Exam 5 Herbal Medicines Flashcards
What is an important screening question?
Do you use herbal supplement instead of or as an adjunct to conventional treatments?
Most popular products used by adults for health reasons?
fish oil/omega 3/DHA glucosamine echinacea flaxseed oil or pills ginseng
52% of respondents said they used what types of supplements?
multivitamins
vitamins E and C
calcium
B-complex vitamins
Mean age of individuals taking supplements?
71.4 years
What is polypharmacy?
taking more than 1 type of medication
What is polyherbacy?
taking 2 or more herbal products
Prevalence of polypharmacy?
72.3% (almost 3 quarter)
Prevalence of polyherbacy?
16.2%
What percentage at risk of having at least 1 possible drug and herbal-supplement interaction?
31.5% (almost a 1/3)
Herbal products and dietary supplements used?
glucosamine garlic echinacea gingko biloba herbal tea cod liver oil St John's wort ginseng saw palmetto
Most common reasons for older adults to take herbal stuff?
improve general wellness
help manage arthritis
prevent/manage colds
improve memory
Greatest number of reported interactions with HDS?
warfarin (most) insulin aspirin digoxin ticlopidine
HDS products containing ____ were more likely to have documented interactions with meds and contraindications than vitamins, minerals and other types of dietary supplements.
herbs
Patients using medications that have a _____ = greater risk for adverse outcomes because of HDS-drug interactions?
narrow therapeutic range
2 examples of meds with narrow therapeutic range?
warfarin
digoxin
Many herbs act as ___ and ___ medications and patients are ___ of these effects?
anti-platelet
anticoagulant
unaware
Common herbs: ginkgo, garlic, ginseng, ginger antagonize ___?
platelet activating factor
What should be discontinued before surgery?
all herbal medicines
How many days before surgery should all herbal meds be discontinued?
14 days
When “g” is followed by a ____, the herb is associated with a bleeding effect?
vowel
Neumonic for herbs and bleeding?
Few G’s
Name some herbs linked to bleeding?
Few G's feverfew ginkgo biloba ginger garlic ginseng
Garlic components implicated with bleeding?
Ajoene
Allicin
Sulfur containing compounds
Defined as inhibits production and/or release of chemical mediators?
antiplatelet
MOA for garlic antiplatelet?
inhibits production and/or release of chemical mediators:
platelet activating factor
adenosine
Ginkgo components implicated in bleeding?
Terpenoids
MOA for ginkgo antiplatelet?
increase prothrombin time and decreases platelet activity
What should you not use with ginkgo for the severe risk for spontaneous bleeding
aspirin and warfarin
Ginseng component implicated in bleeding?
ginsenosides
MOA for ginseng antiplatelet?
inhibit PAF, platelet aggregation, thrombin and thromboplastin
Ginseng + __? = potential bleeding?
aspirin
NSAIDS
warfarin
heparin
Ginger components implicated in bleeding?
pungent principles
volatile oils
proteolytic enzymes
MOA for ginger antiplatelet?
reduces platelet thromboxane, inhibits platelet aggregation
Feverfew causes what?
irritation of oral mucosa and tongue
Major active antidepressive constituents in St. John’s wort?
hyperforin
hypericin
St. John’s other biologically active consituents?
flavonoids
tannins
St. John’s wort component implicated in bleeding?
hypericin
MOA for St. John’s wort?
induces some cytochrome P450 liver enzymes
reduces anticoagulant effect of warfarin (increases clotting) and lowers the INR
Vitamin E use?
fat soluble vitamin
Vitamin E is an ____?
antioxidant
Vitamin E may alter what?
vitamin K’s effect on clotting factors
Echinacea use?
common cold, cough, and bronchitis
Echinacea is ____, especially if used with other meds that are also ____.
hepatotoxic
Echinacea may decrease effectiveness of ____?
corticosteroids
Feverfew use?
migraine prophylaxis fever reducer anti-inflammatory RA muscle soreness
Feverfew inhibits ____?
platelet activity
Up to 15% of Feverfew users may develop ___?
aphthous ulcers
Feverfew may cause irritation to ___?
oral mucosa/tongue
When is Feverfew contraindicated?
pregnancy
Kava-kava use?
anxiety
stress relief
minor tranquilizer
skeletal muscle relaxant
Kava-kava potentiates what?
CNS effects of other CNS depressants?
Kava-kava may interfere with what drugs?
alcohol, BDZ’s, barbituates, sedatives, general anesthesia
Kava-kava contraindications?
pregnancy
lactation
Parkinson’s disease
Licorice use?
gastric disorders
antitussive
aphthous ulcers
herpes simplex
Licorice may cause ___?
hypertension
Licorice may alter ___?
platelet aggregation
Licorice contraindications?
pregnancy
lactation
liver or renal impairment
Valerian use?
mild sedative
mild anxiolytic: anxiety
depression
insomnia
Valerian potentiates effects of ___ including ___?
CNS depressants
barbiturates
Dentists must seek alternative analgesics because of synergistic effects with ___?
aspirin
NSAIDS
Monitor patients taking ___?
warfarin
Dentists must cross-reference all herbal and prescription medications prior to prescribing to ensure ___?
compatibility
