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herbel Flashcards

1
Q

To be labeled a supplement

A

The herbal product must make no claims to treat, prevent or cure a disease

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2
Q

Impact of Dietary Supplement Health Education Act

A

Restricted FDA ability to control the safe and manufacturing of herbal products

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3
Q

Why herbals initially regulated in 1920s

A

Presence of natural drugs like cocaine and opium

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4
Q

Common Problem with Herbal Medicines

A

Active Ingredient is unknown therfore saftey/side effects/drug interactions cannot be fully understood.

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5
Q

Why herbal symptoms occur (broad)

A

(1) lack of standardization (2) different purities (3) variations in plant conditions and parts

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6
Q

Two tested treatments for usage of Ginko

A

(1) Cerebrovascular insufficeny symptoms (2) Dementia

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7
Q

Tested Treatment for St. John’s Warts

A

Depression

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8
Q

Six Popular Herbal Supplements (Focus of the Lecture)

A

(1) St. John’s Wort (2) Ginko (3) Kava (4) Ephedrine (5) Omega-3-Fatty Acid (6) Turmeric./Curcumin

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9
Q

Active Ingredient St. John’s Wort

A

Hypericin

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10
Q

Prescribed use of St. John’s Wort

A

Anxiety, Depression, Insomnia (only in Germany)

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11
Q

Pharmokinetics of St. John’s Wort: Admin, Peak Blood LEvel, Half Life, Steady State

A

(1) Administered Orally (2) Peak Blood Levels at 5 hours after (3) Half Life of 25 hours (4) Steady State of 4-6 days

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12
Q

Pharmodynamics of St. John’s Wort (reduce reuptake of 3 NT, binds to 3 types of receptors, has on chemical neuronal influence)

A

(1) Reduced Reuptake of 5HT, NE, DA (2) Bind at GABA Receptors (3) Bind at Benzodiazepine Receptors (4) Blind to glutamatergic NMDA-type receptors (5) Antioxadtive

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13
Q

Clinical efficacy of St. John’s WOrt

A

Now just seend as effective in treatment of mild to moderate depression

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14
Q

What St. John’s Wort inhibits

A

(1) CYP-2D6/CYP-2C9 are inhibited by Hyperforin (2) CYP-1A2 is inhibited by Quercitin

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15
Q

In SJW inhibits CYP1A2

A

Quercitin

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16
Q

In SJW inhibits CYP2D6 and CYP2C9

A

Hyperforin

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17
Q

SJW influence on COdeine

A

SJW decreases effectiveness of codeine due to a inhibition of CYP2D6 which converts codeine into mmorphine

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18
Q

SJW influence on caffeine, tricyclics, antipsychotics

A

INcreased blood level of all three

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19
Q

SJW influence on CYP-3A4

A

Increased activivty… causing reduced levels of drugs that are cardiac and anti-inlammatory

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20
Q

Side effects of SJW

A

Mild: Sedation/Lethargy/Upset GI….. ALso photosensativity, hypomania, seotonin syndrome when combined with SSRIs (agitation, diarrhea, increased heart rate, hallucinations. nasuea, vomitting)

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21
Q

Ginko extract

A

EGb-760

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22
Q

Benefit of Ginko flavonoids and terpenoids

A

(1) Reduce free radicals implicated in the cell damage that cuases Alzheimer’s disease (2)Ginkogolide B inhibits platelet aggregation and slows blood clotting

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23
Q

Harms of GInko flavonoids and Terpenoids

A

Increased tendency to bleed and potentiate action of blood thinners…. also ainhibit CYP-1A2

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24
Q

Pharmokinetics of Ginko (Absorbtion, Peak PLasma, Half life)

A

(1) Taken orally (2) Peak plasma in 2-3 hours (3) Half life of 5 hours

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25
Pharmodynamics of Ginko (homeostatic impact and brain function)
Egb-761 extract may act on processes involved in homeostasis of inflammation and oxidative stress ,,, (resulting in membrane protection and neurotransmission modulation)...EEG studies show increased ALPHA wave activity
26
Clinical Efficencey of Ginko
Ginko modestly improves cognitive functioning associated with cerebrovascular impairments but does not prevent the icidence of AD
27
Side Effects of GInko
(1) Mild GI upset (2) Mild Headaches [most common complaint] (3) Exacerbate bleeding problems and interacts with aspirin and other anticoagulants (4) Unknown saftey in pregnancy and lactation
28
Kava similar to
Ethyl alcohol--induces relaxation, improved social interaction & sleep
29
Kava inhibits
CYP450 liver enzyme
30
Kava most active ingredient
Kava Lactone
31
Kava anesthetic-like effect
Blocking sodium channels
32
Kava Clinical Effects
Seen as a short term remedy for moderate anxiety...depressive and GAD symptoms also can be improved with Kava
33
Kava Side Effects
(1) Drowsiness, nasea, muscle weakness, blurred vision, yellow skin, sedative effects (2) DO NOT combine with alcohol, benzoids, barbiturates, THC or CNS (3) Can result in hepatotoxcitity
34
Ephedrine course
Release catecholamine neurotransmitters (NE, DA, EP)
35
Epedrine benefits
Reduce appetite, stimulate cardiac function and pyscho-stimulant
36
Epderine harms
Release of adrenaline can increase blood pressure, heart rate, and force of cardiac contraction/cardiac output..... FATAL CARDIAC ARRYTHMIAS RESULTS
37
Doping substance of herbals
ephedrine
38
Caffeine and Ephedrine
Toxic combination because caffine increases the cardiovascular toxcity of ephedrine
39
Psuedoephedrine
A synthetic steroisomer to the ephedrine molecule ... must sign for it because it can be converted into methamphetamine in large doses
40
Two Major Omega-3-FA
EPA/DHA
41
Omega-3-Fatty Acids Found In
Wild Fish, Flax Seeds, Olive Oil, Walnuts, Dark Leafy Veggies
42
Where EPA/DHA most deficent
(1) Western Diets (2) During Pregnancy (3) Normal Brain maturations
43
EPA/DHA deficencies cause
Mood disorders, chronic pain syndromes
44
EPA/DHA antidepressant
Useful in treatment of depression and BP
45
ADHD link to Omega-3-FA
Children with ADHD consumed 50% less omega-3-FA rich food
46
Normal Course of Omega-6-FA
Omega-6-Fatty Acids activate Aracidonic Acid which can in turn activate prostaglandins which cause inflamation
47
How Omega-3-Fatty Acids impact Omega-6-Fatty Acids
Omega-3-Fatty Acids Inhibits the Arachidonic Acid (more specifically they inhibit the COX enzyme which converts arachidonic acid to prostagladins
48
Current Westen Ratio of Omega 3 to OMega 6
1:8
49
Ideal Ratio of Omega 3 to Omega 6
1:1
50
OMega 3 link to Dementis
DHA can reduce cognitive decline
51
Omega-3-Index
% of EPA + DHA in red blood cells... low index may mean risk for sudden cardiac death
52
Recommended dose during pregnanct
200 mg/daty
53
Suggested way of consuming DHA/EPA
Not through fish due to mercury but instead consider using supplements
54
Benefits of Omega-3-FA in pregnancy
Requires for normal fetal development and optimal maternal outcome...necessary for development of neural/retinal tissues,,,, may reduce allergy susceptibility,,,, may treat depressive symptoms in pregnant females
55
Benefits of Turmeric and Curcumin
Impact: Inflammation, cardiovascular, cancer, digestive system, anti-bacterial, anti-fungal, alzheimers, memory
56
NSAIDS
Nonnarcotic (non-steroidal) anti-inflammatory analgesics
57
Acute pain
Suddenly, usually self limited (opiods best)
58
Chornic Pain
Represents a disease by itself..presists over time... leads to loss of independence, loss of interpersonal relationships, work issues, anxiety, depression
59
Chronic Pain Treatment Options
(1) NSAIDS (2) Antidepressants with NE potentiating action (3) Mood stabilizing anticonvulsants (4) Opiod Analgesics
60
NSAID impact on tissue injury
Reduce inflammation and reduce transmission of pain impulses
61
NSAID euphoria
Does not produce
62
NSAID course of action
Work by inhibiting synthesis and release of prostaglandins (body hormones that produce the local inflammatory resposne)
63
Prostaglandins
Body hormone that produce inflammatory resposne
64
NSAIDS chemical relation
nONE
65
NSAID COX influence
NSAID block the COX. THey are known as COX inhibitors...
66
COX role
Convert arachidonic acid to prostaglandins
67
Cox ENzymes
COx 1 and COx2
68
COX 1- ENzyme
Mediates production of prostaglandins that protect the GI tract and allow for normal platlet functioning in blood clotting
69
Inhibition of COX1
Loss of protection for GI cells which cause ulcers ...ALso Loss of platlet function which reduces ability of blood to clot... GOOD because it reduces risk of stroeks and heart attacks BAD because it causes excessive bleeding
70
COX 2 Enzyme
INDUCED in response to inflamations. LEads to the production of prostaglandins to mediate inflammation and pain
71
Asprin
Good for low intensity pain
72
Antipyretic effect
(reduction of fever) due to inhibition of prostaglandin synthesis in the hypothalamus
73
Key parts of aspring
Carboxylic acid and an ester
74
Examples of nonselective COX inhibitors
Aspring, acetaminophen, ibuprofen
75
Nonselective COX inhibitors impact
(1) Anti-inflammatory (2) anti-pyretic (3) Analgesic (4) inhibition of platlet aggregation (5) adverse effects on GI tract
76
Asprin Benefits
Can bind to an inhibit blood platelets (prevent blood clotting)
77
Apsring Harms
Gastric Upset...also if given when someone has flu can cause Rye syndrome
78
Tylenol difference than Asprin
Does not inhibit platlet function, does not cause Rye syndrome, cause less GI distress
79
Adverse effect of acetaminophen
Liver damage, hypertension in females
80
Advil compared to tylenol and asprin
Advil is better tolerated than aspin.. but it does inhibit platlet aggregation like aspring
81
Selective COX 2 inhibit benefit
Reduce risk of cancer, and reduce rate of gastric ulcers while providing same benefits as aspring
82
Example of COX2 inhibitor
Celebrex
83
Celebrex impact
Does not inhibit platlet aggregation so might increase incidence of heart attack BUT it reduces pain and inflammation with less GI distress
84
Nitroasprins
Nitric oxide bound to an NSAID via an ester linkage

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