Herbal medications

Question 1

Common name for Saw palmetto

Answer 1

American dwarf palm or cabbange palm

Question 2

Saw palmetto: Typical use

Answer 2

BPH (Benign Prostatic Hyperplasia) Mild to Moderate

Question 3

Mechanism of Action of Saw palmetto

Answer 3

Contains beta-sitosterol; inhibits cell proliferation and promotes apoptosis of prostate cancer cells, and its anti-inflammatory properties have been linked to its inhibitory actions on cyclooxygenase and lipoexygenase

Question 4

Saw palmetto: Warnings

Answer 4

Women should not take it for urogenital issues if they take HCs, HRT, have BCA, or are pregnant

Question 5

Saw palmetto: dosage

Answer 5

100-400 mg BID daily. Therapeutic benefits are observed within 3-4 weeks after the initiation of treatment, which usually lasts for 3-6 months

Question 6

St. Johns Wort: Typical use

Answer 6

Mild-moderate depression

Question 7

St. John’s Wort: MOA

Answer 7

Hypericin may have a minor role in MAO inhibition. Hyperforin is generally agreed to be the active component. Both inhibit synaptic reuptake of serotonin but they also inhibit reuptake of dopamine and noradrenaline. Also LT increases the synaptic density of serotonin receptors by 50%

Question 8

SJW: Other uses

Answer 8

Anti-bacterial properties when used topically. Hyperforin is effective in inhibiting gram-positive bacteria (MRSA). It may have anti-viral properties (mostly against influenza). Inhibit tumor cell growth.

Question 9

SJW: Adverse Effects

Answer 9

Mild side effects include GI symptoms, mild sedation or tiredness, dizziness, headache, and dry mouth

Question 10

SJW: Other effects

Answer 10

1 - Transient photosensitivity when administered in high doses; 2 - serotonin syndrome when co-administered with SSRIs

Question 11

SJW: Drug Interactions

Answer 11

Decreases the bioavailability of: Warfarin, OCs, antiretroviral protease inhibitors, theophylline; simvastatin; digoxin

Question 12

SJW: Warnings

Answer 12

Avoid during pregnancy

Question 13

SJW: Dose

Answer 13

500-1,800 mg/day

Question 14

Ginkgo: uses

Answer 14

Intermittent claudication, age-related memory loss, dementia, and early stages of Alzheimer’s . Antioxidant & anti-inflammatory properties. Prevent platelet aggregation and contraction of smooth muscles in the respiratory tract

Question 15

Ginkgo: Doses

Answer 15

120-240 mg/day in 2-3 doses for 6 months or longer

Question 16

Ginkgo: Adverse Effects

Answer 16

Less than 2% of patients develop SE namely HA, nausea, or mild GI symptoms

Question 17

Ginkgo: Warnings

Answer 17

It is advisable to discontinue ginkgo several days prior to surgery

Question 18

Ginkgo: Toxicilogy

Answer 18

Should not be used during pregnancy; Severe contact dermatitis from direct contact with the pulp of ginkgo fruit. Pollen from male tree can can be allergenic for sensitive individuals. Ingestion of ginkgo seeds in large amounts (> 50) can cause HA, N/D, and seizures