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CDM 1 Exam 1 > Herbals Uses > Flashcards

Herbals Uses Flashcards

1
Q

Acai (Uses)

A

Weight loss + Anti Aging

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2
Q

Acai (Efficacy)

A

insufficient evidence

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3
Q

Acai (Adverse Effects)

A

Generally well tolerated

Changas disease (Parasitic protozoan) from contaminated raw fruit and juice

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4
Q

Acai (Important Considerations)

A

Avoid if having MRI, may affect results

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5
Q

Bitter orange (Uses)

A

Weight loss

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6
Q

Bitter orange (Adverse Effects)

A

Prolong QT interval

Caution anyone with Hypertension or Heart Disease

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7
Q

Bitter orange (Important Considerations)

A

Related to ephedrine, banned by many sports

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8
Q

Black cohosh (Uses)

A

?able: may reduce hot flash freq compared to baseline but not placebo

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9
Q

Black cohosh (Efficacy)

A

Effectiveness can depend on formulation

Not effective for hot flashes related to breast cancer treatment

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10
Q

Black cohosh (Adverse Effects)

A

Similar to SSRI

Rash, GI, Tender Boobs, Headache, Weight Gain

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11
Q

Black cohosh (Important Considerations)

A

Contraindicated pregnancy due to uterine contractions

MOA more like SSRIs than phytoestrogens

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12
Q

Caffeine (Uses)

A

Used in weight loss

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13
Q

Caffeine (Efficacy)

A

None really

can give mental acuity but there’s a sweet spot

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14
Q

Caffeine (Adverse Effects)

A

increased HR,BP and diuretic effects

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15
Q

Caffeine (Important Considerations)

A

High doses increase anxiety and decrease mental acuity

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16
Q

Cranberry (Uses)

A

Urinary Tract infections

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17
Q

Cranberry (Efficacy)

A 
Treatment = not effective
Prevention = maybe 1/3 reduce risk
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18
Q

Cranberry (Adverse Effects)

A

Stomach upset and Diarrhea in high doses

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19
Q

Cranberry MOA

A

prevents bacterial adhesion to urinary tract walls and not due to acidification of urine

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20
Q

Echinacea (Uses)

A

Common Cold and Upper respiratory infections

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21
Q

Echinacea (Efficacy)

A

may have limited benefit for prevention

does not shorten the length of cold

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22
Q

Echinacea (Adverse Effects)

A

GI
Rash (Children)
Allergic reactions

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23
Q

Echinacea (Important Considerations)

A

Avoid in patient with autoimmune disorders

Avoid in patients with ragweed allergy, history of asthma,atopy or allergic rhinitis.

Interacts with some CYP but not clinically significant

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24
Q

Fish oil (Uses)

A

Hyperlipidemia (High doses are RX)
CVD (reduce BP)
HF (Dietary oil will reduce risk of CHF by 15%)
Mental development in infants (doesn’t do anything to prevent stuff such as dementia)

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25
Q

Fish oil (Efficacy)

A

Hyperlipidemia: Decreases
TG—high doses, Rx

Reduces BP modestly
(2-5 SBP/1-3 DBP)

DIETARY fish oil reduces
risk of CHF by 15%

Mental development
(infants)

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26
Q

Fish oil (Adverse Effects)

A 
Fishy Burp
Bad Breath (Use EC)
Heartburn
Loose Stools
** Slightly increased LDL**
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27
Q

Fish oil (Important Considerations)

A

Take with meals, freeze caps, use enteric coated to
minimize AE

May inhibit platelet aggregation (>3g/day)

AHA recommends 2 servings/week, non-fried fish in
place of other proteins

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28
Q

Flaxseed (Uses)

A

Hot Flashes

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29
Q

Flaxseed (Efficacy)

A

Questionable, need 40Gram/Day and take 1-2 month potentially to work

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30
Q

Flaxseed (Adverse Effects)

A

Bloating
Diarrhea
Flatulence
Abdominal Pain

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31
Q

Flaxseed (Important Considerations)

A

1-2 months to see benefit, amount required is a lot (40Gram). Questionable efficacy

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32
Q

Garcinia (Uses)

A

Weight Loss

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33
Q

Garcinia (Efficacy)

A

Review of 11 studies found no sig effect on weight loss

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34
Q

Garcinia (Adverse Effects)

A

Mild GI
Liver toxicity requiring transplant

No warfarin interactions

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35
Q

Garcinia (Important Considerations)

A

Active ingredient is HCA (Hydroxycitric acid)

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36
Q

Garlic (Uses)

A

Not significant Cholesterol

Hypertension

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37
Q

Garlic (Efficacy)

A

HTN: Limited (decreases
SBP 7-8%)

Lipids: None (recent
studies)

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38
Q

Garlic (Adverse Effects)

A

Heartburn
Flatulence
Nausea/Vomiting
Contact Dermatitis

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39
Q

Garlic (Important Considerations)

A

Must take daily for >2 months to see clinical benefit

odorless garlic won’t work too well

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40
Q

Ginkgo (Uses)

A

Dementia

Peripheral Arterial Disease (Blood clot risk)

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41
Q

Ginkgo (Efficacy)

A

May improve cognitive symptoms in patients with dementia

No benefit in slowing or preventing dementia

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42
Q

Ginkgo (Adverse Effects)

A

Allergic reactions (Poison oak, ivy and mango tin)

Bleeding

43
Q

Ginkgo (Important Considerations)

A

Decreases Blood viscosity = bleeding risk

Need 2-3 weeks for initial effect

44
Q

Ginseng (Uses)

A

general wellbeing

Immune Stimulant

Sexual Dysfunction

45
Q

Ginseng (Efficacy)

A

Minimal; depends on

indication

46
Q

Ginseng (Adverse Effects)

A

Insomnia (Take in AM)
Headache
Estrogenic effects (Rare, high dose)

47
Q

Ginseng (Important Considerations)

A

We focus on Panax Ginseng

Increased risk of bleeding (Antiplatelet agents = Anticoagulants)
Hypoglycemia w/ Diabetes medications
48
Q

Glucosamine (Uses)

A

Osteoarthritis but not Rheumatoid Arthritis

49
Q

Glucosamine (Efficacy)

A

Sulfate: Improves pain and functionality for osteoarthritis of the knee when used for >4 Weeks

No improvement in osteoarthritis of the hip

Dependent on formulation

50
Q

Glucosamine (Adverse Effects)

A

Mild GI complains

51
Q

Glucosamine (Important Considerations)

A

Warfarin: increased INR

Shellfish allergy….Naturally derived = bad but synthetic would most likely be Safe

52
Q

Melatonin (Uses)

A

Jetlag and Insomnia

53
Q

Melatonin (Efficacy)

A

Best evidence for improving insomnia in elderly

54
Q

Melatonin (Adverse Effects)

A

if dose too high it can cause insomnia so lower dose should you tried

Dose: 2-3mg QHS, can go up to 10

55
Q

Melatonin (Important Considerations)

A

Mechanism: It regulates circadian rhythm’s and is a natural hormone secreted from pineal gland

Don’t use natural, only synthetic derived

56
Q

Red clover (Uses)

A

Hot flashes

57
Q

Red clover (Efficacy)

A

mixed evidence shows no benefit over placebo

58
Q

Red clover (Adverse Effects)

A

Nausea, Vomiting, Vag Spotting

59
Q

Red clover (Important Considerations)

A

Avoid if taking tamoxifen
Avoid in women with estrogen-dependent cancers
May increase risk of bleeding with anti-platelet agents or anticoagulants

60
Q

SAMe (Uses)

A

increases Serotonin, NE and Dopamine levels

61
Q

SAMe (Efficacy)

A

Insufficient evidence

62
Q

SAMe (Adverse Effects)

A

Headache
Dry mouth
Insomnia
Nausea,vomiting, diarrhea

63
Q

SAMe (Important Considerations)

A

Concerns: Product quality and Cost

64
Q

Saw palmetto (Uses)

A

BPH

65
Q

Saw palmetto (Efficacy)

A

Likely ineffective for BPH

5a-reductase inhibitors = similar in relieving BPH symptoms
A1-blockers= Palmetto less effective for Urinary symptoms and reducing prostate volume

66
Q

Saw palmetto (Adverse Effects)

A 
Dizziness
Headache
Decreased Libido
GI Complaints
Bleeding
67
Q

Saw palmetto (Important Considerations)

A

Prolonged Bleeding time

68
Q

Soy (Uses)

A

Hot flashes

Takes up to 2 months

Always choose Protein (Food) over Soy supplement

** Protein can reduce LDL by 10% and BP **

69
Q

Soy (Efficacy)

A

Soy PROTEIN may modestly decrease severity/freq of hot flashes

take up to 2 months to work

70
Q

Soy (Adverse Effects)

A

Generally well tolerated

** Avoid Supplements**

71
Q

Soy (Important Considerations)

A

PROTEIN&raquo_space; Supplements

Takes 2 months to work

72
Q

St. John’s Wort (Uses)

A

Effective for mild-moderate depression

73
Q

St. John’s Wort (Efficacy)

A

effective, high placebo effect

74
Q

St. John’s Wort (Adverse Effects)

A

** Shit Load**

** Photosensitivity (5-10mg Hypericin)
Dry mouth
Fatigue
Restlessness
Vivid dreams
Dizziness
Insomnia
75
Q

St. John’s Wort (Important Considerations)

A

Potent inducer of CYP3A4, P-gp….will decrease effectiveness of drugs related to those

Midl inducer: 1A2, 2C9, 2C19

76
Q

Valerian (Uses)

A

Insomnia

77
Q

Valerian (Dosing)

A

May take a few days to weeks for full effect

Taper when discontinuing

78
Q

Valerian (Adverse Effects)

A

Headache
Nervousness
Excitability
Hepatotoxicity (Rare)

79
Q

Valerian (Important Considerations)

A

Not as fast as benzo, shouldn’t be used with them because similar MOA

80
Q

Reasons to re-evaluate herbal use? (Counseling points)

A 
Plan on becoming pregnant
Breastfeeding
Need surgery/invasive procedures (Due to bleeding)
Have cancer or starting chemo
Change in medical condition
Starting or stoping medications
81
Q

Drugs used for menopause?

A

Soy
Black cohosh
Red clover
Flaxseed

82
Q

What makes Menopause herbals “work”

A

Phytoestrogens “plant estrogens” = what make them work

Isoflavones = most potent of these/ most studied

83
Q

Is soy effective for women who have hot flashes related to breast cancer?

A

No

84
Q

Who should avoid Soy supplements?

A

if taking tamoxifen
Women with estrogen-dependent cancers

** In general Soy protein is the better choice, answer is never Soy Supplements **

85
Q

Black Cohosh MOA?

A

thought to be similar to SSRIs

86
Q

Black Cohosh Contraindications

A

Pregnancy: increased risk of miscarriage

87
Q

How often should you get LFTs on Black Cohosh?

A

every 6 mo - 1yr

88
Q

Why is Caffeine given combo with Ephedrine?

A

Caffeine decreases breakdown of NE in synaptic cleft
Ephedrine increase release of NE

Combo gives sustained effect

89
Q

Ephedra Adverse effects

A 
Heart Attack
Arrhythmia
Stroke
Psychosis 
Death
Seizures
90
Q

Is ephedrine and derivates allowed to be used by athletes?

A

No, banned by every organization

91
Q

Who should avoid immunostimulants?

A

Those with allergies, autoimmune disorders and those on immunosuppressive therapies

92
Q

Fish Oil interactions?

A

Over 3g can inhibit platelet aggregation

93
Q

Garlic Interactions

A

Antiplatelet agens and anticoagulants

induces P-gp efflux pump (decrease serum conc of P-GP substrates)

94
Q

Soy Health Claim

A

Consuming 25 grams of soy protein per day reduces the risk of heart disease

95
Q

St. John’s Wort Dosing

A

May take 3-4 weeks to see maximal effects

Taper when discontinuing to avoid withdrawal effects

96
Q

St. Johns Wort MOA

A

Inhibits reuptake of serotonin, NE and Dopamine

Gaba effects

97
Q

Ginkgo Interactions

A

Antiplatelet agents or anticoagulants (Stop 2 week before surgery)

Induce CYP2C19 (moderate)
Medications that can lower seizure threshold
98
Q

Ginkgo toxin from seeds can cause…

A

seizures

99
Q

Valerian MOA

A

May increase GABA activity in CNS by inhibiting enzyme that metabolizes GABA

Benzo like effects

100
Q

What is Glucosamine derived from?

A

Exoskeletons of shrimp, lobster, and crabs or made synthetically

101
Q

Saw Palmetto MOA

A

Antiandrogenic
Antiproliferative
Anti-inflammatory
5-Alpha reductase activity

102
Q

Cranberry Interactions

A

Warfarin: increases INR

May inhibit CYP3A4

103
Q

What does Fish oil contain, and differences between Plant based Fatty Acid and ones from fish.

A

Contains EPA and DHA…… plant based Fatty Acid are not as effective because the ALA gets converted to EPA/DHA in small amounts

CDM 1 Exam 1 (14 decks)

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