Herbal agents

Question 1

Describe Ginger: uses, side effects, precautions, interactions

Answer 1

uses: nausea, dyspepsia, constipation, colic
side effects: heartburn, bloating, flatus, belching precautions/interactions: increase risk of bleeding, should not take with aspirin or warfarin

Question 2

Ginseng: uses, side effects, precautions, interactions

Answer 2

Uses: increase overall physical and mental wellbeing, lower cholesterol, reduce fatigue, enhance libido
SE: insomnia, n/d, headaches, nervousness, nosebleeds
precautions/ interactions: increased risk of bleeding, don’t take with ASA or warfarin, BP changes, mania in depressed patients taking MAOIs, may inhibit effects of opioids

Question 3

St. John’s Wort: uses, side effects, precautions, interactions

Answer 3

Forms: crushed flower bud, seed pods, tea, tablets
Uses: depression, anxiety, sleep disorders, improve BPH symptoms
SE: sunlight sensitivity, anxiety, dry mouth, dizzy, GI symptoms, fatigue, headache, sexual dysfunction
Cautions: increase risk of blood clots, don’t take with ASA or warfarin. MANY drug interactions: SSRI- can lead to serotonin syndrome, decrease effectiveness of OCPs, digoxin, alprazolam, amitriptyline
increased effectiveness of narcotics, decrease effectiveness of HIV antiretrovirals
Reacts with light
may lead to cataract formation

Question 4

Echinacea (pink Coneflower): uses, side effects, precautions, interactions

Answer 4

forms: extract, capsule, root or whole plant
use: treat common cold symptoms
SE: allergic reaction, nausea, abd pain, dysuria, myalgia
cautions: anaphylaxis, hepatotoxicity
nephrotoxicity
potential increased sedation effects during anesthesia

Question 5

Gingko biloba: uses, side effects, precautions, interactions

*cute little old lady in the diabetes clinic takes her gingko

Answer 5

Forms: leaves, extracts, tablets, tea
use: memory and concentration enhancer, intermittent claudication, glaucoma
SE: n/v/d, headaches, dizziness, palpitations
cautions: increased risk of bleeding, don’t take with ASA or warfarin, may increase BP overtime

Question 6

Black cohosh: uses, side effects, precautions, interactions

Answer 6

Forms: plant root and stems- capsules or liquid
use: improving premenstrual and menopausal discomfort
SE: N/v, dizziness, mastalgia, weight gain
caution: large amounts may cause seizures, visual disturbances, bradycardia and others.
may increase risk of vaginal bleeding
mimics estrogen effects; don’t coincide with taking hormone replacement

Question 7

Evening primrose: uses, side effects, precautions, interactions

Answer 7

form: oil from plant or root
use: improve premenstrual and menopausal discomfort, releive diabetic neuropathic pain
SE: nausea, soft stool, headache, allergy
caution: may increase risk of epilepsy in patients taking antipsychotics, may increase incidence of seizures in those with epilepsy requiring anaesthesia

Question 8

Kava Kava: uses, side effects, precautions, interactions

Answer 8

form: root powder mixed with cold water to drink
use: improve relaxation without disruption of mental clarity
SE: rash, eye irritation
caution: high dose and long term use can lead to hypertension, liver damage, visual impairment and dry skin
alcohol increases effects
may worsen Parkinson’s symptoms
may impair reaction time when driving

Question 9

Garlic: uses, side effects, precautions, interactions

Answer 9

use: improve indigestion, respiratory complaints
increase energy levels
SE: bad breath, nausea, indigestion
caution: increased risk of bleeding, should not be taken with ASA or oral anticoagulants

Question 10

Which herbal supplements increase bleeding risk (4)?

** hint *** all start with G

Answer 10

gingko biloba, garlic, ginger, ginseng

don’t take with aspirin, warfarin, oral anticoagulants.