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Pharm. II > Exam 5 Herbal Medicines > Flashcards

Exam 5 Herbal Medicines Flashcards

1
Q

What are the indications for garlic? (4)

A

1) Anti-lipidemic
2) Antimicrobial
3) Anti-asthmatic
4) Anti-inflammatory

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2
Q

What are the indications for Ginkgo? (3)

A

1) Prevent decreased cerebral function
2) Peripheral vascular insufficiency associated w/ Alzheimer’s disease or age-related dementia
3) Improve memory and cognition

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3
Q

What are the indications for Ginseng? (7)

A

1) Anti-cancer
2) Slows aging
3) Prevent heart attack
4) Improve digestion
5) Reduce hypertension
6) Strengthen immunity
7) CNS stimulant

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4
Q

What are the indications for Ginger? (3)

A

1) Relieve motion sickness and morning sickness
2) Decrease arthritis pain and inflammation
3) Relieve upset stomach

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5
Q

What are the indication for Feverfew?

A

1 ) Anti-inflammatory (rheumatoid arthritis)

2) Fever reduction
3) Preventative for migraine headache (prophylaxis)

4) Muscle soreness
- -Abrupt discontinuation: rebound headaches, joint pain and stiffness, anxiety.

5) Active: sesquiterpene lactone, parthenolide

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6
Q

What are the indications for Fish Oils?

A

1) Skin disorders
2) Cardioprotection
3) Diabetes
4) Headache
5) Immune support
6) Memory
7) PMS
8) Ulcerative colitis

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7
Q

What are the indications for St. John’s Wort?

A

1) Reduce mild to moderate depression
2) Most widely studied herb with demonstrated efficacy
3) Weed-like plant
4) Renders oral contraceptives ineffective in some users

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8
Q

Major active antidepressive constituents in St. John’s wort are________ and ___________.

Other biologically active constituents: ___________ and __________

A
  • hyperforin
  • hypericin
  • flavonoids
  • tannins
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9
Q

What is the mechanism for St. John’s Wort?

A
  • The exact mechanism = unclear

- Mechanism is believed to involve inhibition of serotonin (5-HT) reuptake

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10
Q

Hyperforin is the major constituent for St. John’s Wort. It has been to _______ the uptake of _______, ________, _________ , __________ and _________

A
  • inhibit
  • 5-HT
  • dopamine
  • norepinephrine
  • GABA
  • glutamate
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11
Q

What are the indications for Vitamin E?

A

1) Use: fat soluble vitamin

2) Antioxidant
■ Prevents oxidation of vitamins A & C
■ Protects polyunsaturated fatty acids in membranes from free radical damage
■ Protects RBCs against hemolysis

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12
Q

What is the uses for Echinacea?

dangers?

A

■ common cold
■ cough
■ bronchitis

○ Limit use to 10 days
○ Hepatotoxic, when used with other hepatotoxic meds

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13
Q

What are the indications for Kava-Kava?

A

1) anxiety
2) stress relief; acts like a minor tranquilizer, skeletal muscle relaxant
- FDA monitoring for hepatotoxicity

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14
Q

What are the indications for ● Licorice (Glycyrrhiza glabra)?

A

1) Gastric disorders
2) Antitussive
3) Aphthous ulcers
4) Herpes simplex

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15
Q

What are the indications for Valerian ?

A

1) Mild sedative
2) Mild anxiolytic
3) Anxiety
4) Depression
5) Insomnia

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16
Q

When the “g” is followed by a __________ (ex: ginkgo) the herb is associated w/ a __________ effect
○ Includes: _______, _______, ginger, _______, and __________

A
  • vowel
  • bleeding
  • feverfew,
  • ginkgo biloba
  • garlic
  • ginseng
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17
Q

What are Garlic’s components implicated w/ bleeding?

A

1) Ajoene
2) Allicin-strong odor and flavor; platelet effect is irreversible
3) Sulfur containing compounds

○Effect: Antiplatelet= inhibits production and/or release of chemical mediators:
■ Platelet activating factor
■ Adenosine (decreases platelet function)

18
Q

What is Ginkgo’s components implicated in bleeding?

A

1) Terpenoids
2) Potent antagonist of platelet activating facor
3) Long-lasting and rapid onset w/ oral dosing

–Effect: Antiplatelet= INCREASES prothrombin time and DECREASES platelet activity

○ Risk for severe spontaneous bleeding w/ concurrent use of aspirin + warfarin

19
Q

What is Ginseng’s components implicated in bleeding?

A

■ Ginsenosides

–Effect: Antiplatelet = inhibit PAF, platelet aggregation, thrombin and thromboplastin

20
Q

What is Ginger’s components implicated in bleeding?

A

1) Pungent principles
2) Volatile oils
3) Proteolytic enzymes
- -Effect: Antiplatelet= reduces platelet thromboxane, inhibits platelet aggregation

○ Mixed reports in literatiere
○ Most significant effects w/ raw ginger

21
Q

What is Feverfew’s components implicated in bleeding?

A

Effect: inhibits platelet aggregation

22
Q

What is John’s Wort components implicated in bleeding?

A
  • hypericin
  • Increases clotting and lowers the INR
  • Decreased efficacy of anticoagulants
23
Q

What is Vitamin E’s components implicated in bleeding?

A
  • May alter the effect of vitamin K on clotting factors

- Increases risk for spontaneous hemorrhage

24
Q

What is Licorice’s components implicated in bleeding?

A

May alter platelet aggregation

25
Q 
Fish Oils	
Effects:	
\_\_\_\_\_\_\_\_\_\_ platelet aggregation and\_\_\_\_\_\_\_\_bleeding time 
\_\_\_\_\_\_\_\_\_fibrinolysis
may \_\_\_\_\_\_\_\_ von Willebrand factor
\_\_\_\_\_\_\_\_ fibrinogen 
\_\_\_\_\_\_\_ factor V levels
\_\_\_\_\_\_\_\_\_ thrombin generation in plasma .
A
  • Decrease
  • prolong
  • increase
  • reduce
  • reduce
  • reduce
  • reduce
26
Q

Fish Oils:
Intake of _________ or greater of omega-3 fatty acids may ________ risk of bleeding

-Very large intakes of ______oil/omega-3 may ___________risk of hemorrhagic (bleeding) _________

High doses have also been associated with ______and blood in __________

A
  • 3 grams/day
  • increase risk of bleeding
  • fish
  • increase
  • stroke
  • nosebleed
  • urine
27
Q

Medications with a ______therapeutic range (ex: ______, _______) = ______ risk for adverse outcomes b/c of HDS-drug interactions

-Important for patients on _________ (warfarin) who concomitantly took ______ products that had ______ or __________effects

A
  • narrow
  • (warfarin, digoxin)
  • greater
  • anticoagulants (warfarin)
  • HDS products
  • antiplatelet
  • anticoagulant
28
Q

How does Ginkgo alter effect of Warfarin?

A

○ Antiplatelet = increases prothrombin time and decreases platelet activity

○ Risk for severe spontaneous bleeding w/ concurrent use of aspirin and warfarin

29
Q

How does Ginseng alter effect of Warfarin?

A

○ Antiplatelet = inhibit PAF, platelet aggregation, thrombin and thromboplastin
○ Potentiates bleeding w/ aspirin, NSAIDs, warfarin, heparin

30
Q

How does St. John’s Wort alter effect of Warfarin?

A

1) Induces cytochrome P450 liver enzymes

2) Reduces anticoagulant effect of warfarin (increases clotting) and lowers INR

31
Q

How does Vitamin E alter effect of Warfarin?

A

-Interacts with warfarin: increases -hypoprothrombinemia= delays clotting and increases risk for spontaneous hemorrhage

32
Q

Dental considerations:

Synergistic drug effects w/ ______, _________: seek _________ analgesics
● Monitor patients on _______ for herbal use and ______ appropriately
● Cross-reference all herbal and prescription medications to _____ ___________________using a database (LexiComp for Dentistry)

A 
-aspirin
 NSAIDS
 -alternative 
-warfarin 
-counsel 
-ensure
- compatibility
33
Q

What is the dental implication of

Echinacea?

A

May decrease effectiveness of corticosteroids

34
Q

What is the dental implication of

Feverfew ?

A

○ Up to 15% of users may develop aphthous ulcers
○ May cause irritation of oral mucosa/tongue
○ Contraindicated in pregnancy
○ Increases risk for photosensitivity

35
Q

What are the dental implication of

Feverfew ?

A
  • Potentiates CNS effects of other CNS depressants: alcohol, BDZs, barbituates, sedatives, general anesthesia = caution w/ sedation dentistry
  • Contraindicated in pregnancy lactation and Parkinson’s disease (may cause dopamine antagonism)
36
Q

What are the dental implication of Licorice??

A

1) May cause hypertension: (monitor vital signs)

2) Contraindicated in pregnancy, lactation, liver or renal impairment

37
Q

What are the dental implication of St. John’s Wort??

A

○ General anesthetics= patient difficult to awaken

○ Increases photosensitivity or tetracyclines

○ Reduces effect of glucocorticoids

38
Q

What are the dental implication of Valerian?

A

○ Causes drowsiness and sedation

○ Potentiates the effects of CNS depressants, including barbiturates

39
Q

What are the dental implication o Vitamin E

A

○ May alter the effect of vitamin K on clotting factors

○ hypoprothrombinemia

40
Q

What is the rationale for discontinuing herbal supplement use 2 weeks prior to surgical procedures?

A

● All herbal medicines should be discontinued for 14 days prior to surgery (including oral surgery)

● Common herbs: ginkgo, garlic, ginseng, ginger
-Antagonize platelet activating factor

41
Q

Describe the rationale for discontinuing herbal supplement like John’s Wort?

A

1) DECREASES effects of many medications
2) Multiple drug interactions
3) General anesthetics= patient difficult to awaken
4) DECREASED efficacy of anticoagulants

Pharm. II (13 decks)

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