Herbals Flashcards
What populations can benefit from taking vitamin A supplements, besides in deficiency?
None
What populations can benefit from taking vitamin D supplements, besides in deficiency?
Older adults/Institutionalized Exposure to limited sunlight Dark skinned individuals Obese Individuals Individuals with GI disorders
What populations can benefit from taking vitamin E supplements, besides in deficiency?
None
What populations can benefit from taking vitamin K supplements, besides in deficiency?
All newborns given IM vitamin K @ birth to prevent hemorrhagic disease of the newborn
What populations can benefit from taking vitamin C supplements, besides in deficiency?
None
What populations can benefit from taking vitamin B1 (thiamine) supplements, besides in deficiency?
Chronic alcoholics: Wernicke-Korsakoff Syndrome (Vision changes/ataxia/memory loss)
~20% Fatal if untreated
What populations can benefit from taking vitamin B12 (cobalamin) supplements, besides in deficiency?
The elderly (poor absorption) Vegans & Vegetarians Alcoholics Pernicious anemia GI malabsorption disorders
What populations can benefit from taking vitamin B9 (folate) supplements, besides in deficiency?
Women of childbearing age to prevent neural tube defects
Is melatonin proven effective for insomnia/jet lag or changing sleep patterns?
For cognitive impairment?
+/-
No
What meds should melatonin not be combined with?
Anti-seizure meds or warfarin
Is glucosamine/chondroitin proven effective for OA?
No
What are fish oils proven effective for?
Decrease CVD, BP, HR
Decrease CHD death
Decrease sudden cardiac death
Is co-enzyme Q proven effective for heart conditions, CHF/Angina, HTN/diabetes, or migraines?
No, only useful in very rare genetic CoQ deficiency.
Bitter Orange (ephedra replacement): Common uses?
Adverse effects?
Major drug interactions?
Nausea, constipation, weight loss
^HR, ^BP. Stroke, MI (esp. w/caffeine)
MAOI (contains tyramine metabolites), inhibits gut 3A4
Ephedra (banned in US):
Common uses?
Adverse effects?
Major drug interactions?
Colds/fever/flu, weight loss
^ risk CVD, stroke. Death.
Additive effect w/stimulants
Ginger:
Common uses?
Clinical trial evidence?
Adverse effects?
Major drug interactions?
GI upsets/nausea, CVD/Inflammation, RA
Yes: for nausea
^ risk of bleeding
Anticoagulants
Hawthorn:
Common uses?
Clinical trial evidence?
Adverse effects?
Major drug interactions?
Heart disease, CHF/HTN, angina
YES: mild heart failure
None
Digoxin/Nitrates, BP meds
Horse chestnut:
Common uses?
Clinical trial evidence?
Adverse effects?
Major drug interactions?
Chronic venous insufficiency, varicose veins, hemorrhoids
Yes!
Raw seed contains poisonous esculin toxin, which may exacerbate kidney disease
Anticoagulants
Kava:
Common uses?
Clinical trial evidence?
Adverse effects?
Major drug interactions?
Insomnia, anxiety, depression, ADHD
YES
Liver damage (potentially serious), muscle spasms
Additive effect w/sedatives. ^ acetaminophen toxicity
St. John’s Wort:
Common uses?
Clinical trial evidence?
Adverse effects?
Major drug interactions?
Depression/anxiety, sleep disorders, heart palpitations, wound healing, chronic fatigue, migraine
YES
Photosensitization
SEROTONIN SYNDROME [with SSRI, MAOI, TCA etc]
May induce mania in bipolar, depressed/psychotic
Potential for birth defects
Antidepressants
Increased expression 3A4/2C19:
Decreased OCT, cyclosporin, statins, HIV PI, and more
Thunder God Vine: (not on list)
Common uses?
Clinical trial evidence?
Adverse effects?
RA, obesity
Yes
Yes
Supplements that are contraindicated w/anticoagulants? (4)
Ginger
Horse Chestnut
Melatonin (warfarin)
Vitamin K
