Herbal Meds Flashcards
What is pharmacognosy?
The study of natural product molecules that are useful for their medicinal, ecological, gustatory, or other functional properties
What is the DSHEA?
Manufacturers must evaluate, the purity, strength, and purity of their products
Also, report adverse side effects
What does the DSHEA not do?
No need to prove efficacy
What are the major problems with supplements?
Studies are lacking or conflicting results
Doses and formulations vary between studies
Why is there a dearth of studies for herbs?
cannot patent herbs
What are the labels that are used to identify supplements that were produced properly? Does this mean that they are safe and/or efficacious
USP
Does not identify safe or efficacious supplements
What is the use of Echinacea?
Decrease duration and intensity of colds
What is the MOA of Echinacea? (3)
Immune modulating (increase cytokine production)
Anti-inflammatory (inhibits cyclooxygenase)
Increases numbers of immune cells
What are the adverse effects of Echinacea?
Pts with immunodeficiencies should not take it
Allergic reactions
What are the drugs that Echinacea interact with? What can it cause?
Etoposide
Thrombocytopenia
What is the medical use of Ginkgo Biloba? What are the two active components?
Improve memory/alzheimer’s
Flavone glycosides and terpenoids
What is the MOA of Ginkgo Biloba?
Cerebral cortex 5HT1A receptor are reduced
What are the adverse effects of Ginkgo Biloba?
n/v/d
HA
What are the drug interactions with Gingko?
Antiplatelet actions (ASA)
Uncooked Ginkgo seeds can cause what?
Seizures
In whom is Gingko contraindicated?
Seizure prone pts
What are the uses of Garlic?
Atherosclerosis
Hypercholesterolemia
HTN
What are the active ingredients in Garlic? MOA (4)?
Allicin
- Inhibits HMG-CoA
- Inhibit ACE
- Increase H2S production
- Increase NO availability
What are the adverse effects of Garlic?
Increased bleeding
What is the effect of Garlic on HIV drugs? How?
Reduces bioavailability d/t increase in P-glycoprotein drug transporter
What are the uses of Ginseng? (3)
Boosts immune system, physical and mental health
Erectile dysfunction
What are the adverse effects of Ginseng?
CNS stimulation and HTN
What are the drug interactions with Ginseng?
Immune modulating drugs
What is the use of Milk Thistle?
Help reduce cirrhosis, hepatitis, or drug induced hepatotoxicity
What is the active ingredient in milk thistle? MOA?
Silymarin
Reducing collagen accumulation in liver
What is St. John’s Wort used for? Active ingredient? MOA?
Antidepressant
Hypericin/hyperforin
SSRI
What are the adverse effects of St. John’s Wort? MOA?
Photosensitization and decreased of other drug concentration–
Induces hepatic CYP enzymes
What is the use of Saw Palmetto? Active ingredient? MOA?
Treating BPH
Sterols and FAs
Inhibits 5-alpha reductase (testosterone to DHT)
What are the primary uses of Glucosamine and chondroitin?
Osteoarthritis
What is glucosamine?
Substrate for the synthesis of cartilage
What is chondroitin?
Functions to prevent cartilage breakdown
What are the drug-drug interactions with Glucosamine and chondroitin?
Maybe enhance Warfarin
What is the use of melatonin? MOA?
Hypnotic
Normally found in the pineal gland that is induced by darkness, and causes sleepiness
What is the rx drug that agonizes melatonin receptors?
Ramelteon (MT1 and MT2)
What are the melatonin receptors that cause sleep? What type of receptors are these?
MT1 and MT2
G-protein coupled receptors
What are the adverse effects of melatonin?
Drowsiness
Decrease sperm quality in men and reduces LH in women
What is the use of butterbur?
Migraine treatment
What is the use of feverfew? Adverse effects?
Migraine treatment
Induces uterine contractions
Mouth ulcerations
What is the physiologic function of CoQ10?
Mitochondrial cofactor that functions in the electron transport chain
Also, antioxidant
What happens with CoQ10 with age?
Decreases
What is the use of supplemental CoQ10?
Reduced statin induced myopathy
HTN
Migraines
What is the effect of statins on CoQ10?
Decrease
What are the adverse effects of CoQ10? Why?
May exacerbate warfarin, since it is very similar structurally to vit K
What are the uses of fish oil?
treats hypertriglyceridemia
CVD
Which herb can cause seizures?
Ginkgo
What herbs can cause bleeding?
Gingko
Garlic
Glucosamine
What herbs can decrease fertility?
Melatonin
What herbs are immune modulating?
Echinacea
Ginseng
Which herb is a major inducer of p450 enzymes?
St. John’s wort