Herbals Flashcards
What is the problem with using herbals? (3)
- Amount of active ingredient? (Each capsule can have differing amounts of the active ingredient)
- Safety and efficacy (Can’t assume that they are safe, the FDA has to prove that they are unsafe, after the drug comes onto the market. and then file lawsuit) Herbals don’t have to prove that the actually work.
- Serious Interactions: Always ask and assess patients use of herbals. 70% of patients don’t report their use of herbals.
pain caused by too little blood flow, usually during exercise
Claudication
What is different about the process conventional drugs must go through to get approved compared to herbals?
- Must be approved by the FDA through a rigorous process (multi-step process).
- Drugs are presumed dangerous and go under rigorous testing before manufacturers are able to release to the public.
What is different about the process herbals must go through to get approved compared to conventional drugs?
- Are allowed on the market with prior testing for safety or efficacy
- FDA must seek to prove a supplement is not safe to have it removed (presumed safe until proven hazardous)
- Supplement are often “outed” by investigational journalists
Why is it essential to assess for clients for the use of herbals & supplements?
Principal concerns: increased ________ and decreased therapeutic affects.
These interactions can __________ or inhibit pharmaceutical drug effects
Many supplements effect the ___ system and PGP
Herbal supplement can interact with standard drug regimens.
Toxicity
potentiate
CYP
What are The 4 G’s?
garlic,
ginger root,
ginkgo biloba,
and glucosamine
Explain why garlic, ginger root, ginkgo biloba, and glucosamine must not be combined with antiplatelet and anticoagulant medications.
Garlic, ginger root, ginkgo biloba, and glucosamine all pose risks of bleeding.
What does St Johns Wort block?
Blocks re-uptake of norepinephrine and serotonin
What does St Johns Wort induce?
CYP3A4
What is SAMe’s mechanism?
Helps synthesize neurotransmitters and hormones
Pineal gland slows in ability with age at __ years old
40
Where is melatonin produced?
pineal gland
What herbal is useful as a sleep aid?
Melatonin
Ginko biloba induces ___________
vasodilation
Why is kava not a safe alternative to benzodiazepines?
- Can cause severe liver injury (public warning in 2002 by FDA)
- Hepatotoxicity
- Sales are restricted in many countries (but not yet in the US).
St. Johns wort: MOA?
Blocks reuptake of NE and 5-HT
St. Johns wort: induces ___
CYP3A4
St. John’s wort: increases ____
P-glycoprotein
St. John’s wort: side effect?
Photosensitivity
St. John’s wort: Effective for depression?
Support for mild-moderate depression
Not for severe depression
SAMe: What does it do?
Helps synthesize NT and hormones
SAMe: Evidence for depression?
Yes, evidence for mild depression. The effectiveness of SAMe is similar to SSRIs–SAMe is very expensive. If you have mild depression, might as well go get prescribed a SSRI instead of go buy the expensive SAMe
Melatonin: Produced where?
Pineal gland
Melatonin: When is it synthesized?
During darkness
Melatonin: Bad or good research support with the effectiveness?
Good
What other disorders is melatonin be tried in?
Alzheimers and bipolar
Ginkgo biloba: induces ____
Vasodilation
Ginkgo biloba: weak evidence for _____
memory enhancement
Ginkgo bilbo is an ______.
Anticoagulant
What is ginkgo bilbo good for?
Claudication (muscle pain due to restricted blood flow)
Omega 3 FA: What do they contain?
EPA (heart)
DHA (brain)
What do omega 3 FA improve?
Nerve conduction
