Herbal/nutritional supplement Flashcards
Echinacea Purpurea
Uses: anti-inflammatory, antimicrobial and antioxidant effects, immune modulation
Toxicities: bad taste, GI upset, rash
Drug interactions: no drug interaction
Garlic
Uses
1. Atineoplastic
2. Antimicrobial
3. Reducing hypertension - anti-platelet
4. *Hypoglycemic, apparently for diabetes
Toxicities: nausea, d, GI upset, dermatitis from handling raw garlic
Drug interaction: warfarin, ibuprofen, aspirin (anticlotting medication)
-antiviral protease inhibitor (saquinavir)
Ginkgo
Uses:
1. Cardiovascular - increases blood flow, reduces blood viscosity, promote vasodilation, increases NO, antagonizes platelet activating factor
3. Cerebral insufficiency - trouble concentrating, confusion, anxiety, depression, hearing loss, headache, dementia
4. Metabolic: antioxidant, radical scavenging
Toxicities: seizures, nausea, stomach upset, diarrhea, allergy, anxiety, and insomnia
**ton of drug interactions
-warfarin, aspirin
-NNRTI class of antiretrovirals
-anti-depressants
-antipsychotic medication
-anticonvulsants
Ginseng
Drug with a ton of Uses:
1. immune modulation (stimulatory)
2. antimicrobial
3. CNS effects; increase neural progenitors and increase NTs
4. Antiplatelet
5. cardioprotective
6. antioxidant, antiinflammatory, analgesia, anticancer
7. increasing insulin release, and insulin sensitivity - hypoglycemic
Toxicities: hypertension, central nervous system stimulation (insomnia and nervousness)
-**vaginal bleeding and mastalgia
Interactions: warfarin, psychiatric, estrogenic, hypoglycemic medication, CNS drugs (antidepressant, antipsychotic)
Milk thistle - let the milk flow
Use:
1. Increase lactation in women
2. Liver disease: limits hepatic injury, anti-inflammatory properties
3. reduce tumor initiation
Toxicities: dermatologic, GI upset, headaches, **at really high doses can have laxative effect by stimulation of bile flow and secretion
*no drug interaction
St. Johns Wort
- Antidepressant
- antiviral, anticancer
Toxicities: the mood destabilizer - hypomania, mania, autonomic arousal
**photosensitization
Drug interaction: inducer of CYP3A4 so dosage has to be faster
-digoxin
-warfarin
-birth control drugs
-other antidepressants or stimulants to avoid serotonin syndrome
Saw Palmetto
- benign prostate hyperplasia
Toxicities: libido, nausea, abdominal pain, diarrhea, fatigue headache, rhinitis
*no drug interaction
Coenzyme 10
Use-increasing muscle function, cardiac
- metabolic protection of ischemic myocardium
- potent antioxidant (reduces hypertension)
- prevents statin induced myopathy
Toxicities: none
Drug drug interaction: warfarin because of similarity to vitamin K
Glucosamine
Use:
1. Primarily pain from pain associated with knee osteoarthritis
Toxicities:? dunno, well actually none!
Drug interaction: warfarin
Melatonin
Use - insomnia, jet lag
Contraception: blocks ovulation in women, fucks up sperm quality in men
-hypertension
Toxicities: well tolerated
Drug interactions: warfarin, SSRIs, nonsteroidal anti-inflammatory drugs
A man is taking a statin to lower his cholesterol. After seeing an advertisement in the AARP magazine, the patient decides to take a supplement that has not only been shown to reduce systolic and diastolic blood pressure but is also purported to prevent stain -induced myopathy, what is he taking.
CoQ10
What are the findings from the jigsaw, all 5
- Use of immunosuppressive agent cyclosporine with St. Johns Wort lead to induction of CYP3A4 which decreased levels and thereby efficacy.
2- increased efficacy of oral contraceptives with the consumption of grapefruit juice,
3- use of nnRTI induced CYP3A4 which lowered available concentration of itraconazole. Protease inhibitors inhibit CYP3A4 so they balance.
- Decreased absorption of ciprofloxacin if patient takes over the counter antacids containing aluminum or magnesium.
- increased exposure of isoniazid in patients with slow acetylator phenotype
