Portugal, Hung
ing per capita (calculated onthe bas ures’ prices
وا and recent Unted Nations projections of 2 rs) was $25.00
inGermany, $1880 in France, $950 i
Kingdom, $4.10 in Spain, $12 30n Belgium, $13.00 in Switzer
n Avaria, $5.0 in the Netherlands, and
صفحه 21:
kere Grorle اب ۵) 6
صفحه 22:
*fatigue (ginseng and others)
*insomnia (valerian)
*anxiety/depression (kava, chamomile, skullcap, St.
John’s Wort)
752 11 (echinacea, goldenseal, atragalus,
pau d’arco)
palmetto, pygeum) مق
(black cohosh, soy, evening primrose) ...~~
صفحه 23:
۱۸۱ رب Ca Nicecd
ف
ااا Ve can AN acd
و
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0
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صفحه 24:
اعداسه ها کر همم Oe ONC
عدا ل مت
از صدحاد 96 5 00
4
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(Re BE ee hice
صفحه 25:
اعداسه ها کر همم Oe ONC
Mine Kenai رت ها مت
tere ۵ 8 ٩۵ و سا 6
- 46. رسیطلا oe -9 3
2 ا oe -9 ao
peace 20 96 06
0 ia ovo 004 9 ae
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ca مومس سا
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De el eee oan eee oe ee Reed
ی aed ak nee Oneahia cede oa elk caemuaeat ed
Pe ee ed One Renner cael ae aera
1/۱ oe ee eee
صفحه 26:
ON RCs aI eek aaa ROL Nas ad
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صفحه 27:
کر مر ۱4
عم 90 42 0ه
Ouse warket Tele) SS
Octurd cred asor 9
امه سس
S.O 9000 وعلمك ما۹
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Ref: HerbalGram 2008;78:61-62
صفحه 28:
ة 2 بط ره ۳۳
ار
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2060
enol
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Ref: HerbalGram 2008;78:61-62
صفحه 29:
Kaufman et al. JAMA 2002;287:337-344
Table 3 Ten Most Commonly Used Herbals/Supplements:1-Week Prevalence, %, by Sex and Age®
Men ‘Women
1844y —4564y By 1044 ال >65y Total
Rank —_Herbal'Supplement 62528 0-3 0-248 (n= 595) (n=486) (n= 351) (N= 2500)
1 Ginseng 4 4 <i 2 3 2 33
(1 > 4 1 1 4 0 22
3 Alum sativum <i 4 4 1 3 3 19
4... 00 2 2 4 at 5 4 19
5. wort <i 2 0 2 3 1 13
6 Eehinacea augustiola 1 1 0 1 3 > 13
7 ممما > <i 1 1 3 1 11
8. 0 <i 1 1 0 3 10
0-7 4 0 0 0 0 09
0 Serenoa repens 1 1 4 0 41 0 09
‘Any use 12 7 1 0 23 14 14
*Peroetages weighted accarg ta aus Sze
صفحه 30:
OsePul Werbal Products
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تسیا سر
Dik Thete مت
دعسم وس
6 Da
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8. سب لب و2 «دصاصل amc tad
میم هه
ease a Ra aoe
(CT راوج
مت سس Cad
FR 0 بو
للك مت مه
صفحه 31:
Cer OM aA ara
5 Vacate case} ۱۲ ام رو مت
عد همست ی
0 0 ۱9 اس و متس
فنك
Ls Ce a anata d dswewrrken, vier
٠ اس وس ت۱9 بصوطا8)
0 od 5
hyperteusiog, heart
° pohiwbe Previle dysPucvion
صفحه 32:
Werbd Products Orewed Ore
a الیهس مس
1 ieee * Kowbuckd Tea
oe ee ON Ca)
بت نكا
0 الم بای موی
AQ oy 0 مم8
Cdaws A Ce mad
rd را سومان
اا 0 سوت
ری( ۰ CowPrey
لبلب ممت
صفحه 33:
۱ exon aba Need eran aed
07 عدو ولج 2000”
0 2-86 040 (CN Para Ce rad
status (except howevpubic products)
۱ oo cane calcd
اسر NN ce oe و cece
ODL eM GCA cig A ا Le
مس هس
۱ ae Tae ea (CAC
۱ Nace اوه رص ادك
صفحه 34:
(Ee m0 Issues
ری مر بطم مت مد
بت -
oi همم ات هت
ولو
شا سس یه مها مار هرب در ره
۹ high dose OC
اه مه سوت وال رای
طاعناها لمرو - (09©)0
Selim ل ا انه
(OGLE)
صفحه 35:
۱۱۱ م لل
(OGLE®)
ل CLA od CL ACCA oa CS
SNA Scan ON aN Comes ل
SM an rom oon cara ODO)
۱ od eM CaS ULAR Nc RCM caro
جوجكا لصورصنت صا ججوصلانج
Se eer cere aU el mca eRe hare
BS OCR cen ا AUIS TAN md
Be ee SN RI Neco Bcc aa NaC مصصط
0 ااي
رح ها روم لا
۱ by CTO; al ese by POO
صفحه 36:
۱۱۱ م لل
(OGLE®)
۱ suppleswedts une ut coosidered Poods, Pood
ما سس
۱
۱ اه
Se rr cate Ora] ners Mc eran PO ach bee ard
جوجهكا لصوردنت صا ججوصلارج
Te etc emcees at mot ised eae ie hace
SCS ONC RA ce Vea aN cB caNN يي ed
0 RI Ne Co Bac يي SC مصصطا
UN xa am Oe
رح ها روم لا
ل ل لم انا
صفحه 37:
۱۱۱ م لل
(OGLE®)
۱ suppleswedts une ut coosidered Poods, Pood
ما سس
۱
۱ اه
Se rr cate Ora] ners Mc eran PO ach bee ard
جوجهكا لصوردنت صا ججوصلارج
Te etc emcees at mot ised eae ie hace
SCS ONC RA ce Vea aN cB caNN يي ed
0 RI Ne Co Bac يي SC مصصطا
UN xa am Oe
رح ها روم لا
ل ل لم انا
صفحه 38:
۱۱۱ م لل
(OGLE®)
۱ suppleswedts une ut coosidered Poods, Pood
ما سس
۱
۱ اه
Se rr cate Ora] ners Mc eran PO ach bee ard
جوجهكا لصوردنت صا ججوصلارج
Te etc emcees at mot ised eae ie hace
SCS ONC RA ce Vea aN cB caNN يي ed
0 RI Ne Co Bac يي SC مصصطا
UN xa am Oe
رح ها روم لا
ل ل لم انا
صفحه 39:
۱۱۱ م لل
(OGLE®)
۱ suppleswedts une ut coosidered Poods, Pood
ما سس
۱
۱ اه
Se rr cate Ora] ners Mc eran PO ach bee ard
جوجهكا لصوردنت صا ججوصلارج
Te etc emcees at mot ised eae ie hace
SCS ONC RA ce Vea aN cB caNN يي ed
0 RI Ne Co Bac يي SC مصصطا
UN xa am Oe
رح ها روم لا
ل ل لم انا
صفحه 40:
(۹ ۱2۹ ۱3۳ ca
مه سم سا 99
OCG رس رسمه سرا
Se يا ةا
لت سم 0 sywpiows (acer, hot Pleshes, wridkles
مت
بموصك عونا بممسوجمم بمصانيجم "لججبلووووهو" ٠
suppeweds wil be ta place ot he POO by 900
۶ مت ما ار درا رات Gued Requirewed bil
(®EGR @il). QOow wendiory reporicy 7 COO oP serine
wdverse eveds Por supplewedts aun OTC products
صفحه 41:
ean 00 ار و1۹
oe Ar ed et oe a oa acd ا
میا
هم ص هم مرا
وه پا ون ی
ل ام هت سم
dietary supplewed hibel te rappropricie °
مره سم ی 7
ce od age cir at ره
Caer aoe as i 0
ی مها ee Ma a
(Ole)
صفحه 42:
1 (ein EN cand
0 Gil huge problews to quay podirct
* Oveticd und oricvicd eleweus to torchesiry
Serr MR come TAT
صفحه 43:
تک ۱۸
۱
< متحختصصها (0؟) مصتحصها بلس )90(
۰ عاك سرا (hele)
٠ POO "0۹9 0.0
Sela ead (ORS ada
* Ghop{o Oca 009
۱ عاك فياف سرت
SC a عاك "9
۱ ره 09 00
OO 099 را
صفحه 44:
350
۱ Panax speci
300"
HB Eleutherococcus senticosus
Percentage of the Amount Indicated on Label
te EGET Nan sition op We
Code for Ginseng Product Tested
Variation in the Amounts of Active Ginsenosides (Panax Species) and
Eleutherosides (Eleutherococcus senticosus) in Ginseng Products in Re-
lation to the Amounts Indicated on Their Labels.
‘Adapted from Harkey et al. (Am J Clin Nutr 2001;73:1101-6), with the per-
mission of the publisher.
صفحه 45:
Ce ae Rae Cer ee ای سس ور و
relent
stew 0 ant لم
صفحه 46:
Internet Marketing of Herbal Products Study
Morris and Avorn JAMA 2003;290:1505-1509
Methods: Searched using 5 search engines the first
page hits for 8 popular herbals
Findings: 273 of 338 (81%) made 1 or more health
claim
only 12% provided references to back
claim
only 39% of kava sites mentioned
hepatotoxicity
صفحه 47:
Examples of Internet Health Claims JAMA 2003;290:1505-
1509)
Ginkgo Biloba“Its effects in improving circulation also contribute
to its use for impotency and peripheral vascular insufficiency
Ginkgo treats depression, headaches, memory loss and ringing in
the ears (tinnitus). It is also recommended for Alzheimer's,
asthma, eczema, heart and kidney disorders.”
St John's Wort “St John's wort is effective in the treatment
of mild to moderate depression ... recent studies have shown that
it could have a potent anti-viral effect against enveloped viruses.”
Echinacea “Because it has natural antibiotic actions,
Echinacea is considered an excellent herb for infections of all
kinds. In addition, it works to boost lymphatic cleansing of the
blood, enhances the immune system and has cortisone like
properties which contribute to its anti-inflammatory action. It is
recommended for stubborn viral infections, yeast infections and
for arthritic conditions.”
Saw Palmetto “The lipophilic extract of the saw palmetto
(ser repens) berries is the most widely used herbal preventive
ی ی ی مق تس باق کب 0 te
صفحه 48:
ما سم ما همم سم سس رت
weuddivas vod suggestive i PO (‘Or) ۱
© * setup ppetew i review boticds Por OTC status
° urge to study requatory systews ta ver poudiries
سامت بو تما
Se hee a و ened
products tat way wt weet OTO data requirewec
© ood Por we of vuside experts to product reviews
صفحه 49:
ca ادق
0 posts warnings of contaminated or harmful
supplements
* tiratricol or TRIAC (triiodothyroacetic acid)
earistolochic acid (renal toxicity)
*ephedra alkaloids
ا
*Kava and hepatotoxicity
*FDA recall of PC-SPES (contamination with warfarin
and maybe DES)
صفحه 50:
حوصن إن 8 )
بفستصصلين: عوجاودا حجن حاتم مودو Dew vowpentd ©
accd اللي ناك 5
ed crac ee RR Rrra a on col لل
اس ات مه Sk
* COCs Por Oey Guppleweds we ww ic efPevt
صفحه 51:
OGP-OF
*United States Pharmacopoeia/National Formulary
*Non profit corporation that sets standards for drugs
and biologics
*Is in the process of creating standards for dietary
supplements
*Limits on heavy metals, pesticides
*Limits on microbial contamination
*Quality control specs for marker compounds
صفحه 52:
Oriental Ginseng te pate Bod
صفحه 53:
OG Otay Gupplewedt OrrPicaiva Progra
Manufacturer must agree to meet standards set by
USP and their monographs
*Must agree to inspections and random analyses of
products
*USP analyzes the product and inspects the
manufacturing facility
*Pharmavite is the first manufacturer to seek USP
verification (Nature Made, Nature’s Resource) for their
line of herbals and dietary supplements. The “USP” will
appear on the labels.
صفحه 54:
4
51122115
*Membership is $24/yr and includes access to The
Natural Pharmacist database
* Manufacturers whose products “pass” are listed on
consumerlab’s website (www.consumerlab.com)
*Manufacturers who do not pass are also listed
*A manufacturer whose product “passes” can (for a
fee) include the consumerlab seal on their label
صفحه 55:
- ce cal purses, und fergie ww wubb
— better educaivg oo subject tt pracvusy schools
cand vier kedlks proPessioes trotatacy
= wore Prequedt wed beter OC prowuws
swore researck wiuipy sc OCB
OA RO iO ccd
— pressure ts va Por POO bw “adapt” tp COO
صفحه 56:
Produ Gelection Issues
سك Mr eae
See a ca Meee Re oc oan Doe
0 Dr gs Bias a a a _
EE ae one tas همست
ac ci hoe a giao ana od ل
select products thot have butch cucvbers, expiry does, acd
يي ل يننا
Sr a Rad
صفحه 57:
امه لممه) عصوو() وموق)
Warner Lambert
Quanterra Mental® (ginkgo)
Quanterra Prostate® (saw palmetto)
Whitehall-Robins Healthcare
Centrum® botanicals line
Pharmaton (Boehringer Ingelheim)
Ginsana ® (ginseng)
Ginkoba ® (ginkgo)
Venastat ® (horse chestnut)
Movana ® (St. John’s wort)
صحطهعع زو
Alluna ® (valerian and hops)
Pharmavite
Nature Made ®
Nature’s Resource ®
Phyto-Phamica
Nature’s Way
صفحه 58:
۱۹ 4
QOrivy wik OOs ued vier prescribers
Ns a eR a
۱ er the best products
۱۳ رم وی و ead
A Batra رت
صفحه 59:
Chovstey Werbds -@duice Por ام
Qe swe pou hwe wo wourde duu.
Getect “aoe broad”, qualiy product;
4B the adveriotay saps “cure” “breakthrough”
“detoxPy/” etz — Porset a!
fo word toerucioes wih Rx or viker OTTO
wedroulow.
Ove vor supplewect (stig typ edion!) of ۰
wits lobes ta vase ve Puture موه ها و
adverse rewiow.