Herbal Medicines

Question 1

Echinacea

Answer 1

–stimulates immune system
Periop: allergic rxns, hepatotoxicity,interference with immunosuppressants (discontinue as far before surgery as possible)

Question 2

Ephedra

Answer 2

–promotes weight loss; increases energy

Periop: ephedrine-like sympathetic stimulation, MI, stroke (discontinue at least 24hrs before surgery)

Question 3

Garlic

Answer 3

–reduces BP and cholesterol

Periop: inhibition of platelet aggregation-irreversible (Discontinue 7 days before surgery)

Question 4

Ginkgo

Answer 4

–improves cognitive function, increases peripheral perfusion
Periop: inhibition of platelet-activating factor (discontinue 36hrs prior to surgery)

Question 5

Ginseng

Answer 5

–protects against stress

Periop: hypoglycemia; inhibition of platelet aggregation and coagulation cascade (discontinue 7 days prior to surgery)

Question 6

Kava

Answer 6

–decreases anxiety
Periop: GABA-mediated hypnotic effects may decrease MAC. possible risk of accute withdrawal. (Discontinue 24 hrs prior to surgery)

Question 7

St. John’s Wort

Answer 7

–reverses mild to moderate depression
Periop: inhibits serotonin, norepi and dopamine reuptake; increases drug metabolism. (discontinue 5 days prior to surgery)

Question 8

Valerian

Answer 8

–reduces anxiety
Periop: GABA-mediated hypnotic effects may decrease MAC. benzodiazepine-like withdrawal. syndrome (taper does weeks before surgery)

Question 9

Yohimbine

Answer 9

–historically used to increase sexual arousal

Periop: hypertension, sleep disturbances (dangerous when combined with sympathomimetics or MAO inhibitors)