05_Safety and Contraindications

Question 1

What are some basic safety concerns in herbal medicine?

Answer 1

• Correct identification of plants
• Contamination
• Toxic or poisonous plant constituents
• Schedule 20 (restricted herbs)
• Dose ranges for various conditions
• Hygiene in preparation of herbs
• Practitioner competence
• Working alongside pharmaceutical drugs

Question 2

Why is correct identification of medicinal plants vital?

Answer 2

It is a basic skill of all herbalists to ensure safety and efficacy in herbal medicine

Question 3

What methods are used for plant identification?

Answer 3

• Organoleptic testing (sight, smell, taste)
• Chemical signature testing
• Genetic profiling

Question 4

What are common risks for contamination in herbal medicine?

Answer 4

• Plant contaminants
• Chemical contaminants
• Insects and parasites
• Hygiene concerns in production facilities

Question 5

What are some toxic constituents found in plants?

Answer 5

Pyrrolizidine Alkaloids

Question 6

What is Schedule 20 in the UK?

Answer 6

A list of herbs restricted by law, created by Statutory Instrument ‘SI 2130’ in 1978

Question 7

What does Young’s Rule help determine?

Answer 7

Paediatric doses based on the age of the child

Question 8

What hygiene practices are important in herbal medicine?

Answer 8

• Cleanliness of production facilities
• Regular cleansing of herb preparation areas
• Personal hygiene (e.g. hand washing, nail clipping)

Question 9

What are the key components of practitioner competence?

Answer 9

• Training
• Knowing limits of competence
• Communication with health professionals
• Understanding of biomedical pathologies

Question 10

Why must herbalists know about pharmaceuticals?

Answer 10

• They can alter the symptom picture
• They can interact with herbs

Question 11

What is the estimated NHS spending on pharmaceutical drugs in the UK?

Answer 11

Around £12bn

Question 12

True or False: Side effects of drugs can mimic the symptoms for which the drug is prescribed.

Answer 12

True

Question 13

What is the drug-checking protocol?

Answer 13

• Obtain a list of all drugs taken
• Research effects and contraindications
• Enquire about symptoms experienced before taking prescription drugs

Question 14

What are examples of self-medication with pharmaceuticals?

Answer 14

• NSAIDs (e.g. Aspirin)
• Antacids (e.g. Gaviscon)
• Anti-histamines (e.g. Piriton)
• Laxatives (e.g. Lactulose)

Question 15

What types of prescribed drugs are considered non-essential?

Answer 15

• Antidepressants
• NSAIDs for arthritic pain
• Bronchodilators for asthma

Question 16

What are drugs considered essential for life?

Answer 16

• Insulin for diabetes
• Levothyroxine for hypothyroidism
• Antibiotics for life-threatening infections

Question 17

What are additive effects in the context of herb-drug interactions?

Answer 17

Herbs that increase the effect of drugs

Question 18

What are some examples of herbs with additive effects?

Answer 18

• Ginkgo with anticoagulants
• Valerian with sedatives
• Hawthorn with hypotensives

Question 19

What are antagonistic effects in herb-drug interactions?

Answer 19

Herbs that reduce the effect of drugs

Question 20

Name a herb that may interact with anticoagulants.

Answer 20

St John’s Wort

Question 21

What is the role of pharmacokinetics in drug interactions?

Answer 21

It describes the rate at which drugs are metabolised in the body

Question 22

Fill in the blank: Some herbs can _______ the effects of drugs taken, by reducing pharmacokinetics.

Answer 22

increase

Question 23

What is a potential side effect of St John’s Wort?

Answer 23

It may render anticoagulants less effective

Question 24

What caution should be taken with herbal actions and pathologies?

Answer 24

Some herb actions may mimic symptoms of certain diseases

Question 25

Give an example of a herb that may exacerbate hypertension.

Answer 25

Liquorice

Question 26

What is the importance of understanding herb-drug interactions?

Answer 26

To ensure safe and effective use of herbal medicine alongside pharmaceuticals

Question 27

What caution should be taken with stimulants?

Answer 27

Avoid stimulants with hypertension (e.g. Ginseng) ## Footnote Stimulants can exacerbate high blood pressure conditions.

Question 28

Which herbs should be avoided with excess stomach acid?

Answer 28

Bitters ## Footnote Bitters can aggravate conditions like gastritis and ulcers.

Question 29

What herb is contraindicated with peptic/duodenal ulcers?

Answer 29

Cayenne ## Footnote Cayenne can irritate the gastrointestinal tract.

Question 30

Which herb should be avoided in cases of hyperthyroidism?

Answer 30

Kelp ## Footnote Kelp can increase iodine levels, worsening hyperthyroidism.

Question 31

What are goitrogens and their effect on hypothyroidism?

Answer 31

Block iodine uptake ## Footnote Goitrogens can inhibit thyroid function.

Question 32

Which herbs should be avoided with hypothyroidism?

Answer 32

Sedatives ## Footnote Sedatives may further depress thyroid function.

Question 33

What is a caution regarding Ephedra?

Answer 33

Avoid with hypertension and heart disease ## Footnote Ephedra can increase heart rate and blood pressure.

Question 34

What is a concern with Echinacea?

Answer 34

Avoid with autoimmune disease, arthritis, and leukaemia ## Footnote Echinacea can stimulate the immune system, which may be harmful in these conditions.

Question 35

What should be avoided with anticoagulants?

Answer 35

Herbs with thrombocytopaenia or thrombocythemia ## Footnote Anticoagulants can interact negatively with clotting disorders.

Question 36

What is significant about the active ingredients in medicinal herbs?

Answer 36

Many are unknown or incompletely understood ## Footnote This highlights the need for caution in herbal medicine.

Question 37

What should herbalists consider when combining herbs?

Answer 37

Opposing actions and chemical interactions ## Footnote For example, stimulants may counteract sedatives.

Question 38

What is polypharmacy in herbal medicine?

Answer 38

The use of several ingredients in the same mix ## Footnote Each plant contains complex formulas of phytochemicals.

Question 39

What is Simpling in herbal medicine?

Answer 39

Choosing ONE herb that fits the patient’s symptoms ## Footnote It is an art of selecting the most appropriate herb.

Question 40

What should be done when treating women in pregnancy with herbs?

Answer 40

Withdraw all herbs initially and monitor changes ## Footnote The body's response should dictate further treatment.

Question 41

What are some herbs contraindicated in pregnancy?

Answer 41

* Pennyroyal * Rue * Mugwort * Gentian root * Senna pods ## Footnote These herbs may stimulate uterine contractions or cause abortion.

Question 42

What is a 'Schedule 20' herb?

Answer 42

Herbs that are toxic or harmful ## Footnote These herbs are contraindicated due to safety concerns.

Question 43

What is meant by Pharmacokinetics?

Answer 43

The study of how drugs move through the body ## Footnote Herbs can affect the absorption and metabolism of pharmaceutical drugs.

Question 44

Why is caution needed with St John’s Wort?

Answer 44

It can interact with many pharmaceutical drugs ## Footnote St John’s Wort may affect drug metabolism.

Question 45

List three safety considerations in herbal medicine.

Answer 45

* Check for contraindications * Monitor for interactions * Use appropriate dosing ## Footnote Safety is paramount when prescribing herbal remedies.