Herbals Flashcards
Because herbals are FDA regulated as a food instead of a drug, what is not regulated (what do consumers lack info on)?
If there are active ingredients
If ingredients are bioavailable
If dosage is appropriate
If each bottle has the same components
If the pill has any contaminants or additives
Safety studies aren’t required
What are classes 1-4 of herbal safety and toxicity in the American Herbal Product Association?
Class 1: safe
Class 2: restrictions about pregnant/nursing
Class 3: only should be used under supervision of expert
Class 4: not enough data
____ # of americans taking herbs
____% of patients use herbs do not report use preoperatively
70 million
70 %
We tell patients to d/c herbals ___ days prior to surgery
14
Kava Kava
anesthetic considerations
CNS depressant, sedative, anxiolytic
Potential for addiction, tolerance, withdrawal
SE: headache, dizzy, sluggish reflex, less coordinated, HEPATOTOXICITY with long term use
Valerian
anesthetic considerations
Sedative, anxiolytic, sleep aid
Avoid with barbs, opioids, benzos
SE: headache, ataxia
Can develop withdrawal (cardiac abnormalities, delirium)
St Johns Wort
anesthetic considerations
Treats depression, like Prozac
SE: allergy, headache, dizzy, restless, additive effects with anesthesia
Interacts with MAOIs
Inducer of CP450 (interacts with indinovir, cyclosporins, digitalis, CCB, B-blockers, barbs, benzos, birth control, lidocaine, steroids, NSAIDs)
Gingko
anesthesia considerations
Inhibits platelet aggregation and platelet-activating factor
used to improve cognition
SE: BLEEDING, headache, dizzy
enhances other anticoagulants
Garlic
anesthesia considerations
Inhibits platelet aggregation, increased fibrinolysis
SE: BLEEDING, especially with other anticoagulants, HYPOTENSION
Ginseng
anesthesia considerations
Lowers blood glucose, inhibits platelet aggregation, mood/energy enhancer
SE: excitation, tachycardia, headache, HTN, BLEEDING esp with other anticoags, electrolyte disturbance, HYPOGLYCEMIA
Saw Palmetto
anesthesia considerations
Inhibits COX and platelet dysfunction, BLEEDING
Used for BPH
Ephedra
anesthesia considerations
Direct/indirect sympathomimetic effects, CNS stimulant, for weight loss and energy
SE: HTN, tachycardia, arrhythmias, MI, stroke, seizures, panic attack, psycosis, develop tachyphylaxis
lifethreating interaction with MAOIs
Echinacea
anesthesia considerations
Short-term immune system stimulation, treats infections (URIs)
SE: allergic reaction, prolonged use can cause immunosuppression, HYPOGLYCEMIA, HEPATOTOXICITY
Melatonin
anesthesia considerations
Sedative effects, controls sleep-wake cycle
Can interact with anticoagulants, immunosuppressants, diabetic meds, birth control pills
What Carrie said to focus on:
- Know Barash Table
- Know pregnancy categories
- Know DEA classifications
- EXACTLY what is on inpatient order writing
- Who is responsible for what measures
- Needle slide Don’t worry about history stuff
- Know role of IRB
- Purpose of 3 phases, how many people in each
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