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Clinical Methods > Herbal Medicines > Flashcards

Herbal Medicines Flashcards

1
Q

Dietary supplements a special category under dietary medicines. True or false?

A

False,

Dietary supplements a special category under food – NOT drugs.

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2
Q

The FDA is responsible for safety of dietary supplements. True or false?

A

False.

The manufacturer is responsible for safety. The FDA is responsible for taking action if there is a problem.

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3
Q

What are considered dietary supplements? (5)

A

Vitamins
Minerals
Amino acids
Botanicals: herbals or extracts
Glandular extracts from animals or synthetics

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4
Q

What types of pts typically use herbals and dietary supplements? (8)

A

Female
Former or non-smokers
Higher incomes
Exercise regularly
Educated beyond high school
Generally good health
Presurgical patients
Patients with: cancer, liver disease, HIV, asthma, rheumatologic disorders

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5
Q

What are the primary uses for aloe? (3)

A

digestion

cathartic (laxative properties)

burns, infections, wounds

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6
Q

What is the potential concern for those taking aloe?

A

Hypokalemia due to diarrhea.

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7
Q

What are two uses for echinacea?

A

URIs

flu

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8
Q

What is the primary concern for those taking echinacea?

A

Drug toxicity!

It inhibits CYP3A4, so there is an increased risk for drug toxicity for drug metabolized by this enzyme.

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9
Q

What drugs put pts taking echinacea at risk for drug toxicity? (3)

A

Xanax (alprazolam)

Calcium channel blockers

Protease inhibitors (antiviral drugs for HIV, AIDS, and Hep)

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10
Q

What are the uses for garlic? (5)

A

HTN
hyperlipidemia
infections
cancer prevention
atherosclerosis

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11
Q

What are the potential concerns for those taking garlic? (2)

A

Inhibits platelete aggregation
Induces CYP 450 (decreasing the effectiveness of drugs)

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12
Q

What is the major drug interaction for a pt taking garlic?

A

Warfarin, increases INR which increases risk of bleeding.

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13
Q

What are the uses of ginkgo biloba? (6)

A

circulatory disorders
increased mental acuity
tinnitus
vertigo
respiratory disease
sexual dysfunction

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14
Q

What are the signs of ginkgo biloba toxicity? (4)

A

GI discomfort
dizziness
bleeding
seizures

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15
Q

What are the major drug interactions for those taking gingko? (2)

A

Warfarin–due to increased bleeding

MAOIs

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16
Q

What are the uses for ginseng? (4)

A

Immunostimulation
Improve strength and stamina
DM
Menopause

17
Q

What are the potential concerns for those taking ginseng? (5)

A

HTN
Tachycardia
Bleeding
CNS stimulation
Hypoglycemia

18
Q

What are the drug interactions for those taking ginseng? (3)

A

Warfarin
Insulin and sulfonylureas–increases hypoglycemia
MAOIs–increases manic-like episodes

19
Q

What are the uses of saw palmetto? (3)

A

BPH (benign prostatic hyperplasia)
Chronic pelvic pain
Bladder disorders

20
Q

What are the potential concerns for those taking saw palmetto? (2)

A

Intraop bleeding
N/V/D

21
Q

What drugs adversly interact with saw palmetto?

A

Anticoagulants

22
Q

What are the uses of St. John’s wort? (5)

A

Depression
Anxiety
Sleep disorders
Seasonal affective disorder (SAD)
Pre-menstrual syndrome

23
Q

What are the drug interactions of St. John’s wort?

A

St. John’s wort INDUCES CYP 450, 3A4, 2C9.

It alters the effectiveness of many drugs.

24
Q

What are the drugs of concern for anesthesia for those taking St. John’s wort? (3)

A

Calcium channel blockers

Warfarin

Digoxin

25
Q

For pts taking St. John’s wort, there have been case reports of of cardiovascular collapse after induction with fentanyl, propofol, d-tubocurarine followed by maintenance with nitrous oxide, oxygen, and isoflurane. True or false?

A

true

26
Q

What are the uses of CoQ10? (7)

A

CHF
CAD
HTN
Hyperlipidemia
DM
Increases energy
Antioxidant

27
Q

What are the potential concerns/drug interactions for pts taking CoQ10? (3)

A

Decrease effectiveness of warfarin
Hypoglycemia
Statins–can cause a decrease in natural amounts in body

28
Q

What are the uses of dong quai? (2)

A

Menopausal symptoms
Gyn issues like dysmenorrhea

29
Q

What is the potential concern for pts taking dong quai?

A

Possible inhibition of platelet aggregation

30
Q

What are the drug interactions for pts taking dong quai? (2)

A

Increase INR with warfarin
Possible risks with hormone meds because may have estrogen-like effects

31
Q

What dietary supplements increase the risk of bleeding?

A

Ginkgo biloba
Dong quai
Vitamin E
Garlic
Ginseng

Most everything we studied affects bleeding and Jenny stated that things that start with “G”.

32
Q

In general, when should pts discontinue herbal medicins prior to surgery?

A

2-3 weeks prior

33
Q

When should garlic, ginseng, and St. John’s wort be discontinued prior to surgery?

A

7 days

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