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PHAR 154 > Herbals > Flashcards

Herbals Flashcards

1
Q

Pseudoephedrine derivative at a baseball player overdosed on?

A

Ephedra

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2
Q

Natural Salicylate product that eventually led to the development of Aspirin?

A

Willow Bark

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3
Q

Prescription drug that we must monitor very closely for widespread Herbal interactions?

A

Warfarin

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4
Q

Osteoarthritis vs. Rheumatoid Arthritis… How do they present differently?

A

OA: Morning stiffness < 1hr & normalizes; bone on bone & thinning cartilage.

RA: Morning stiffness > 1hr; swollen / inflamed synovial membrane.

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5
Q

How are Glucosamine / Chondroitin proposed to work?

A

Stickiness effect (water molecules stick to their GAG sugar molecules, which serves as a cushion for joints).

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6
Q

How long should Glucosamine be tried out for (if used at all)?

A

3-6mths (& takes at least 4-8wks to even have effects)

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7
Q

How much Glucosamine should be taken per day?

A

500mg TID (or can take all 1500mg OD)

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8
Q

MSM: Good for arthritic pains?

A

Useless (ditch it).

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9
Q

Chondroitin Sulfate dosing?

A

400mg TID

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10
Q

T or F: Chondroitin is available as a solo agent.

A

False… In Glucosamine combo products.

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11
Q

Name of bullshit Pineapple Enzyme product that claims lots of things (including anti-cancer properties)?

A

Bromelain

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12
Q

Around what daily amount of Curcumin (spice found in Turmeric products) has been indicated for relief of arthritic pain?

A

2g / day (which equates to about 30g of Turmeric per day).

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13
Q

Fatty Acids that we desire to increase in the diet for cardioprotective measures?

A

Omega 3s

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14
Q

Conversion rate of ALA to EPA & DHA?

A

5% (super low)

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15
Q

Traditional North American diets have an abundance of Omega 6s in them… How does this excess of Omega 6 intake impact the body?

A

Promotes inflammation… Healthy diets 2-4x more Omega 6s to Omega 3s (but we’re at more like 11-30x Omega 6 to Omega 3).

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16
Q

Benefits of upping Omega 3 FA intake in the diet?

A

-Anti-Inflammatory
-Less Platelet Adhesion

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17
Q

What is the current stance on Omega 3 usage for CV protection?

A

“This doesn’t look as good as we once thought, but worth trying if you want.”

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18
Q

T or F: Omega 3 FA intake has more promise for Secondary Prevention than it does Primary Prevention of adverse CV events.

A

True!

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19
Q

T or F: If one is on prescribed Myocardial Infarction medications, concurrent use of Omega 3s will further decrease their risk of experiencing a subsequent event.

A

False (likely)… Would potentially benefit them if they were on nothing at all (but concurrent use with Rx meds is of little benefit).

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20
Q

Only side effect worth mentioning for those on Omega 3 supplements?

A

Fishy Taste

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21
Q

The AHA recommends consumption of how many grams of combined EPA + DHA per day for those with documented Coronary Heart Disease?

A

1g / day (if secondary prevention)

22
Q

As a primary prevention measure for CHD or other adverse CV events, what is a suitable amount of combined EPA + DHA that one should take per day?

A

500mg / day (or 2 servings of fatty fish per week)

23
Q

T or F: Jackfish / Pike intake (via lakes in Northern Saskatchewan) is a great source of dietary EPA / DHA.

A

False… Need to consume fatty fish (ie. Bluefish, Herring, Salmon, Halibut).

24
Q

As Secondary Prevention of adverse CV events, how much Fish Oil (via Jamieson Capsules) should be taken per day to get close to the 1g EPA + DHA?

A

1000mg TID (delivers a combined 300mg per dose of EPA + DHA)

25
Q

As Primary Prevention of adverse CV events, how much Fish Oil (via Jamieson Capsules) should be taken per day to get close to the 500mg EPA + DHA?

A

1000mg OD (one capsule delivers 300mg per dose of EPA + DHA, which is close enough to the desired 500mg / day).

26
Q

Given Flax is a form of Omega 3 FA, would it be suitable to take for either Primary or Secondary Prevention of an adverse CV event (instead of Fish Oil)?

A

No… Flax is ALA, & conversion factor discussed prior is way too low (5%) to have substantial effects.

27
Q

Between Rheumatoid & Osteoarthritis, which one would Omega 3 consumption benefit more?

A

Rheumatoid Arthritis (AI properties are somewhat beneficial to the progression of the disease)

28
Q

Omega 3s: Good for Depression, Dry Eyes, ADHD?

A

Depression: Inconclusive (mixed).

Dry Eyes: Potentially (but inconclusive).

ADHD: Some promise.

29
Q

Daily intake of combined EPA + DHA required to have TG lowering effects?

A

2-4g

30
Q

1) Metamucil (10g / day)

2) Becel Butter (4tsps = 2g)

3) Soy Milk (4 cups / day = 25g)

-Which one has the most substantial effects on lowering TG’s?

A

Becel Butter (10% at that 4tsp daily intake)…

-Metamucil is 5% & Soy Milk is 5% at their respective doses.

31
Q

What use does Co Q-10 supplementation have with those on Statins?

A

Some link that replenishing Co Q-10 lost from Statin medication reduces muscle pains. However, evidence is inconclusive at best (so tamper expectations).

32
Q

Suggested 1st line therapy for those with Insomnia?

A

Cognitive Behavioral Therapy (CBT)

33
Q

T or F: The Tryptophan found in Turkey is why I’m more tired after eating at Thanksgiving than after a normal supper.

A

False… Sheerly the volume of food you eat that makes you fatigued (turkey has no more effects on drowsiness than other meats).

34
Q

Chamomile: Does it make me sleepier?

A

Highly unlikely

35
Q

T or F: Tolerance can be developed to the sedation that Benadryl offers.

A

True!

36
Q

When do Melatonin levels in the body peak? When are they at their lowest?

A

Highest: Middle of the night (around 2am)

Lowest: Upon waking (8am)

37
Q

T or F: Melatonin provides significant efficacy in terms of improving sleep quality and duration.

A

False…

38
Q

If one desires to take Melatonin for Insomnia, what would be an advisable dosing regimen?

A

1) 1-2mg HS x 2wks, then:

2) 5mg HS x 2wks & re-assess.

39
Q

Am I safe to take Melatonin long-term? Will I develop a tolerance to it? What other s/e’s can occur?

A

-Safe for LT use.

-No evidence of tolerance.

-Mild GI / Headache / Additive Drowsiness (if added on to other agents).

40
Q

Why is there a shift to move away from Nytol & towards Melatonin (especially in elderly)?

A

-On BEERS list to avoid.
-Also, tolerance can develop to DPH.

41
Q

Is it appropriate to step in and recommend Melatonin right away for a child with sleep problems?

A

FALSE (!!!)… Dr.’s call.

42
Q

Full effects of Circadin (SR Oral Melatonin Tabs) are seen after how long?

A

21d (3wks)

43
Q

Flaxseed contains natural estrogenic compounds called ______ that are proposed to have effects on menopausal symptoms.

A

Lignans

44
Q

Flaxseed: CV Protective? Good for Constipation?

A

CV: Likely not (levels of converted Omega 3s way too low as seen prior).

Constipation: Fine (is just dietary fiber so why not).

45
Q

For Mild-Moderate Depression, is St. John’s Wort effective?

A

Just as effective & safe as SSRIs.

46
Q

Is St. John’s Wort effective for severe depressive cases?

A

Less value than mild-moderate.

47
Q

In terms of tolerance, are TCAs better tolerated than Herbal St. John’s Wort?

A

Nope… St. John’s Wort actually better tolerated (& as good or better tolerated than even SSRIs).

48
Q

Why is screening a patient prior to advising St. John’s Wort so important?

A

Hundreds of drug-drug interactions… As a solo entity, is safe (but interacts with sooooo many things).

49
Q

Major drug-drug interactions to be wary of with St. John’s Wort?

A

-Birth Ctrl Pills (reduces contraceptive / hormonal regulatory effectiveness).

-Other Antidepressants (Serotonin Syndrome).

-Warfarin (decreases levels).

-Simvastatin (decreases levels).

-Alprazolam (decreases levels).

50
Q

Standard St. John’s Wort dosing?

A

300mg TID

51
Q

Cranberry Juice / Tablets good as a preventative measure for UTIs? As a treatment measure?

A

Prevention: Some chance for effectiveness (may need 1-2mths for effectiveness).

Treatment: Unlikely it helps.

PHAR 154 (11 decks)

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