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Supplement of The Month
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Supplement of the Month- June 2010 PROBIOTICS
Martha Prieto, PharmD Candidate, 2011, UCSF
Probiotics are this month’s Supplement of the Month. They are also known as acidophilus, lactobacillus, saccharomyces and bifidobacterium, amongst others. Probiotics are not and are not to be confused with prebiotics. You can find them in milk products, yogurts, and also consume them as capsules, tablets, beverages, and powders. These are referred to as beneficial bacteria. They work to maintain the health of the intestinal tract, help digestion, and keep harmful bacteria of the gut under control. They improve the digestion and absorption of proteins, fats, calcium, and phosphorus.
Probiotics are also able to stimulate the body's immune system and are useful in reducing duration and symptoms of gastrointestinal illnesses such as infectious and antibiotic diarrhea, irritable bowel syndrome, and inflammatory bowel diseases. After antibiotic treatment, probiotics may be used to restore healthful bacteria thereby preventing colitis. Also, cheese-containing probiotics may help reduce the risk of a fungal mouth infection.
Probiotics are well tolerated and safe for consumption. Flatulence as a side effect has been reported. If an excessive production of gas is noted patients are advised to start at a low dose and increase over time to minimize side effects.
Probiotics should not be used if patients are allergic to any component of a probiotic-containing product. Caution is advised if patients are sensitive to or intolerant to dairy products containing probiotics. No interactions have been reported with drugs or herbal products. Patients suffering from intestinal damage or infections and patients with a weakened immune systems should not used probiotics.
Probiotics are available as capsules, yogurts, powder, and dairy products in varying doses. A dose of 100 grams of a probiotic drink twice daily can be used to reduce the effects of antibiotic therapy and may be consumed one week after antibiotics.
For diarrhea patients can take Lactobacillus acidophilus preparations, 2 capsules 2 to 4 times daily. Patients are advised to not use this for self medication of diarrhea for more than 2 days if fever is present.
Patients are encouraged consult their doctor or pharmacist whenever considering addition of a supplement to the antiretroviral regimen.
REFERENCES:
Micromedex Database. Probiotic Monograph. Accessed online 04/16/2010.
Natural Standard Database. Probiotic Monograph. Accessed online 04/16/2010.
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Here's what our members are saying ...
"It has been wonderful to work with Michelle! She is a great resource of information when I put patients on complicated drug regimens or when patients have questions about their medications. She has done research on various herbal and nutritional supplements and their interactions with HIV medications. She has been instrumental in getting patients to understand the importance of adherence, when other providers have failed.
Michelle is enthusiastic, approachable and truly devoted to our patients. She is a respected expert in the field of HIV, and has been teaching in various clinics and pharmacies throughout California about HIV treatment and its complicating illnesses. "
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Laura Salazar, MD, AAHIVS
"I am person who has been HIV+ since 1991. I have been taking prescription medications for the treatment of it since then. The constantly changing medication therapies require a pharmacist who is experienced and knowledgeable. Michelle Sherman is the best example of a pharmacist who is both. I have known and trusted Michelle for many years. I believe in her experience and expertise. I am not just a customer who needs prescriptions filled. I am a real person living with HIV. As a man living with HIV for almost 20 years, my commitment is not to any specific retail pharmacy, it is to Michelle Sherman the pharmacist."
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Michael M.
Tustin, CA
 "Michelle Sherman is known as an HIV pharmacy expert throughout southern California. I have had the pleasure of working with her for over a decade in multiple settings: specialty pharmacies, academic and public health clinics, and the lecture hall. She has counseled many of my patients regarding their medications, especially regarding adherence and the use of alternative herbal remedies.
Through her advocacy and compassion, she has earned the respect of the community. Michelle organizes educational lectures for providers and is a popular speaker herself. Whenever I have a question regarding HIV drug interactions and safety, Michelle is the first person I call. The patients and physicians of Orange County are fortunate to have her as a resource.
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Catherine Diamond MD MPH
Associate Professor of Clinical Medicine
University of California Irvine
 "I have worked with Michelle Sherman for over 6 years in the field of HIV Medicine. My patients have benefited from her expertise by avoiding side effects, toxicities and adverse drug interactions. I admire her knowledge of complimentary care products. Feedback from patients is very positive, and her experience with anti-viral medications makes her a valuable resource for patients and physicians alike."
Korey S. Jorgensen MD
Director of HIV Services at The Laguna Beach Community Clinic
"Michelle Sherman has been an Assistant Clinical Professor of Pharmacy at UCSF School of Pharmacy for more than 10 years. Her innovative pharmacy practice rotation equips students with the knowledge and skills to help patients with HIV manage their complex medication regimens. More importantly, Michelle is role model clinician and mentor who demonstrates on a daily basis the importance of quality healthcare with a personal touch."
Robin L. Corelli, Pharm.D.
Professor of Clinical Pharmacy,
Department of Clinical Pharmacy, School of Pharmacy
University of California, San Francisco |
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