herbal Flashcards
How can you tell a supplement from medicine
Supplement is more gentle, diluted, and has less ADE. multichemical, and consistent quality and purity
Medicine has an active constituent, toxicity, and ADE;s
What does the DSHEA legislation say
Allow structure and function statements
Permit FDA oversight in manufacturing process
Require ingredient list and amount
Applied to herbs, minerals, and vitamins
The DSHEA legislation does NOT
allow medical claims
Require safety and efficacy data
require standardization
What are the studied herbs
garlic ginkgo biloba Ginseng Echinacea purpurea milk thistle st john's wort black cohosh saw palmetto ephedra feverfew kavakava valerian marijuana
What herbs have a narrow margin of safety
Aconite pheasant's eye Pasque flower arnica bryony ipecac cinchona bark lily of the valley datura foxglove male fern yellow jasmine henbane blueflag mandrake indian snakeroot bloodroot scotch broom tansy ragwort squill false hellbore european mistletoe
What herbs are potentially hepatotoxic
Chaparral Comfrey heliotrope germander pennyroyal liferoot (also venoocclusive dz)
What herbs are potentially carcinogens
borage
calamus
coltsfoot
sassafras
Are herbs safe?
most are safe with mild and infrequent ADE
ADE can occur and manufacturers have no regulatory responsibility to ensure safety of their products
Do herbs ned to be regulated
legally, they do not need FDA approval
label claims are vague and confusing
products from different manufacturers vary considerably
You are about to start a patient on warfarin but he/she tells you that they eat garlic with every meal and bate in it (wtf). What should you tell them in regards to the garlic soap (topical) before starting them on warfarin
Reduce the use of topical garlic!
In what type of patient would a Ginkgo Biloba trial be appropriate
patient suffering from dementia
What is not an appropriate use of ginseng
lupus
why do many people use echinacea purpurea
to fight the common cold and URI’s
what is a major contraindication for milk thistle
allergy to chamomile
what is a potential ADE of st john’s wort
photosensitivity
what lab test should you order prior to administering black cohosh
LFT’s
which herb can be used to treat BPH
saw palmetto
A 25-year-old female presents to the ED for evaluation after suffering a generalized tonic-clonic seizure. Seizure lasted 1 minute and was witnessed by her boyfriend. Patient did not lose bowel or bladder control during episode. She reports she is feeling better, but still feels like her heart is racing. Patient reports that for the past two weeks she has been taking a weight loss pill given to her by her friend in attempt to get ready for her upcoming pageant. What diet pill do you suspect the patient had been taking?
Ephedra (ma huang)
what is a common use for feverfew and what is a possible side effect seen with use
used for migraine prophylaxis
common ADE: allergic contact dermatitis
if a pt takes >250 mg of Kava per day (max daily dose), what is a serious ADE that can occur
Liver failure
Valerian root extracts are used to induce sleep and improve sleep quality. valerian may enhance the ADE of what drug
Benzodiazepines
Cannabidiol, an active chemical in marijuana, has been aproved by the FDA to treat what condition
specific seizure conditions in those 2+ y/o
