CV Bot Med Flashcards
Angina Pectoris
Allium sativum, Crataegus oxyacantha, Leonurus cardiaca
Atherosclerosis
Allium cepa, allium sativum, ginkgo biloba
Atrial Fibrillation
Convallaria majalis, Leonurus cardiaca
Atrial Premature Beats
Crataegus Oxyacantha, Leonurus cardiaca
Bradycardia
Glycyrrhiza glabra, Rosmarinus officinalis
Bruises (topical)
Aesculus hippocastanum and arnica montana
Capillary Fragility
Aesculus hippocastanum, crataegus laevigata, vaccinum myrtillus (bilberry)
Chronic venous insufficiency
Aesculus hippocastanum, centella asiatica, hamamelis virginiana, vaccinum myrtillus
Congestive Heart Failure
Convallaria Majalis, Crataegus Laevigata, Digitalis purpurea
Edema
Aesculus hippocastanum and taraxacum officinale
Hyperlipidemia and/or Dyslipidemia
Allium cepa, allium sativum, cynara scolymus
Hypertension
For mild : Allium cepa, allium sativum, crataegus laevigata
For serious : Rauvolfia sperentina, Veratrum viride
Hypotension
Convallaria Majalis and glycrrhiza glabra
Post-ischemic stroke recovery
Ginkgo biloba and rosmarinus officinalis
Raynaud’s disease
Capsicum frutenscens, Rosmarinus officinalis, Rauvolfia serpentina, Zingiber officinale
Thrombophlebitis
Aesculus hippocastanum and hamamelis verginiana
Varicose veins
Aesculus hippocastanum, centella asiatica, vaccinum myrillus
Aesculus hippocastanum
- used topically for? internally for?
Horse Chestnut leaves
glycoside lactones
- astringent, vasocontrictive, veno-tonic, anti-inflammatory, mild expectorant
topical: bruises, hemorrhoids, pruritis ani, varicose veins, nocturnal leg swelling
internal: venous insufficiency, DVT, varicose veins, thrombophlebitis, edema, chronic prostatitis
AEs: Nausea, unprocessed fruit is highly toxic
contraindications: high dose
Allium cepa and Allium sativum
Cepa = onion
Sativum = garlic bulb
Constituents : glucosinolates
- Garlic - allin, allicin
Actions :
Anti-atherosclerotic, hypolipidemic, antiplatelet, anti diabetic, anti H-pylori, antihelmintic (garlic)
internal: hyperlipidemia, dyslipidemia, intermittent claudication, ischemic stroke prevention, atherosclerosis, hypercoagulable states, angina pectoris, impotence (from arterial insufficiency), HTN, DM, insufficient lactation, heavy mental; candidiasis at any site, gastroenteritis, intestinal parasites, H.pylori infections, infections in general
Topical : dermatophytosis, onychomycosis, warts, infection vaginitis, otitis media
AEs:
-Anti-platelet activity : bleeding disorders
Interactions:
Anticoagulants : warfarin
May potentiate insulin and hypoglycemic drugs
Arnica montana
- used when?
Arnica flower Asteraceae family
- topical vulnerary, anodyne
used externally for bruises and to reduce pain, phlebitis, rheumatism, strains and sprains, myalgia
do not use in large open wounds > risk of toxicity
CI : Internal use may cause cardiac damage
Capsicum frutescens
- what is it?
- contraindicated?
- interacts with what drug?
cayenne ground dried fruit
- Topical : anodyne, anti-neuralgic, anti-pruritic (depletion of substance P), counter-irritant, anti-inflammatory
- Internal : digestive stimulant, carminative, hypolipidemic, anticatarrhal, antiplatelet, circulatory stimulant
indicated:
external: diabetic neuropathy, pruritis, psoriasis, OA, RA, migraines
internal: hypochlorhydria, H pylori, maldigestion, dyspepsia, biliary insufficiency, atonic constipation, atherosclerosis, GI or resp infection, hypercoagulation, stimulant, capillary atony
contraindicated: pregnancy - uterine stimulant
interactions: compounds dry cough side effect of ACEIs
Centella asiatica
- class
- used in which emergency scenario?
- side effect on labs?
- pregnancy?
Gotu Kola whole plant
- nervine, antipyretic, vulnerary, venotonic, keratolytic, antimycobacterial, nootropic
indicated: Insomnia, dementia, poor memory, mycobacteria’s infection, sore throat, tonsillitis, cystitis, hepatitis, measures, wounds, leprosy, eczema, syphilis, varicose veins, chronic venous insufficiency
AEs: photosensitization, DM or HLD (could increase blood glucose and lipids), possible infertility
contraindicated: pregnancy
Convallaria majalis
- contains? does what to the heart?
- how do you treat an OD?
- contraindicated?
- interactions?
lily of the valley flower tips and rhizome low dose herb
cardioactive glycoside
- positive ionotropic (contractility), negative chronotropic (rate), negative dromotropic (conduction), positive bathmotropic (excitability)
- natiuretic, diuretic
- dose-dependent venoconstrictive
indicated: CHF, atrial arrhythmias, hypotension
AEs: nausea, vomiting, headache, yellow/green halo around objects
Toxicity : much wider therapeutic window that’s Digitalis, although overdose can be lethal; antidote- potassium
contraindications: digitalis and other cardiac glycosides (convallaria, digitalis, leonurus)
interactions:
Toxicity potentiated by K+ and Mg+ depleting drugs (diuretics, steroids)
Ca+ can promote arrhythmias
BB can cause heart block
Crataegus oxyacantha (laevigata)
Hawthorn berries, flower, leaf
Anti-atherosclerotic, antioxidant, antihypertensive, positive inotropic, negative chronotropic, inflammation modulating
indicated: CHF, angina, arrhythmias, cardiac weakness, valvular murmurs, cap fragility, HTN
interacts: antiplatelets increase bleed risk, may enhance glycoside drug/herbs, avoid with antiarrhthymics, increased side effects of BBs - may cause rebound HTN with concomitant use
Cynara scolymus
- indications? actions?
Artichoke Asteraceae family
- bitter, hypolipidemic
indicated: dyslipidemia, poor digestion
contraindicated in bitter CIs
Digitalis purpurea
- contains what? effects on heart?
foxglove leaf low dose herb
- cardiac glycosides* positive ionotrope, negative chronotrope
- cardiac stimulant, diuretic, emetic at high doses, vaso-constrictor
indicated: CHF, atrial arrhythmias
AEs: narrow therapeutic range, GI sxs, yellow or green halo around objects, death
contraindicated: 1/2 degree AV block, severe carditis, angina, arrhythmias, bradycardia. cardiac hypertrophy, aortic stenosis, kidney failure, hypokalemia/calcemia, hypercalcemia, pregnancy, lactation
interactions: hypokalemic drugs/diuretics, corticosteroids. anti-arrhythmics, pseudoephedrine, glycyrrhiza, calcium > will promote arrhythmia, potentiates BBs
Ginkgo biloba
- actions?
- indications?
- contraindications?
ginkgo leaf
Anti atherosclerotic, antioxidant, inflammation modulating, antineoplastic, nootropic, anti-platelet
indicated: atherosclerosis, intermittent claudication, impotence, post-ischemic stroke, phlebitis, cerebrovascular insufficiency (depression, dementia, poor memory)
contraindicated: intracranial bleed, severe bleeding
interactions: blood thinners, as it inhibits PAF
Glycyrrhiza glabra
Licorice root
Glycyrrhizin (saponin) : decreases degradation of cortisol in LV and KDs, thus systemic inflammation modulator ; adaptogen, decreases testosterone synthesis; antiviral; hepatoprotective ; phytoestrogen; stimulating expectorant
Flavonoids : immunomodulating, inflammation modulating, demulcent, anti H. Pylori
Polysaccharides : immunomodulating, demulcent
Tx :
Glycyrrhizin-containing preparation : viral hepatitis, hepatic cirrhosis, hypertestosteronism, estrogen imbalance (menopause sxs), menorrhagia, chronic inflammation, cancer, HSV, HIV/AIDS, postherpetic neuralgia (topical), infxn in general, periodontal dx (topical) asthma, COPD, dry cough, hypotension, hypoadrenocorticism, CVS
Glycyrrhizin not required : gastritis, PUD, esophagitis, H.pylori, IBD, lower UTI
AEs: can lead to pseudoaldosteronism
Early : weakness, fatigue, edema, weight loss, HTN, hypokalemia
Late : rhabdomyolysis, KD failure, hypertensive encephalopathy
contraindicated in HTN as it can increase corticosteroids and HTN, hyperaldosteronism, estrogen dependent cancers (theoretically); chronic OD, pregnancy (short term use only)
Toxicity : the systemic increase in cortisol, a weak aldosterone receptor, causes pseudo hyperaldosteronism (largely a result of hypokalemia. Non-Glycyrrhizin contains products do not cause.
interacts:
- K+ decreases toxicity
- Licorice can increase corticosteroids
- Use with extreme care in pts taking mineralocorticoids
- Synergistic toxicity with other medications that deplete K+ (cathartic laxative abuse, some diuretics and corticosteroids)
Increased danger of toxicity with drugs that are toxic in a setting of hypokalemia (digoxin, quinidine, gentamicin)
Hamamelis virginiana
- contains?
- used?
- high doses can cause?
Witch hazel twig and leaf
contains tannins - astringent, anti-inflammatory, local hemostatic effects
indications: external use all cases of bleeding, hemorrhoids, varicose veins, bruises, inflammation. can control diarrhea and dysentery, sore throat, tonsillitis, acute catarrh. can use internally, but use common sense.
AEs: high doses can increase risk of esophageal and liver cancer (drinking teas 15-20 cups/day)
Leonurus cardiaca
- contains what?
- indications?
Motherwort whole plant
- cardiac glycosides
- hypotensive, inhibits myocardial cell firing, diuretic, antispasmodic (uterus and blood vessels), sedative (but takes months), improves mesenteric circulation and coronary perfusion
indicated: nervousness, irritable, restless, menopause, hyperthyroidism, palpitations/anxiety, reduced coronary perfusion
contraindicated: pregnancy
Rauwolfia serpentina
- contains what? has what effect on heart?
- contraindicated?
snake root low dose herb
- indole alkaloid reserpine*
- antihypertensive alkaloids: releases noradrenaline and inhibits its resorption > lowers catecholamines > hypotensive effect
- antiarrhythmic alkaloids ajmaline
indications: HTN, nervousness, insomnia
AEs: nasal congestion, depression, tiredness, ED
contraindicated: depression, PD, ulceration, pheochromocytoma, pregnancy, lactation
interacts: increases alcohol impairment, increases effect of neuroleptics and barbituates, severe bradycardia with digitalis glycosides, herb effect is reduced w/ levodopa, increase in extra pyramidal motor sxs w sympathomimetics
Rosmarinus officinalis
- how is it used topical? internal?
- at toxic doses > ?
- pregnancy?
- pharm interactions?
Rosemary oil from leaves
antimicrobial, hypertensive, circ stimulant, antioxidant, carminative, circulation improvement when applied topically, nervine
topical: myalgia, neuralgia, arthritis
internal: dyspepsia, loss of appetite
AEs: at toxic doses > coma, spasm, vomiting, death
CI: pregnancy, epilepsy
interacts: doxorubicin, vinblastine
Taraxacum officinale
- root/leaf differences
- dont use with what pharms? which vit does it deplete?
Dandelion root/leaf asteraceae family
- root is a hepatotonic and cholagogue, bitter, antirheumatic, anti-inflammatory
- leaf is a bitter, diuretic, antiviral, choleretic
root: poor digestion, cholecystitis
leaf: lower UTIs, urolithiasis, edema, topical warts, CHF
leaf: contraindicated w use of BBs
contraindicated in bitter digestive complaints and asteraceae
whole plant is diuretic (avoid with Lithium)
interacts: PPIs, Li, hypoglycemics, reduces vit B absorption
Vaccinium myrtillus
- used for?
- interacts?
Bilberry, Blue Berry leaf and fruit
- contains potent antioxidants, used for microvascular protection, venotonic, anti-diarrheal, nutrient, astringent, hypoglycemic
leaf: acute or chronic dysentery, cystitis, DM, (external for burns or skin disease)
fruit: diarrhea, myopia, retinopathies, inflammation, varicose veins
AEs: diarrhea, long term use of leaf can damage liver and kidneys d/y hydroquinones
contraindicated: pregnancy, lactation
interacts: insulin, hypoglycemics, tannins
Veratrum album/viride
- actions?
- what drug is the antidote in overdose?
american hellebore dried rhizome and root low dose herb
-circulatory depressant, antispasmodic, hypotensive
album: protoveratrine A and B are sensory nerve irritants and inhibit activation of Na channels
- indicated: internal hypertension and topical insecticide
viride: alkaloids inhibit activation of Na channels in heart cell regulators to reduce BP and slow HR
- indicated: rapid full pulse, HTN, fever, inflammation, flushed skin, blood shot eyes
AEs: lacrimation, salivation, vomiting, burning sensation in mouth and throat, inability to swallow, vertigo, paralysis, convulsions, death give atropine and send to ED
do not ever prescribe this. extremely toxic CI in pregnancy and lactation
Zingiber officinale
- dont take more than how many grams in preg?
Ginger root
carminative, antispasmodic, warming stimulant, anti-emetic, rubefacient, diaphoretic, emmenagogue, anti-inflammatory
indicated for: nausea, flatulence, abd discomfort, and diarrhea, loss of appetite, motion sickness, RA (inhibits COX and LOX)
AEs: Gi complaints
contraindicated: no more than 2 g in pregnancy, dont take with gallstones, not in pts at risk of hemorrhage
interacts: anticoags
