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Spring 2018 Pharm Exam 4 > #7: Herbals > Flashcards

#7: Herbals Flashcards

1
Q

what are herbal preparations used for in the US

A

herbal preparations used as dietary supplements

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2
Q

Definition of Dietary supplement

  1. must contain what
  2. is FDA involved in approval
  3. are these food or drugs
A

Definition of Dietary Supplement

  1. must contain 1+ dietary ingredients
  2. FDA NOT involved in approval process (unless toxicity rigorously proven)
  3. FOOD not drugs
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3
Q

4 Problems w/Herbals

A

Problems w/Herbals

  1. variability in dosing
  2. contamination
  3. only few studies to support health claims
  4. complex misture –> interactions
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4
Q

3 Misconceptions about herbals

A

Misconceptions about herbals

  1. herbals NOT always safe
  2. FDA does NOT approve them
  3. US does NOT have most rigorous stds in world for herbal preps
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5
Q

3 Regulations for Rx drugs

A

Regulations for Rx drugs

  1. safety + efficacy and approp indications
  2. strength + purity
  3. must test in animals 1st
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6
Q

Garlic

  1. main purported use
  2. other 3 purported uses
  3. 2 alternative drugs
A

Garlic

  1. main purported use = lower lipids (chol)
  2. others = decr BP/plt aggreg, antimicrobial
  3. alt = statins and bile sequestering drugs
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7
Q

Garlic vs statins and bile sequestering drugs

- which better at lowering chol

A

Statins and bile sequestering drugs

-better at lowering chol vs garlic

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8
Q

Gingko

  1. 2 MOAs
  2. main purported use
A

Gingko

  1. MOA
    - free radical scavenger
    - inhibits plt aggreg –> incr blood flow
  2. main purported use = improve memory
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9
Q

Gingko + memory

  1. Studies trying to prove improved memory in pts w/ what dz
  2. recommendation from latest double blind trial on gingko
  3. alt to gingko
A

Gingko + memory

  1. Studies trying to prove improved memory in pts w/ Alz Dz
  2. recommendation from latest double blind trial = ginko NOT recommended for preventing dementia (results not diff from placebo)
  3. alt to gingko = donezepil (modest memory improvement)
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10
Q

St. Johns Wart

  1. purported use
  2. MOA
  3. 1 AE
  4. 3 alternative drugs
A

St. Johns Wart

  1. purported use = anti depressant
  2. MOA = components bind to GABA and 5-HT rec
  3. 1 AE = photosensitivity
  4. 3 alt drugs
    - SSRIs, Trycyclics, MAOIs
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11
Q

St Johns Wart: drug Interactions

  1. causes sedation w/ _______
  2. incr BP and HR w/ ________
  3. what does it do to the levels of protease inhibitors, OCPs, anti-leukemia drug imatinib mesylate (Gleevac)
A

St Johns Wart: drug Interactions

  1. causes sedation w/ SSRIs
  2. incr BP and HR w/ MAOIs
  3. DECR levels of protease inhibitors, OCPs, anti-leukemia drug imatinib mesylate (Gleevac)
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12
Q

St Johns Wart vs placebo for depression

- what did trials show

A

St Johns Wart vs placebo for depression

- no difference vs placebo

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13
Q

Ginseng

  1. purported use (2)
  2. MOA - increases what (2)
  3. what does it interfere w/
A

Ginseng

  1. purported use (2) = adaptogen and general cure all
  2. 2 MOAs
    - increases steroid production and NO production
  3. interferes w/ digoxin assays
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14
Q

Ginseng

- what are the 3 main AEs

A

Ginseng AEs

  1. CNS excitation
  2. abn menstruation
  3. HYPOglycemia
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15
Q

which Herbal is marketed as relieving menopausal Sxs and PMS

A

Black Cohosh

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16
Q

Black Cohosh

  1. major AE(rare) and CI
  2. alt to it
A

Black Cohosh

  1. major AE = liver toxicity
    - CI in liver dz
  2. alt = estrogen therapy
17
Q

Black Cohosh Studies

  1. results of smaller studies
  2. result of larger double blind trial
A

Black Cohosh Study results

  1. smaller studies = helped w/ post menopausal and PMS Sxs
  2. larger double blind trial = No diff b/t it and placebo
18
Q

What drug is marketed as effective in improving pain and swelling in OA and based on some trials might actually be effective

A

Glucosamine

-purported use: improve pain and swelling in OA

19
Q

Glucosamine

- is it FDA approved/recommended for OA

A

Glucosamine

- NOT FDA approved/recommended for OA

20
Q

Glucosamine: possible effectiveness

  1. what type of property does it have
  2. what does it form in cells
  3. relief described as sim to what drug
A

Glucosamine: possible effectiveness

  1. anti inflam property
  2. forms connnective tissue matrix
  3. relief described as sim to ibuprofen
21
Q

What is the main purported use of fish oils (omega-3 FAs)

A

main purported use of fish oils (omega-3 FAs)

- hyperlipidemia (decr TGs)

22
Q
  1. high BP
  2. CVD prevention
  3. Macular degeneration
  4. ADD
  5. RA

purported uses of ______

A

other purported uses of fish oils (omega-3 FAs)

  1. high BP
  2. CVD prevention
  3. Macular degeneration
  4. ADD
  5. RA
23
Q

What dietary modification can pts do to have protective effect from CVD

A

Eating fish regularly (2-3x/wk) = protective effect vs CVD

24
Q

Fish oil supp and CVD prevention

- eating fish = prev CVD, does fish oil supp provide same benefit?

A

Fish oil supp and CVD prevention

  • NO evid that taking fish oil supp provide same benefit as eating fish
25
Q

Fish Oil AEs

  1. incr levels of what
  2. risk at high doses
  3. decr levels of what
A

Fish Oil AEs

  1. incr levels of LDL
  2. risk at high doses = bleeding
  3. decr levels Vit E
26
Q

What is the ONLY herbal that is FDA approved

- 3 formulation names

A

Fish oils/omega 3 =ONLY herbal that is FDA approved

3 formulations

  1. Lovaza
  2. Vascepa
  3. Epanova
27
Q

Fish Oils: Lovaza

  1. what is it indicated spp as
  2. who is it indicated in
  3. what is the benefit of giving it w/ a statin
A

Fish Oils: Lovaza

  1. indicated spp as adjunct to diet
  2. indicated in adults w/v. high TGs ( > 500)
  3. benefit of giving it w/ a statin –> doesnt raise LDL levels as much
28
Q

What is the most dangerous herbal (caused numerous deaths)

A

Kratom = most dangerous herbal

29
Q

Kratom: purported uses

  1. what types of effects does it have, which cause what feeling
  2. ppl use it for relief from 3 things
A

Kratom: purported uses

  1. opioid like effects–> euphoria
  2. ppl use it for relief from
    - pain
    - anxiety
    - depression
30
Q

Kratom: 4 AEs

A

Kratom: 4 AEs

  1. Addiction
  2. N/V
  3. Constipation
  4. confusion
31
Q

Most deaths a/w Kratom occurred when it was mixed with what other drug

A

Most deaths a/w Kratom occurred when it was mixed with opioids

Spring 2018 Pharm Exam 4 (7 decks)

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