Exam 5: Herbs Flashcards
What were the most popular products (herbs) used by adults for health reasons?
- fish oil/omega 3/DHA (37.4%)
- glucosamine (19.9%)
- echinacea (19.8%)
- flaxseed oil or pills (15.9%)
- ginseng (14.1%)
What are the 4 most COMMONLY used herbal preparations
- multivitamins/multiminerals
- vitamins E and C
- Calcium
- B-complex vitamins
List the herbal products and dietary supplements used
Glucosamine or glucosamine/chondroitin Garlic Echinacea Gingko biloba Herbal tea Cod liver oil St John's wort Ginseng Saw palmetto
What were the most common reasons for taking an herbal product or dietary supplement
- to improve general wellness
- to help manage arthritis
- to help prevent or manage colds
- to improve memory
What were the 5 herbal supplements that had the greatest number of documented interactions with medications
- St. John’s wort
- Magnesium
- calcium
- iron
- ginkgo
What medications had the greatest number of reported interactions with HDS?
- warfarin (MOST)
- insulin
- aspirin
- digoxin
- ticlopidine
Which herbs are commonly involved in bleeding?
ginkgo, garlic, ginseng, ginger
**Antagonize platelet activating factor
T or F, All herbal medicines should be discontinued for 14 days prior to surgery (including oral surgery)
True
When the “g” is followed by a vowel…?
the herb is associated with a bleeding effect
When the “g” is followed by a consonant…?
there is not a concern for bleeding
List the effects of garlic
Anti-lipidemic
Antimicrobial
Anti-asthmatic
Anti-Inflammatory
List the components of garlic that have been implicated with bleeding
- Ajoene
- Allicin (Strong odor; platelet effect is irreversible)
- Sulfur containing compounds
What effect does Garlic have on bleeding
Antiplatelet
- inhibits production and/or release of chemical mediators
Effects of Ginkgo
- Prevent decreased cerebral function
- Peripheral vascular insufficiency associated with Alzheimer’s disease or age-related dementia
- Improve memory and cognition
What components of Ginkgo are implicated in bleeding
Terpenoids
- potent antagonists of platelet activating factor
- Long-lasting and rapid onset with oral dosing
ANTI PLATELET effect ** Increases prothrombin time and decreases platelet activity
Ginkgo has risk for severe spontaneous bleeding with concurrent use of what other drugs?
Aspirin
Warfarin
List the effects of Ginseng
Anti-cncer Slows aging Prevent heart attack Improve digestion Reduce hypertension Strengthen immunity CNS stimulant
What components of Ginseng have been implicated in bleeding
Ginsenosides
ANTI PLATELET effect ***inhibit PAF, platelet aggregation, thrombin and thromboplastin
Ginseng potentiates bleeding with what other drugs?
aspirin
NSAIDS
warfarin
heparin
Effects of Ginger
Relieve motion sickness and morning sickness
Decrease arthritis pain and inflammation
Relieve upset stomach
What components of Ginger have been implicated in bleeding
Pungent principles
Volatile oils
Proteolytic enzymes
ANTI PLATELET effect ***reduces platelet thromboxane, inhibits platelet aggregation
Effects of Feverfew
Anti-inflammatory (RA)
Preventive for migraine headache
Muscle soreness
What is the anti platelet effect of Feverfew
Inhibits platelet aggregation
Feverfew may cause what?
- **Irritation of oral mucosa and tongue
- Increases risk for photosensitivity
Effect of St. John’s Wort
Reduce mild to moderate depression
What are the major active anti depressive constituents are in St John’s wort
- hyperforin (MAJOR)
- hypericin
Others
- flavonoids
- tannins
Hyperforin has been shown to do what biochemically?
inhibit uptake of 5-HT, dopamine, norepinephrine, GABA and glutamate
What components of St. John’s wort have been implicated in bleeding
hypericin
- **Induces some cytochrome P450 liver enzymes
- **Reduces anticoagulant effect of warfarin (increases clotting) and lowers the INR
Effects of Vitamin E
Antioxidant
- Prevents oxidation of vitamins A and C
- Protects polyunsaturated fatty acids in membranes from free radical damage
- Protects RBCs against hemolysis
**May also alter the effect of Vitamin K on clotting factors
Use of Echinacea
Common Cold
Cough
Bronchitis
Adverse effects of Echinacea
Hepatotoxic, especially when used with other hepatotoxic med
Echinacea may decrease effectiveness of what other drugs
corticosteroids
Use for Feverfew
Migraine prophylaxis
Fever reduction
Anti-inflammatory (RA, muscle soreness)
Feverfew is contraindicated when?
Pregnancy
What adverse effect may occur with Feverfew
May cause irritation of oral mucosa/tongue
Up to 15% of users may develop aphthous ulcers
Use of Kava-Kava
Anxiety, Stress relief
Minor tranquilizer actions
Skeletal muscle relaxant
Effects of Kava-Kava
Potentiates CNS effects of other CNS depressants: alcohol, BDZs, barbiturates, etc.
***Caution with sedation dentistry
Kava-Kava is contraindicated when?
in Pregnancy, lactation and Parkinson’s disease
Use of Licorice
gastric disorders
antitussive
aphthous ulcers
herpes simplex
Licorice may cause what?
hypertension
May alter platelet aggregation
Licorice is contraindicated when?
Pregnancy, lactation, liver or renal impairment
Use of Valerian
mild sedative
mild anxiolytic
anxiety, depression, insomnia
Effects of Valerian
Potentiates the effects of CNS depressants, including barbiturates
