Herbal Medicines Flashcards
What is the most common CAM therapy?
Natural Products- 17.7%
What is aspirin produced from?
bark of the willow tree
What is opium produced from?
papaver somniferous
What was the dietary supplement health and education act of 1994?
- Defines and regulates dietary supplements
- a dietary supplement must contain one or more dietary ingredients including vitamines, minerals, herbs, amino acids, dietary substance, metabolist, constituent, extract or combo of above
- cannot be approved or authorized for investigation as a new drug, abx., or biologic unless labeled before investigation
- needs clinical trials before it becomes a drug
What are some interesting facts about regulation of dietary supplements?
- Manufacturers are not required to prove efficacy, safety, or quality of their products
- not required to reprot any post marketing adverse events to any central agnecy
- manufactured before 1994- grandfathered in
- after 1994- need reasonable evidence of their safety or reasonable expectation of their safety must be reviewed not approved
What did the Good Manufacturing Practices do?
- Set of guidelines by FDA to try to regulate produciton and manufacturing
- No real oversight
- variation in quality, harvesting, storage condition, processing, purity and efficacy of herbals
- some have outright substitiutions are contain things like laxatives
What did the office of alternative medicine do? Where was it housed?
Housed at NIH
- Studied and evaluated complementary and alternative medicine practices to disseminate the results
What is the National Cwenter for Complementary and Alternative Medicine?
- define, through rigorous scientific investigation, the usefulness and safety of complementary and integrative health interventions and the role in improving health and health care
- produce scientific evidence to inform decision making by the public, health care professionals and policy makers
What is echinacea?
Chemistrym, pharmacologic and clinical effects, adverse effects
- Chemistry- not a single compound but multiple comounds
- Pharmacologic and CLinical effects
- anti-inflammatory
- cancer
- immune modulation
- URI treatment
- recurrent URI preventions- shown most effective to prevent further colds
- Adverse effects:
- allergic reaction
- caution in pt with liver dysfunction
- may alter cyp (1A2, 3A4)
- caution in antipsychotic and antidepressants
- poor wound healing
- decrease effectiveness of steroids
What is ephedra?
Chemistry, pharmacology &clinical effects, adverse effects?
- Chemistry- alkaloid ephedrine
- Pharmacology & Clinical
- has both direct and indirect effects on alpha and beta receptors
- CNS stimulant
- weight loss supplement
- treatmnet of asthma
- adverse effects
- palpitation, tachycardia, HTN, CMP (chornic
- fatal arrhythmias and MI
- Hemodynamic instability intraop
- CNS: sz, stroke, psychosis
- other- hepatitis
What is ginseng?
Chemistry, pharmacology &clinical effects, adverse effects?
- CHemistry- ginsenosides- like steroids
- pharmacology &clinical effects
- memory enhancer
- physical enhancer
- lower BG
- alter coag pathway, inhibits plt aggregation
- immunomodulation
- aphrodisiac
- Adverse effects
- increased bleeding
- inhibit PLT (irreversible)
- hypoglycemia
- interacts adversely with MAOI
- increased bleeding
What is ginger?
Chemistry, pharmacology &clinical effects, adverse effects?
- Chemistry- shoagaol, gingerol, galanolactone
- antagnoizes serotinin receptors (like zofron)
- inhibits prostaglandin
- inhibita thromboxane synthetase
- pharmacology
- GI discomfort
- anti-inflammatory
- Nausea/motion
- respriatory problems
- sore throat
- increased bleeding time
- adverse effects:
- increased bleeding
- hyperglycemia
- pregnancy - possibly safe?
What is garlic?
Chemistry, pharmacology &clinical effects, adverse effects?
- Chemistry- sulfur containing compounds- alliin or ajoene
- potent abs propertieis
- hmg coa reductase
- cystein- alters arachidonic acid metabolism
- Pharm and clinical application
- decrease BP
- Decrease atheroscleosis
- decrease lipid/cholesterol
- inhibit PLT aggregation
- anti-tussive/expectorant
- adverse effects
- bleeding
- smell
- GI upset
What is Kava?
Chemistry, pharmacology &clinical effects, adverse effects?
- Chem- may potentiate GABA
- Pharmacology and clinical application
- anxiolytic
- sedative
- antiepileptic
- neuroprotective
- adverse effects
- addiction/tolerance
- withdrawal
- inhibit cytochrome p450 and 2EI
- Glutathione depletion- acetaminophen induced cytotoxicity
What is valerian?
Chemistry, indication &clinical effects, adverse effects?
- Chemistry- sesquiterpines
- modulation of GABA NT, inhibit GABA breakdown or reuptake
- indication
- insomnia
- sedation
- anxiety
- Adverse effects:
- withdrawal symptoms if stopped after long term use
- interacts with alchol/sedatives
- hepatotoxicity with long term use
taper dose, continue up to day of sx
