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Anesthesia Pharm > Herbals > Flashcards

Herbals Flashcards

1
Q

What the dietary supplement and health education act does

A

Considers herbals food not a med. no proof of safety/quality control, no regulations. Can’t promise a cure but can claim effect

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2
Q

Herbals: consumers dont know what 5 things

A

If there are active ingredients, if ingredients are bioavailable, if dose is right, if each bottle has same components, if pill has contaminants

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3
Q

Example of quality control where herb potency and amount varied widely between manufacturers

A

Ginseng

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4
Q

Classes 1 and 2 of herbals

A

1- safe when used appropriately. 2- restrictions a- external only, b- not use if pregnant c- not used while nursing

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5
Q

Herbal classes 3 and 4

A

3- use only under expert supervision, 4- insufficient data available

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6
Q

Profile of herbal user: sex, age, race, education, procedures

A

Female, 40-60, white, college edu, neurosurgical/obstetrical/gyn procedures

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7
Q

How herbals affect periop period 3

A

Direct intrinsic effects (pts physiology), pharmacodynamics (alt action of other drugs), pharmacokinetics (alter abs/met/dist of other drugs)

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8
Q

Specific anesthesia concerns w herbals 6

A

Prolonged anesthetic effects, inc bleed risk, hypo/hypertension, hypoglycemia, hepatotoxic, interact w other meds

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9
Q

When to D/c herbals

A

14 days before

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10
Q

Kava kava effect

A

CNS depressant, sedative, anxiolytic. Prolongs anesthesia effect

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11
Q

Kava kava concerns

A

Inc sedative fx anesthesia, addiction/withdrawal, SE H/A/dizzy, long term use can discolor skin, hepatotoxic

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12
Q

Valerian does what

A

Sedative, mild anxiolytic, sleep aid

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13
Q

Valerian concern w anesthesia

A

Potentiated effects. Avoid w barbs, opioids, benzos

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14
Q

Valerian: SE, syndrome

A

HA, excitability, ataxia, gi discomfort. Withdrawal: delirium, cardiac abn

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15
Q

St. John’s wart- what it is

A

Prozac alternative, tx depression

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16
Q

St. John’s wart: SE, does what to liver

A

Allergic, HA, dizzy, restless, tired, photosensitive, additive w anesthesia. Induces cytochrome p450- inc metabolism reduces effectiveness of drugs

17
Q

St. John’s wart: caution w which drugs

A

MAOI (central serotonin excess). Indonavir, cyclosporine, dig, CCB, BB, phenobarb, phenytoin, BC pills, benzos, Coumadin, alfentanil, lidocaine, steroids, NSAIDS

18
Q

3 herbals that potentiate anesthesia

A

Valerian, kava, St. John’s wart

19
Q

Herbals that inc bleeding risk

A

Ginkgo, garlic, ginseng, saw palmetto

20
Q

Ginkgo: use, SE

A

Impairs cognition and circulation. HA, dizzy, GI, dermal

21
Q

Gingko: how it increases bleed risk

A

Inhibits plt aggregation and plt activating factor. Enhances coag effect of Coumadin, NSAIDs, and ASA

22
Q

Garlic: indication, how it inc bleed risk

A

Anticancer, tx htn and cholesterol. Inhibits plt aggregation and increases fibrinolysis, may be irreversible in high doses

23
Q

Garlic: enhances __ effect and does what to VS

A

Warfarin, lowers BP

24
Q

Ginseng: indication, what concerns us

A

Mood/energy enhances. Lowers bg and inhibits plt aggreg

25
Q

Ginseng: SE

A

Nervousness, excitation, tachycardia, cant concentrate, insomnia, HA, htn, epistaxis, allergies, lyte disturbances, addiction

26
Q

Ginseng: caution in who, avoid what, may decrease effectiveness of what

A

Caution if coagulopathic/on anticoags. Avoid ASA, NSAIDs. Dec effectiveness of warfarin

27
Q

Saw palmetto: use, what concerns us

A

BPH. Inhibits COX and plt dysfunction

28
Q

Ephedra: what it does

A

Direct and indirect sympathomimetic, CNS stimulant

29
Q

Ephedra concerns

A

Htn, tachycardia, arrhythmias, vasospasm. MI, stroke, agit, insomnia. Tachyphylaxis of catecholamine stores. Life threat w MAOI

30
Q

Echinacea: use, concerns

A

Immune system stim. Decreases effectiveness of immunosuppressive meds. Worsens bg control in DM- hypoglycemia. Hepatotoxic

31
Q

Melatonin: how it affects us, may interact w what

A

Crosses BBB and inc sedative fx or hypnotics and benzos. Interacts w anticoags, immunosuppressants, dm meds, bc pills

32
Q

Which herbals to D.C. And when

A

If coag, cns effects, or bg alt 2 weeks prior

Anesthesia Pharm (12 decks)

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