Herbal medications Flashcards
what are the problems with evidence of effectiveness for dietary supplements?
- lack of large double blind RCTs
2. doses and formulations vary between studies
what is the caveat to regulatory companies like USP?
do not ensure safety or effectiveness
what is the role of regulatory companies like USP?
ensure that manufacturing and quality have been tested
what is the main therapeutic use for echinacea?
decrease duration and intensity of common cold
what are the results of in vitro and animal model studies of echinacea?
- immune modulating (increase cytokine production)
- antiinflammatory (inhibits COX)
- increase number of immunological blood cells
what are the adverse effects of echinacea?
rash
severe thrombocytopenia
inhibitor of cyp
echinacea is contraindicated in what population?
immunodepressed
what are the therapeutic uses for gingko biloba?
treatment / prevention of alzheimers
peripheral vascular disease
what are the effects of gingko biloba on the CNS (in animal studies)?
increase in 5-HT receptor density
what are the adverse effects of gingko?
antiplatelet
bleeding
diarrhea
anxiety
most clinical studies have used what formulation of garlic?
dried and powdered
what are the primary uses for garlic?
atherosclerosis
high cholesterol
HTN
what are the mechanisms by which garlic can attenuate elevated BP?
- inhibit ACE
- increase NO
- increase H2S production
all enhance vasodilation
what is the main adverse effect of garlic?
bleeding
what is the primary intended use for ginseng?
boost immune system, stamina, mental and physical performance
what are the adverse effects of ginseng?
CNS stimulation
irritability
manic behavior
ginseng has drug interactions with what other drugs?
autoimmune disorders
anticoagulants
antiplatelets
antipsychotics
what is the primary intended use of milkthistle?
liver disease
what are some of the proposed MOAs of milkthistle?
reducing collagen accumulation (mouse livers)
prevention of HCV into liver cells (in vitro)
what is the primary use of st johns wort?
antidepressant
what is the proposed MOA of st johns wort?
inhibit reuptake of serotonin, DA, NE (in vitro)
what is the main adverse effect of st johns wort? why?
decreased serum concentrations of other drugs
inducer of cyp enzymes
what is the primary intended use of saw palmetto?
BPH
what is the primary intended use of glucosamine and chondroitin?
osteoarthritis
what are the main adverse effects of glucosamine and chondroitin?
enhancement of anticoagulant effects of warfarin
increase fasting blood glucose
what is the main adverse effect of melatonin?
decrease sperm quality in men
reduce luteinizing hormone in women
butterbur is used as an herbal supplement for what condition?
migraine
which herbal supplements are used to treat migraines?
butterbur
feverfew
coenzyme Q
what are the primary uses for coQ10?
reduce statin induced myopathy HTN ischemic heart disease neurodegenerative disorders migraine
what is the main contraindication for coQ10 use?
warfarin
what are the primary intended uses for fish oil?
hypertriglyceridemia
CV disease
which drug has seizures as an adverse effect?
gingko
which drugs hae bleeding as an adverse effect?
gingko
garlic
glucosamine / chondroitin
which drug has reproductive dysfunction as an adverse effect?
melatonin
which drugs have immune modulation as an adverse effect?
echinacea
gingseng
which drug has drug metabolism as an adverse effect?
st johns wort
