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560 P BOTANICAL MEDICINE > EXAM 1 > Flashcards

EXAM 1 Flashcards

1
Q

According to the articles on regulatory issues, all of the following except one are good arguments in favor of stricter regulation of botanical medicines? Which one is not a good argument?

  1. ) Inconsistent reporting of adverse events
  2. ) Potential adulteration of some preparations with drugs
  3. ) Possible interactions between herbs and drugs
  4. ) Lack of consistent standardization among herbal preparations
  5. ) Excessive prices for commercial herbal products
A

5

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2
Q

T/F: DNA barcoding can be useful for identifying intact plants, but may not be reliable for evaluating the quality of dietary supplements that are botanical extracts.

A

T

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3
Q

Which one of the following is not a difference between the US and European countries such as Germany regarding the status of herbal medicines?

  1. ) Herbal products are regulated as dietary supplements in the US.
  2. ) The U.S. has always led the way worldwide in the development and testing of botanical medicine products
  3. ) Herbal medicines have higher stature in medical education and clinical practice in European countries such as Germany.
  4. ) Herbal medicines are subjected to more regulation in European countries such as Germany.
A

2

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4
Q

Match the drug with the herb from which it was originally isolated:

  1. ) Digoxin
  2. ) Codeine/morphine
  3. ) Aspirin
  4. ) Quinine
Choices:
A.) Willow bark
B.) Chinchona bark
C.) Opium poppy
D.) Foxglove leaf
A
  1. ) Foxglove leaf
  2. ) Opium poppy
  3. ) Willow bark
  4. ) Chinchona bark
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5
Q

A typical botanical extract can be expected to concentrate active substances from the dried herb by how much in terms of an herb-to-extract ratio?

  1. ) 5:1
  2. ) 10:1
  3. ) 2:1
  4. ) 3:1
A

1

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6
Q

Which of the following, if any, is not one of the factors that can affect the content of active constituents of medicinal herbs?

  1. ) Soil quality
  2. ) Plant genetics
  3. ) Cultivation
  4. ) All of these factors affect the content of active constituents of medicinal herbs
  5. ) Climate
A

4

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7
Q

T/F: Standardization of botanical preparations is simply a process of adjusting chemistry to produce the desired content.

A

F

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8
Q

Choose the correct statement about the use of solvents for preparing botanical extracts:

  1. ) Aqueous extracts are high in lipophilic constituents while alcohol extracts are high in polar compounds
  2. ) Aqueous and alcohol extracts are both high in polar compounds
  3. ) Aqueous and alcohol extracts are both high in lipophilic constituents
  4. ) Aqueous extracts are high in polar compounds while alcohol extracts are high in lipophilic constituents
A

4

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9
Q

T/F: Using marker compounds to adjust the quality of botanical extracts can always be expected to guarantee consistent therapeutic potency of the product.

A

F

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10
Q

Match the liquid dosage form with the appropriate description:

  1. ) Common preparation using alcohol or alcohol+water to produce extracts of a wide variety of herbs and herb combinations
  2. ) Especially useful for giving botanical medicines to children
  3. ) Alcohol-free preparation that would be expected to contain only lipid-soluble components
  4. ) A solution of a volatile substance in alcohol or alcohol+water
  5. ) Made from fresh plant parts and contain water-soluble components

Tictures, syrups, medicinal spirits, medicinal oils, plant juices

A
  1. )Tinctures
  2. ) Syrups
  3. ) Medicinal oils
  4. ) Medicinal spirits
  5. ) Plant juices
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11
Q

MATCH:

  1. SPIRIT
  2. MACERATION
  3. INFUSION
  4. DECOCTION

A. covered with water, boiled, simmer 10 minutes, strained
B. covered with room temperature, stands 6 hours, strained
C. a solution of volatile substance in alcohol of alcohol + water
D. water poured boiling over herb and covered, steeped 10 minutes, then strain

A
  1. C
  2. B
  3. D
  4. A
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12
Q

Which of the following, if any, is NOT an advantage of coated tablets over uncoated tablets?

  1. ) Reduces the cost of the product
  2. ) Masks any unpleasant tastes of active ingredients
  3. ) Improves ease of swallowing
  4. ) Allows for controlled or delayed release of active ingredients
  5. ) Extends shelf life
  6. ) All of these are advantages of coated tablets over uncoated tablets
A

1

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13
Q

When should enteric-coated tablets or capsules be taken?

  1. ) At least one hour before a meal
  2. ) Immediately before a meal
  3. ) Immediately following a meal
  4. ) During a meal
A

1

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14
Q

Match the description with the method of medicinal tea preparation:

  1. ) Pour boiling water over herb, cover vessel, steep for 5-10 minutes, then strain
  2. ) Cover herb with water, bring to a boil, simmer for 5-10 minutes, then strain
  3. ) Cover herb with room-temperature water, let stand for 6-8 hours, then strain

Choices:
A.) Maceration
B.) Infusion
C.) Decoction

A
  1. B
  2. C
  3. A
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15
Q

Botanical product labels in the US are allowed to describe the purpose of the product according to which one of the following rules?

  1. ) Can describe a therapeutic effect on a disease state if supported by a reasonable amount of scientific evidence.
  2. ) Can describe a therapeutic effect on a disease state regardless of whether there is support from a reasonable amount of scientific evidence.
  3. ) Can describe an effect on the structure or function of the body regardless of whether there is support from a reasonable amount of scientific evidence.
  4. ) Can describe an effect on the structure or function of the body if supported by a reasonable amount of scientific evidence.
A

4

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16
Q

Only one of the following statements regarding the German Commission E is correct. Which one?

  1. ) Commission E monographs only review single herbs and preparations made from them
  2. ) The Commission E monographs are only available in German language editions
  3. ) The Commission E continues to gather and review monographs today
  4. ) The Commission E was appointed by a government agency to review phytotherapeutic agents for efficacy and safety
A

4

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17
Q

T/F: The authors of our text present data showing that the placebo effect does not account for much of the therapeutic effect of treating disorders such as widespread pain, insomnia, gastric symptoms, and depression.

A

F

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18
Q

Match the latin binomial with the common name:

  1. ) Allium sativa
  2. ) Cyamopsis tetragonolobus
  3. ) Monascus purpureus
  4. ) Allium cepa
Choices:
A.) Red yeast
B.) Garlic
C.) Onion
D.) Indian guar
A
  1. B
  2. D
  3. A
  4. C
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19
Q

Match the herb with the one specific part used in botanical medicine. Not all answers need to be used:

  1. ) Allium sativa
  2. ) Avena sativa
  3. ) Allium cepa
  4. ) Ginkgo biloba

Choices:
A.) Leaf
B.) Bulb
C.) Seed coat (bran)

A
  1. B
  2. C
  3. B
  4. A
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20
Q

Which two botanicals have been shown to increase walking distance in subjects with peripheral arterial disease?

  1. ) Ginkgo biloba
  2. ) Allium cepa
  3. ) Red yeast rice
  4. ) Allium sativa
A

1 & 4

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21
Q

Which of the following is true about the relationship of alliin, alliinase, and allicin?

  1. ) Allicin acts on alliin to produce allianase
  2. ) Allianase acts on alliin to produce allicin
  3. ) Alliin acts on allicin to produce allianase
  4. ) Allianase acts on allicin to produce alliin
A

2

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22
Q

Match the garlic preparation with the correct description:

  1. ) Garlic powder
  2. ) Garlic oil
  3. ) Aged garlic

Choices:
A.) Fermentation product subject to degradation of of active constituents
B.) Used in most clinical trials
C.) Steam distillation product subject to enzymatic and thermal breakdown of active constituents

A
  1. B
  2. C
  3. A
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23
Q

Which of the following, if any, is not a therapeutic effect of garlic demonstrated in at least some clinical studies?

  1. ) Lowers total blood cholesterol
  2. ) Inhibits progression of atherosclerosis
  3. ) All of the above are therapeutic effects demonstrated in some studies
  4. ) Lowers blood triglycerides
  5. ) Lowers blood pressure
A

3

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24
Q

T/F: According to human research, garlic can reduce platelet aggregation after a few days of treatment.

A

F

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25
Q

Which two adverse effects should be monitored in patients taking garlic?

  1. ) Muscle pain, tenderness, and weakness
  2. ) Elevated liver enzymes
  3. ) Excessive bleeding tendency
  4. ) Hypotension
A

3 & 4

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26
Q

What is the most likely mechanism for the effects of guar gum on blood cholesterol?

  1. ) Inhibition of cholesterol uptake from the gut
  2. ) Inhibition of cholesterol synthesis
  3. ) Direct inhibition of VLDL formation
  4. ) Acceleration of cholesterol catabolism
A

1

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27
Q

What is the most likely mechanism for the effects of red yeast rice on blood cholesterol?

  1. ) Direct inhibition of VLDL formation
  2. ) Acceleration of cholesterol catabolism
  3. ) Inhibition of cholesterol synthesis
  4. ) Inhibition of cholesterol uptake from the gut
A

3

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28
Q

What is the most likely mechanism for the effects of garlic on blood cholesterol?

  1. ) Direct inhibition of VLDL formation
  2. ) Inhibition of cholesterol synthesis
  3. ) Acceleration of cholesterol catabolism
  4. ) Inhibition of cholesterol uptake from the gut
A

2

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29
Q

Which of the following is the family of active constituents associated with red yeast rice?

  1. ) Reserve polysaccharides
  2. ) Thiosulfinates
  3. ) Monacolins
  4. ) Phospholipids
A

3

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30
Q

Which two adverse effects should be monitored in patients taking red yeast rice?

  1. ) Excessive bleeding tendency
  2. ) Muscle pain, tenderness, and weakness
  3. ) Elevated liver enzymes
  4. ) Hypotension
A

2 & 3

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31
Q

According to the National Institutes of Health article, garlic has been found to interfere with the effectiveness of what type of drug?

  1. ) an anti-inflammatory drug
  2. ) an antidepressant drug
  3. ) a cholesterol-lowering drug
  4. ) an HIV drug
A

4

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32
Q

Which of the following is the most accurate list of possible side effects of ginkgo biloba?

  1. ) headache, itchy eyes, gastrointestinal issues, asthma, fatigue, and drowsiness
  2. ) breath and body odor, heartburn, upset stomach, and allergic reactions
  3. ) anxiety, difficulty urinating, dry mouth, headache, heart damage, high blood pressure, irregular heart rhythms
  4. ) headache, nausea, gastrointestinal upset, diarrhea, dizziness, or allergic skin reactions
A

4

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33
Q

Large amounts of a dangerous toxin are found in which ginkgo preparation?

  1. ) root
  2. ) commercial standardized extracts
  3. ) bark
  4. ) roasted seeds
A

4

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34
Q

Match the latin binomial with the common name:

  1. ) Hamamelis virginiana
  2. ) Matricaria recutita
  3. ) Oenotherae biennis
  4. ) Ananas comosus
  5. ) Symphytum officinale
  6. ) Melaleuca alternifolia
Choices:
A.) Tea tree oil
B.) Evening primrose
C.) Witch Hazel
D.) Pineapple (Bromelain)
E.) German chamomile
F.) Comfrey
A
  1. C
  2. E
  3. B
  4. D
  5. F
  6. A
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35
Q

Match the herb with the one specific part used in botanical medicine

  1. ) Calendula
  2. ) Arnica
  3. ) Chamomile
  4. ) Evening primrose
  5. ) Witch hazel
  6. ) Comfrey
Choices:
A.) Flower
B.) Seed oil
C.) Leaves and root
D.) Leaves, twigs and bark
A
  1. A
  2. A
  3. A
  4. B
  5. D
  6. C
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36
Q

Match the active constituent with the herb:

  1. ) gamma-linolenic acid
  2. ) tannins
  3. ) apigenin
  4. ) (+)-terpinen-4-ol
Choices:
A.) Tea tree oil
B.) Evening primrose oil
C.) Chamomile
D.) Witch hazel
A
  1. B
  2. D
  3. C
  4. A
37
Q

Match the botanical medicine with the health condition for which it has promising or good evidence as a therapeutic intervention:

  1. ) Bromelain
  2. ) Aloe vera
  3. ) Tea tree oil
  4. ) Witch hazel
  5. ) Evening primrose oil
Choices:
A.) Hemorrhoidal disease
B.) Psoriasis and genital herpes
C.) Post-operative or post-traumatic swelling, especially of the nose and paranasal sinuses
D.) Atopic eczema
E.) Cutaneous fungal infections
A
  1. C
  2. B
  3. E
  4. A
  5. D
38
Q

Comfrey products should have declared content of what potentially-toxic constituent?

  1. ) clotrimazole
  2. ) podophyllin toxin
  3. ) unsaturated pyrrolizidine alkaloids
  4. ) anthranoid compounds
A

3

39
Q

Which botanical medicine may potentiate the effects of anticoagulant and platelet-inhibiting medications?

  1. ) Bromelain
  2. ) Arnica
  3. ) Chamomile
  4. ) Comfrey
A

1

40
Q

A German product containing which herb has shown positive results in the treatment of several types of skin disorders, including decubitus ulcers?

  1. ) Lemon balm
  2. ) Comfrey
  3. ) Chamomile
  4. ) Witch hazel
A

3

41
Q

Which preparation of aloe vera is suitable for topical treatment of skin conditions?

  1. ) latex
  2. ) gel
  3. ) juice
  4. ) both gel and latex
A

2

42
Q

An anti-inflammatory product called Phlogenzym (marketed in North America as Wobenzym PS) contains several ingredients, one of which is ___________.

  1. ) Bromelain
  2. ) Evening primrose oil
  3. ) Borage oil
  4. ) Arnica
A

1

43
Q

Which botanical is used both topically as an extract in tinctures, ointments, and oils as well as orally in homeopathic dilutions?

  1. ) Comfrey
  2. ) Arnica
  3. ) Chamomile
  4. ) Witch hazel
A

2

44
Q

Which botanical agent may increase the potency of certain antibiotics?

  1. ) Bromelain
  2. ) Evening primrose oil
  3. ) Arnica
  4. ) Witch hazel
A

1

45
Q

Match the latin binomial with the common name:

  1. ) Devil’s claw
  2. ) Frankincense
  3. ) Feverfew
  4. ) Butterbur
Choices:
A.) Tanacetum perthenium
B.) Harpagophytum procumbens
C.) Boswellia serrata
D.) Petasites hybridus
A
  1. B
  2. C
  3. A
  4. D
46
Q

Match the herb with the one specific part used for pain in botanical medicine:

  1. ) Devil’s claw
  2. ) Boswellin
  3. ) Willow
  4. ) Peppermint
  5. ) Feverfew
  6. ) Butterbur
Choices:
A.) essential oil from leaf
B.) tuber
C.) gum resin
D.) leaf
E.) bark
F.) rhizome
A
  1. B
  2. C
  3. E
  4. A
  5. D
  6. F
47
Q

Match the proposed active constituent or licensed standardized extract with the herb

  1. ) parthenolide
  2. ) capsaicinoids
  3. ) salicin
    4) Petadolex
Choices:
A.) Cayenne
B.) Butterbur
C.) Feverfew
D.) Devil's claw
E.) Willow bark
A
  1. C
  2. A
  3. E
    4 B
48
Q

Persons allergic to members of the daisy family should be cautious consuming which TWO herbs?

  1. ) Devil’s claw
  2. ) Butterbur
  3. ) Willow bark
  4. ) Feverfew
A

2 & 4

49
Q

Persons sensitive to aspirin should not use which herb?

  1. ) Butterbur
  2. ) Willow bark
  3. ) Devil’s claw
  4. ) Feverfew
A

2

50
Q

Which botanical has been shown effective against some types of pain when used topically?

  1. ) Devil’s claw
  2. ) Capsaicin
  3. ) Feverfew
A

2

51
Q

Which botanical has been shown clinically effective specifically against tension headache when used topically?

  1. ) Feverfew
  2. ) Willow bark
  3. ) Butterbur
  4. ) Peppermint
A

4

52
Q

For which TWO painful conditions have Devil’s claw preparations been studied in controlled trials?

  1. ) Osteoarthritis
  2. ) Chronic back pain
  3. ) Tension headache
  4. ) Diabetic neuropathy
  5. ) Migraine headache
A

1 & 2

53
Q

Capsaicin preparations have been studied in controlled trials for treating all of the following painful conditions except one. Which one has NOT been studied?

  1. ) Rheumatic disorders
  2. ) Diabetic polyneuropathy
  3. ) Skin ulcers
  4. ) Postherpetic neuralgia
A

3

54
Q

Which botanical has been found more effective as the whole dried herb than as an ethanolic extract?

  1. ) Butterbur
  2. ) Willow
  3. ) Feverfew
  4. ) Boswellin
A

3

55
Q

For which botanical extract is it important to have a guarantee that it is free of pyrrolizidine alkaloids?

  1. ) Feverfew
  2. ) Boswellin
  3. ) Butterbur
  4. ) Willow
A

3

56
Q

Interrupting which herb after taking it for a long time may result in difficulty sleeping, headaches, joint pain, nervousness, and stiff muscles?

  1. ) Boswellin
  2. ) Butterbur
  3. ) Devil’s claw
  4. ) Feverfew
A

4

57
Q

T/F: The traditional use of ginkgo biloba is based on medicinal use in Asia, not in Europe.

A

T

58
Q

On which two families of constituents are medicinal ginkgo extracts standardized?

  1. ) vanillic acids
  2. ) hydroxykynurenic acids
  3. ) flavonoid glycosides
  4. ) terpene lactones
A

3 & 4

59
Q

Which constituent of ginkgo must be removed because it has been shown to incite allergic responses and other toxic reactions?

  1. ) bilobalides
  2. ) kaempferol glycosides
  3. ) ginkgolic acids
  4. ) ginkgolides
A

3

60
Q

Indicate whether the statement fits the description of ginkgo biloba, St. John’s wort, or both:

  1. ) Plant part(s) used: leaf only
  2. ) Plant part(s) used: leaf and flowers
  3. ) Clinically-proven preparations are 35-67:1 concentrates
  4. ) Extracts contain phytochemicals from the flavonoid family

Choices:
A.) Ginkgo biloba
B.) St. John’s wort
C.) Both Ginkgo biloba and St. John’s wort

A
  1. A
  2. B
  3. A
  4. C
61
Q

T/F: The traditional use of ginkgo biloba is based on medicinal use in Asia, not in Europe.

A

T

62
Q 
What is the volatile oil content of typical herbs that contain such oils?
A) 4-6%
B) 7-10%
C) 1-2%
D) 2-3%
A

C

63
Q

Which of the following, if any, is not true regarding fingerprint chromatograms?
A) All of these are true
B) Can confirm product identity by comparing products to standard reference samples
C) Can characterize the presence and relative amounts of several herb components
D) Can be used to compare batches of the same product for quality control
E) Utilizes high-performance liquid chromatography

A

A

64
Q

Common preparation using alcohol or alcohol+water to produce extracts of a wide variety of herbs and herb combinations

A

Ticture

65
Q 
Which TWO of the following are alternate terms for lozenges?
A) Troches
B) Granules
C) Pastilles
D) Tablets
A

A C

66
Q

Water poured boiling over herb and covered, steeped 10 minutes, then strain

A

Infusion

67
Q

Covered with water, boiled, simmer 10 minutes, strained

A

Decoction

68
Q

Covered with room temperature water, stands 6 hours, strained

A

Maceration

69
Q

The European Union relies on which agency to update critical information about phytomedicines?
A) U.S. Food and Drug Agency
B) World Health Organization
C) German Commission E
D) European Scientific Cooperative on Phytotherapy

A

D

70
Q

When a study reports only the change in outcome within each group, this is called a before and after comparison, and is a common error that may fail to detect a lack of blinding.
A) Before and after
B) Lack of blinding
C) Large placebo effect

A

A and C

71
Q

When a study reports only the change in outcome within each group, this is called a before and after comparison, and is a common error that may fail to detect a lack of blinding.
A) Before and after
B) Lack of blinding
C) Large placebo effect

A

A and C

72
Q

The health condition for which it has promising or good evidence as a therapeutic intervention- Post-operative or post-traumatic swelling, especially of the nose/paranasal sinuses?

A

Bromelain

73
Q 
Comfrey products should have declared content of what potentially-toxic constituent?
A.) Clotrimazole
B.) Anthranoid compounds
C. ) Podophyllin toxin
D.) Unsaturated pyrrolizidine alkaloids
A

D

74
Q 
Which botanical medicine may potentiate the effects of anticoagulant and platelet-inhibiting medications?
A.) Comfrey
B.) Arnica
C.) Chamomile
D.) Bromelain
A

D

75
Q 
A German product containing which herb has shown positive results in the treatment of several types of skin disorders, including decubitus ulcers?
A.) Chamomile
B.) Comfrey
C.) Lemon balm
D.) Witch hazel
A

A

76
Q 
Which preparation of aloe vera is suitable for topical treatment of skin conditions?
A.) Gel
B.) Latex
C.) Juice
D.) Both gel and latex
A

A

77
Q 
Which botanical agent, in combination with trypsin and rutosid, has been shown to be as effective as nonsteroidal anti-inflammatory drugs (NSAIDs) for treating knee pain?
A.) Borage oil
B.) Bromelain
C.) Arnica
D.) Evening primrose oil
A

B

78
Q 
Which botanical is used both topically as an extract in tinctures, ointments, and oils as well as orally in homeopathic dilutions?
A.) Arnica
B.) Witch hazel
C.) Chamomile
D.) Comfrey
A

A

79
Q 
Which botanical agent may increase the absorption of certain antibiotics?
A.) Evening primrose oil
B.) Witch hazel
C.) Arnica
D.) Bromelain
A

D

80
Q 
In clinical trials using Harpagophytum extracts with standardized active principle content, what is the minimum amount of harpagoside prescribed per day?
A.) 2.4 grams
B.) 10 mg
C.) 50 mg
D.) 2 grams
E.) 100 mg
A

C

81
Q

Given the pharmacokinetics of harpagoside, both of the following statements are true: 1) a single morning dose could be expected to reduce symptoms within half an hour, and 2) relief should persist for the entire day.
A.) True
B.) False

A

B

82
Q 
Persons allergic to members of the daisy family should be cautious consuming which TWO herbs?
A.) Devil's claw
B.) Willow bark
C.) Feverfew
D.) Butterbur
A

C and d

83
Q

The traditional use of ginkgo biloba is based on medicinal use in Asia, not in Europe.
A.) True
B.) False

A

A

84
Q 
Persons sensitive to aspirin should not use which herb?
A.) Devil's claw
B.) Butterbur
C.) Willow bark
D.) Feverfew
A

C

85
Q 
Which TWO botanicals have been shown effective against some types of pain when used topically?
A.) Devil's claw
B.) Feverfew
C.) Peppermint
D.) Capsaicin
A

C and d

86
Q 
Which botanical has been shown clinically effective specifically against tension headache?
A.) Peppermint
B.) Feverfew
C.) Willow bark
D.) Butterbur
A

A

87
Q 
For which TWO painful conditions have Devil's claw preparations been studied in controlled trials?
A.) Osteoarthritis
B.) Tension headache
C.) Migraine headache
D.) Diabetic neuropathy
E.) Chronic back pain
A

A and E

88
Q 
Capsaicin preparations have been studied in controlled trials for treating all of the following painful conditions except one. Which one has NOT been studied?
A.) Postherpetic neuralgia
B.) Diabetic polyneuropathy
C.) Migraine headache
D.) Rheumatic disorders
A

C

89
Q 
Which botanical has been found more effective as the whole dried herb than as an ethanolic extract?
A.) Butterbur
B.) Boswellin
C.) Willow
D.) Feverfew
A

D

560 P BOTANICAL MEDICINE (2 decks)

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