herbals Flashcards
good evidence of decreased BPH symptoms (improved urine flow) w/out shrinking prostate
beta sitosterols
inhibits CYP3A4
bitter orange
for preventing/treating UTI or H. pylori infections or to prevent dental plaque (Reported to have antioxidant/anticancer activity)
formulation:berries, extracts, teas, capsules, or tablets
components found in cranberry may prevent bacteria, such as E. Coli from clinging to the cells along the UT walls.
Proanthocyanidins(PACs) in cranberry juice – thought to have inhibitory effect upon the ability of E. Coli to adhere to the urothepithelial wall.
Cranberry containing products more effective in: women, children, cranberry juice drinkers, ppl using cranberry containing products >2x/day
ADE: GI upset or diarrhea w/excessive drinking
cranberry juice
Found widely, including heart, kidney, liver, and skeletal muscle
Potent antioxidant: role in maintain healthy muscle, low serum levels in Parkinson’s disease
HTN: lowers SBP/DBP compared w/placebo
Ischemic heart disease: improvements observed in HDL cholesterol, exercise tolerance
Prevention of statin-induced myopathy: inconclusive
well tolerated, rarely leading to any ADE
Structural similarity with vitamin K, resulting in possible reduction of warfarin activity (monitor)
Final analysis: good evidence to decrease BP & where diet is deficient
co-enzyme Q
Inhibits CYP1A2, intestinal CYP3A4, and INDUCES CYP3A4
Antagonize immunosuppressants like: azathioprine, corticosteroids, cyclosporine, and tacrolimus
No clear evidence of therapeutic effect
echinacea
Cardiovascular toxicity; used for weight loss
ephedra
Prolonged bleeding time; Good evidence of decreased cholesterol, no other evidence
garlic
Inhibits CYP1A2, CYP2D6, Prolonged bleeding time (antiplatelet action)
Mental health: modestly effective in slowing down decline-equivalent to AchE inhibitor like donepezil; use as additive with AchE inhibitors
gingko biloba
Prolonged bleeding time(antiplatelet action;) inhibits CYP2D6;
Antagonizes immunosuppressants like: azathioprine, corticosteroids, cyclosporine, and tacrolimus
Final analysis: MAY provide benefit in CV disorders, decrease LDL cholesterol, decrease blood sugar, boost immune system and antimicrobial agents and enhance response to flu vaccine
ginseng
Hepatotox; used as sleeping aid, anti-anxiety
kava kava
Pseudo-hyper aldosteronism; the metabolite glycyrhizzin promotes salt and water retention by the kidney; this occurs despite normal levels of aldosterone; the effect is an increase in BP and potential ADE especially in pts treated w/HTN or other CV diseases
licorice
Good evidence for decreased jet lag
Natural supplements for mental health: Improves in sleep quality in pts with schizophrenia, major depression and seasonal affective disorder; alternative to drugs in children/elderly
Serotonin derivative produced in pineal gland and some other tissues: involved in regulating sleep-wake cycle(release coincides w/darkness)
Metabolized by CYP1A2. May interact w/other drug substrates ie nifedipine, possible leading to ê BP(mech unknown).
ADE: high levels may cause psychosis, antagonizing SSRIs
increase melatonin levels–>spermatogenesis inhibition.
decreased M/F fertility+ decreased breast milk production
melatonin
Docosahexainoic acid, eicosapentaenoinc acid and alpha-linoleic acid good for health
Slight decrease in BP; high intake required causing increased bleeding
increase HDL(good) + increase LDL(not good!)
decrease risk of second MI + death from any cause: pts also on CV drugs, so effect may be additive;decrease risk of developing CV disease ;protection from cyclosporine toxicity; Functional improvement in rheumatoid arthritis pts
decrease risk of dementia(Alzheimier)
ADE: fishy odor to breath or dysgeusia(taste perversion), and GI upset. Diarrhea or N/V may occur at higher daily doses.
From lecture: may é risk of prostate cancer
omega-3-fatty acid
Natural supplements for mental health: As effective as older TCAs; boosts effectiveness of SSRIs
S-adenosyl-L-methionine
SAM
Found in: Brazil nuts
Seleno-proteins are important antioxidants preventing free radical damage
Clinical effect: Cancer: some studies show beneficial effects in **prostate, colorectal, lung **
HIV: ________deficiency associated with reduced immune function – may be a significant predictor of surviva
selenium
