Herbal Medications Flashcards
Approximately what percentage of the US population
takes herbal medications? What percentage of
these report to healthcare providers that they take
herbal medications?
Over 35% of the populations takes some form of herbal
medication, but only 30% of this population accurately reports
that they take them when asked by a healthcare provider.
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
315.
Does the FDA regulate herbal medications?
The FDA does not regulate herbal supplements as they do
other medications. The FDA can, however, remove an herbal
supplement from the market if they find that it is not fit for
human consumption (for example if it is contaminated with toxic
pesticides or fertilizers or if it is not manufactured according to
standard practices).
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
316.
What legislative act classified herbal medications as
dietary supplements rather than medications?
The U.S. Dietary Supplement Health and Education Act defined
herbal medications as dietary supplements rather than
regulated medications.
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
316.
There are eleven common herbal supplements that
have significant anesthetic implications. Name them.
Valerian, St. John’s wort, saw palmetto, kava, ginseng, ginkgo
biloba, ginger, garlic, feverfew, ephedra, and echinacea
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
317
Several herbal medications promote bleeding.
Which one does so by inhibiting platelet-activating
factor?
Gingko biloba
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
317.
Several herbal medications promote bleeding.
Which one does so by promoting fibrinolysis?
Garlic
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
317.
Several herbal medications promote bleeding.
Which one does so by inhibiting cyclooxygenase?
Saw palmetto
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
317.
What herbal supplement is known to be metabolized
by the cytochrome p450 pathway?
50% of St John’s wort is metabolized via the cytochrome p450
pathway
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
317.
What herbal medication should be tapered over 7
days to prevent withdrawal symptoms?
Valerian, which potentiates barbiturates, should be tapered over
7 days to prevent withdrawal symptoms
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
317.
Name three herbal medications that have been
shown to potentiate barbiturates.
Kava, saw palmetto, and valerian
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
317.
Name five herbal medications that have been shown
to increase the risk of bleeding.
Feverfew, garlic, ginger, ginkgo biloba, and ginseng
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
317.
For what reasons is echinacea commonly used and
what are its most significant side effects?
Echinacea is taken for the treatment and prevention of upper
respiratory infections and flu. Although it has not been proven
conclusively effective in the prevention of colds or flu, it has
demonstrated some degree of immunostimulation and should
be avoided before transplant surgery. It may also result in
increased asthma symptoms and exacerbate allergic rhinitis. In
one study, pediatric patients exposed to echinacea were
significantly more likely to develop a rash than patients who had
not been exposed to it.
Katzung BG, Masters, SB, & Trevor AJ. Basic and Clinical
Pharmacology. 12th ed. New York: McGraw-Hill; 2012: 1128.
Which herbal medication may result in lowered blood
glucose levels?
Ginseng
Nagelhout JJ, Plaus KL. Nurse Anesthesia. 5th ed. St. Louis,
MO: Elsevier Saunders Company; 2014: 346.
In general, how long should herbal medications be
discontinued prior to anesthesia?
1-2 weeks. Patients should be instructed to taper these
medications to prevent withdrawal symptoms that can occur
from herbal medications like valerian.
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
316.
How would the use of St John’s wort affect serum
digoxin levels?
Because St. John’s wort causes enzyme induction, it can result
in decreased serum digoxin levels. It can also similarly affect
warfarin, calcium channel blockers, protease inhibitors,
benzodiazepines, and many other drugs.
Nagelhout JJ, Plaus KL. Nurse Anesthesia. 5th ed. St. Louis,
MO: Elsevier Saunders Company; 2014: 346.
