Alternative Therapies Flashcards
natural coumarin derivatives
anise, celery, chamomile, fenugreek, red clover
natural salicylates
meadowsweet, poplar, willowbark
antiplatelet action
garlic, ginkgo biloba
hypocoagulability- short lived fibrinolytic action
capiscum
inhibits 3A4
bitter orange
inhibits 1A2 and intestinal 3A4; induces 3A4
echinacea
inhibits 1A2 and 2D6
ginkgo biloba
inhibits 2D6
ginseng
induces 1A2, 3A4, 2C9
St. Johns Wort
This list of drugs is impacted by which CYP?:
duloxetine, fluvoxamine, frovatriptan, mexiletine, olanzapine, ropinirole, tacrine, tizanidine and zileuton
1A2
This list of drugs is impacted by which CYP?:
amitriptyline, codeine, desipramine, dextromethorphan, metoprolol, oxycodone, tamoxifen, timolol
2D6
This list of drugs is impacted by which CYP?:
verapamil, cyclosporine, protease inhibitors, midazolam, simvastatin, atorvastatin, tacrolimus, tamoxifen, triazolam
3A4
This list of drugs is impacted by which CYP?:
ARBs, NSAIDs, oral hypoglycemics, warfarin
2C9
antagonize immunosuppressants like azathioprine, corticosteroids, cyclosporine, tacrolimus
echinacea and ginseng
stimulant effects may oppose sedatives and produce additive actions with epi, phentermine, pseudoephedrine, nicotine or amphetamine
caffeine and green tea
contains estrogen-like compounds; long-term use could increase the risk of women developing cancer of the lining of the uterus
red clover
increased mean PSA doubling time (effective in treatment of prostatic cancer); CYP3A4 inhibitor; increase rhabdomyolysis with statins
pomegranate juice
prevent/treat UTI or H. pylori infections, or prevent dental plaque (antioxidant/anticancer activity); side effects: GI upset or diarrhea
cranberry
which vitamins antagonize warfarin?
E and K
potent antioxidant (role in maintaining healthy muscle, low serum levels in Parkinsons); hypertension; ischemic heart disease (improvements observed in HDL cholesterol, exercise tolerance); structural similarity with vit. K resulting in possible reduction in warfarin activity
Coenzyme Q10
serves as a cartilage nutrient; used for pain associated with knee osteoarthritis; sulfate and hydrochloride forms are available (hydrochloride is ineffective); clinical trials inconclusive
glucosamine
serotonin derivative; re-sets body “clock” after jetlag; metabolized by CYP1A2; decrease M/F fertility and breast milk production; interacts with SSRIs and antagonizes effects of antipsychotics
melatonin
good evidence of decreasing BPH symptoms w/o shrinking prostate
beta-sitosterols
may provide benefit in CV disorders, lower LDL, lower blood sugar, boost immune system and antimicrobial agents and enhance response to flu vaccine
ginseng
supplement for mental health: combine with antidepressant; wont work alone
folic acid
supplement for mental health: modestly effective in slowing decline—equivalent to AchE inhibitor; additive with AchE inhibitors
ginkgo biloba
supplement for mental health: as effective as older TCAs; boost effectiveness of SSRIs
SAMe (s-adenosyl-L-methionine)
supplement for mental health: fewer adverse effects than BNZs; useful for sleep/anxiety in children with ANHD
valerian
supplement for mental health: boost effectiveness of antidepressants; may trigger mania in bipolar disorder-use with mood stabilizer
omega 3 FA
supplement for mental health: works in mild/moderate symptoms of depression; possible alternative medication in children/adolescents
St Johns wort
supplement for mental health: improves sleep quality in patient with schizophrenia, major depression and seasonal affective disorder; alternative to drugs in children/elderly
melatonin
mineral: enhances insulin action, carb fat and protein metabolism; no proven effects in diabetes, lipid metabolism or body weight/composition; B blockers, corticosteroids, insulin, nicotinic acid and NSAIDs may be enhanced or may increase absorption
chromium (found in broccoli)
mineral: important antioxidants preventing free radical damage; cancer: some studies show beneficial effects in prostate, colorectal, lung; HIV: deficiency associated with reduced immune function-may by a significant predictor of survival
selenium (found in brazil nuts)
mineral: important cofactor for >300 enzymes, including SOD, involved in protein and carb metabolism; lowers severity of childhood diarrhea in 3rd world; increased healing of gastric ulcers; decreases symptoms of sickle cell anemia
zinc (found in beef, fish, spinach)
