Herbal Meds Intro

Question 1

Herbs for hormonal problems

Answer 1

1) phytoestrogens - converted to estrogens in body by flora
- isoflavones (soy and other legumes)
- lignins (flax seeeds)
- Coumestans (red clover, sunflower seeds, bean sprouts)
- Intestinal flora
2) Androgens and anti-androgens
- saw palmetto
- DHEA-from adrenal cortex- precursor to testosterone and estrogen

Question 2

Isoflavones

• type?
• from?

Answer 2

• phytoestrogen

- soy/legumes

Question 3

Ligins

• type?
• from?

Answer 3

• phytoestrogens

- flax seed grains

Question 4

coumestans

• type?
• from?

Answer 4

-phytoestrogen
-red clover
sun flower seeds
-bean sprouts

Question 5

Echinacea

-use?

Answer 5

-range of infections and malignancies

Question 6

Echinacea

-MOA?

Answer 6

• immune modulating
• anti-inflammatory (inh COX)
• bactericidal and virucidal
• antioxidant

Question 7

• Which species of Echinacae good for immune modulation?

- Effects?

Answer 7

-E purpurea

• inc total circulating WBC
• inc monocytes
• inc neutrophils
• inc NK cells

Question 8

Which species of Echinacea is good for anti-inflammatory?

-Effects?

Answer 8

• E purpurea

- Inh COX –> -inh edema in skin irritation

Question 9

Do not take echinacea with what drugs?

Answer 9

• immunosuppressants!
• due to potential immune modulatory actions

-NOT RECOMMENDED FOR IMMUNE DEFICIENCIES

Question 10

Echinacea AE?

Answer 10

-rash especially in those with allergies to daisy plants (ragweed)

Question 11

Ginko Bilboa

-treats?

Answer 11

• **CARDIOVASCULAR- antioxidant properties==> reduced oxidative stress in coronary artery bypass surgery & promote bloof flow
• asthma
• bronchitis
• fatigue
• tinnitus
• may improve memory tx/prevention of alzheiers or dimentia, Periph artery disease & sexual dysfunction

Question 12

Ginko BIlboa

-active compounds?

Answer 12

• flavone glycosides

- terpenoids

Question 13

Specific ginko leaf extract that helps with cardiovascular?

Answer 13

-EGb 761

Question 14

How does gingo bilboa help wiith CNS? MOA?

Answer 14

-restored 5-HT1A receptor density

Question 15

ginko bilboa

-AE?

Answer 15

• no sig safety concernts
• nausea, headache.. that shit
• may have antiplatelet actions
• seizures with uncooked ginko seed preps

Question 16

Ginko bilboa

-drug interaction?

Answer 16

do not give to patients taking anticoagulants

Question 17

Garlic

-most studied consituent?

Answer 17

allicin - give garlic odor

Question 18

Garlic - effects?

Answer 18

(Cardiovascular)

• inhibit HMG-CoA reductase in human liver cells
• antioxidant
• enhances fibrinolytic activity –> decrease in plaque accumulation with coronary artery disease
• reduce systolic and diastolic BP
• inh ACE –> lower BP
• Antimicrobial - reduce growth of bacteria
• reduce common cold symptoms

Question 19

Garlic adverse effects:

Answer 19

• INC bleeding
• dont use before surgery
• nausea, hypotension allergy

Question 20

Garlic drug interaction?

Answer 20

-prevents bioavailabitliy for antiviral saquinavir

Question 21

Ginseng

-uses:

Answer 21

• boost immune
• erectile ddysfunction
• improve well-bing, stamina, metnal and physical performance
• lower BP
• lower blood glucose

Question 22

Ginseg

-MOA for immune mod

Answer 22

-increased expression of IL2 IL1alpha, & GCSF

==>inc macrophage, activated B and T cells and NK cells

Question 23

Ginseng

-MOA for CNS effects:

Answer 23

-increased levels of Ach, 5-HT, NE, and DA in cerebral cortex

==> stimulation of adrenal cortical steroid synthesis

Question 24

Ginseng -

-MOA for glucose homeostasis

Answer 24

-inc insulin release and inc in insulin receptors

Question 25

Ginseng | -MOA for anti-cancer:

Answer 25

- reduced angiogenesis in tumors | - inc apoptosis of tumor cells

Question 26

Ginseng AE?

Answer 26

- CNS stimulation @ high dose - HTN @ high dose - anti-platelet - clotting issues - inc growth of breast cancer cells (estrogenic activity)

Question 27

Ginseng -drug interactions?

Answer 27

- irritablity, sleeplessness, manic beh in pt taking antipsychotics - do not ue with anticoagulants - Do not use in patients taking immune modulating drugs or those with autoimmune disorders - Caution in patients with hypoglycemic meds

Question 28

Milk THistle | -uses?

Answer 28

* **LIVER! Helps with - cirrhosis - drug induced hepatotox - hepatitis - liver disease

Question 29

Milk THistle | -MOA?

Answer 29

* *How helps with liver: - silybin (active component) reduces leukotriene formation and inh nuclear factor kappa b NF-kB - reduces transforming grwoth factor beta production --> induces liver fibrosis - reduces lipid peroxidation - scavenges free radicals (antioxidant)

Question 30

St Johns Wort | -use?

Answer 30

* antidepressant - metnal disorder - nerve pain - malaria - sedative - wound balm (burns & insect bites)

Question 31

St Johns WOort | -MOA?

Answer 31

Antidepressant: -inh reuptake of 5-ht, DA and NE Hypericin and hyperforin are active ingedietns

Question 32

St Johns Wort | -AE?

Answer 32

- photosensitivity | - hypomania and mania

Question 33

St John Wort | -Drug interactions:

Answer 33

- do not use with other drugs that inh reuptake of neurotransmitters - ******Induce hepatic CYP enzymes = decreased serum concentrations of a lot of drugs

Question 34

Saw palmetto | -use?

Answer 34

-tx of benign prostatic hyperplasia

Question 35

Saw palmetto | -MOA?

Answer 35

- sterols and fatty agents (active ingredients) inh 5alpha reducatase inducesd conversion of testosterone into hihydrotestosterone (DHT) - blocks DHT from binding to androgen receptors

Question 36

Glucosamine and Chondroitin | -use for?

Answer 36

-promote joint health*** = helps with osteoarthritis

Question 37

Glucosamine | -MOA?

Answer 37

-promote joint health = substrate for cartilage synthesis

Question 38

Chondroitin | -MOA?

Answer 38

-in cartilage matrix --> prevents cartilage breakdown and stimulate cartilage repair

Question 39

Glucosamine and chondroitin - | AE & drug interactions?

Answer 39

- increase anticoagulant effects of warfarin | - glucosamine--> increased fasting blood glucose levels and lowered threshold for glucose induced insulin secretion

Question 40

Melatonin | -use?

Answer 40

-regulates sleep-wake cycles

Question 41

Melatonin - AE and drug interactions: * **-Chronic use?

Answer 41

- sleepy things - affects blood pressure (inc and dec) - dec prothrombin time * ****-CHRONIC use = decrease sperm quality in mena nd reduce luteinizing hormone levels in women

Question 42

Herbs for migrane prevention:

Answer 42

- butterbur - feverfew - coenzyme Q10

Question 43

*What drugs reduce CoQ10 levels?

Answer 43

statins*

Question 44

Best use for CoQ10?

Answer 44

lower BP*

Question 45

CoQ10 drug interactions:

Answer 45

-similar structure to vit K = dont take if on warfarin

Question 46

Rosveratrol used for?

Answer 46

atherosclerosis | anti aging