Exam 4 - Herbal medicines and natural treatments

Question 1

Do herbal medicines have to be tested? What do companies have to do because of this?

Answer 1

• no
• cannot market it as a treatment for a specific disorder (anxiety = calming)

Question 2

St. John’s Wort

Answer 2

• hypericin and hyperforin active ingredients
• “provide emotional balance”, primarily used for treatment of depression

Question 3

Pharmacokinetics of St. John’s Wort

Answer 3

• active ingredients interfere w/ liver enzymes, can either increase or decrease level of metabolization of drugs
• peak levels reached in 5 hours
• half life is 25 hours
• can result in adverse effects when combine w/ other drugs

Question 4

Pharmacodynamics of SJW

Answer 4

• mechanism not clear
• inhibits MAO inhibition but only at high concentrations
• bind to GABA, benzo and NMDA receptors

Question 5

Clinical efficacy of SJW

Answer 5

• MAYBE effective in treating MILD depression
• however, 2 large studies showed that it was no more effective than placebo

Question 6

Side effects of SJW

Answer 6

• photosensitivity in fair skinned people
• some psychoactive properties found in mother’s milk
• may precipitate hypomanic state
• if used with SSRIs, may cause serotonin syndrome

Question 7

Ginkgo

Answer 7

• Egb-761
• “mental sharpness”, alleviate symptoms associated w/ range of cognitive disorders
• contains flavonoids (interfere w/ liver enzymes), and terpenoids (interfere w/ clotting factors)

Question 8

Pharmacokinetics of Ginkgo

Answer 8

• readily absorbed, peak concentrations around 2-3 hours
• mech of elimination not known
• half life is 5 hours

Question 9

Pharmacodynamics of Ginkgo

Answer 9

• contains compounds thought to provide membrane protection and neurotransmission modulation
• increased alpha wave activity, indicative of increased altertness (similar to drinking a coffee)

Question 10

Clinical efficacy of Ginkgo

Answer 10

• modest effects on cognitive functioning associated w/ cerebrovascular impairments
• benefit may be solely to due its action to reduce stickiness of blood platelets

Question 11

Side effects of Ginkgo

Answer 11

• headache and GI upset
• can cause spontaneous bleeding an hemorrhaging
• safety in pregnancy has not been established

Question 12

Kava

Answer 12

• similar to alcohol and sedative hypnotics
• root of Kava plant
• induces relaxation, social interaction, sleep and sociocultural life
• used to therapy for anxiety

Question 13

Pharmacokinetics of Kava

Answer 13

• pharmacological action due to kava lactones
• well absorbed
• inhibits cytochrome P450 liver enzymes, potentially increasing blood concentrations and toxicity of drugs

Question 14

Pharmacodynamics of Kava

Answer 14

• bind to either GABA or benzo binding sites
• anticonvulsant and muscle relaxant properties

Question 15

Clinical effects of Kava

Answer 15

• anxiolytic effect at 70 mg
• high doses induces feeling of well being, drowsiness, sedation and feeling of intoxication
• effective for short-term treatment of mild-mod anxiety

Question 16

Side effects of Kava

Answer 16

• drowsiness, nausea, muscle weakness, blurred vision, jaundice
• should not be taken with alcohol, benzos, barbiturates, THC, or other CNS depressants
• should only be used short-term, can cause hepatotoxicity

Question 17

Ephedrine

Answer 17

• naturally occurring psychoactive substance sound in ephedra sinica
• releases epi, norepi, and dopa
• resembles amphet
• increases BP, HR

Question 18

Omega-3 Fatty Acids

Answer 18

• include EPA and DHA
• found in ocean fish

Question 19

Use of Omega-3 Fatty Acids during pregnancy

Answer 19

• required for normal fetal development - neural and retinal tissue growth
• may help or prevent depressive symptoms

Question 20

Use of Omega-3 Fatty Acids in children and adolescents

Answer 20

• efficacy shown in autism spectrum disorder, reduction of allergy risks, and in developmental behaviors
• results mixed for ADHD
• may be beneficial in subthreshold psychosis

Question 21

Antidepressant and Omega-3 Fatty Acids use

Answer 21

• use in BPD is well supported
• can reduce depressive symptoms

Question 22

Cardiovascular effects of Omega-3 Fatty Acids

Answer 22

• reducing risk of CV deaths
• reduces platelet adhesion (heart attacks and strokes)
• benefits on triglycerides

Question 23

Omega-3 and Dementia risk

Answer 23

• DHA may:
  
  • reduce incidence of dementia
  • prevent cognitive decline
  • improve synaptic and NT functioning
  • enhance learning and memory performances
• display neuroprotective properties

Question 24

Valerian

Answer 24

• mild sedative and anxiolytic
• may affect GABA receptors by acting like a mild benzo
• side effects: liver toxicity, headaches, excitability/uneasiness
• potential interaction w/ SSRIs

Question 25

Evening primrose

Answer 25

promoted for treatment of schizo and ADHD

Question 26

Hops

Answer 26

• sedative-hypnotic agent, promoted to treat either insomnia or anxiety

Question 27

Lemon balm/passion flower/skullcap

Answer 27

though to posses CNS sedative properties, promoted as sedatives and anxiolytics