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Psychopharmacology > Lecture 21: Herbal medicines/natural treatments > Flashcards

Lecture 21: Herbal medicines/natural treatments Flashcards

1
Q

Dietary Supplement Heath Education Act (DSHEA)

A

passed in 1994; restricted FDA’s ability to control sale and manufacture of herbal products

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2
Q

do dietary supplements require FDA approval to enter the market?

A

no

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3
Q

what are the conditions for an herbal product labeling itself a supplement?

A

makes no claims to treat, prevent, or cure disease

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4
Q

6 popular herbal supplements

A
  1. st johns wort
  2. ginkgo
  3. kava
  4. ephedrine
  5. omega 3
  6. turmeric/curcumin
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5
Q

3 uses of st johns wort

A

anxiety, depression, insomnia

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6
Q

use of ginkgo

A

dementia

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7
Q

2 uses of kava

A

anxiolytic, sedative

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8
Q

use of ephedrine

A

psychostimulant

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9
Q

active ingredient of st johns wort

A

hypericin or pseudohypericin

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10
Q

most SJW labels overstate the amount of hypericin by a factor of __

A

2

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11
Q

SJW claims to __

A

promote emotional balance

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12
Q

hours to peak blood level of hypericin

A

5h

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13
Q

half life of hypericin

A

25h

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14
Q

steady state of hypericin

A

4-6 days

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15
Q

only __% of hypericin reaches the central circulation

A

15-20%

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16
Q

5 MoAs of hypericum extract

A
  1. reduce reuptake 5HT, NE, DA
  2. bind to GABA receptors
  3. bind to benzo receptors
  4. bind to NMDA recetors
  5. exert antioxidant action
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17
Q

SJW is comparable to ___ for ___ according to a 1996 study

A

TCAs; short term treatment of mild-moderate depression

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18
Q

3 study conclusions about SJW

A
  1. superior to placebo in patients w major depression
  2. similarly effective as standard ADs
  3. fewer side effects
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19
Q

results of analysis of 37 clinical SJW trials

A

minimal beneficial effects on major depression; may benefit people with minor depression

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20
Q

two components of SJW that inhibit drug metabolizing enzymes

A
  1. hyperforin

2. quercitin

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21
Q

hyperforin inhibits (2)

A

CYP-2D6

CYP-2C9

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22
Q

quercitin inhibits __

A

CYP-1A2

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23
Q

SJW reduces the effectiveness of __ by blocking its conversion to ___ by what enzyme?

A

codeine; morphine; CYP-2D6

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24
Q

SJW increases blood levels of (3)

A
  1. caffeine
  2. TCAs
  3. antipsychotics
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25
Q

SJW increases activity of __

A

CYP-3A4

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26
Q

SJW reduces concentration of (5)

A
  1. cardiac and anti inflammatory meds
  2. oxycodone
  3. birth control hormones
  4. anticoagulants
  5. protease inhibitors
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27
Q

5 side effects of SJW

A
  1. sedation/lethargy
  2. GI upset
  3. photosensitivity
  4. hypomania
  5. serotonin syndrome
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28
Q

what does ginkgo come from?

A

ginkgo tree; ginkgo biloba

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29
Q

ginkgo extract for dementia

A

EGb-760

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30
Q

3 effects US manufacturers claim for ginkgo

A
  1. mental sharpness
  2. antioxidant protection
  3. maintain healthy circulation
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31
Q

standard preparation of ginkgo

A
  1. 24% ginkgo flavonoids

2. 6% terpenoids

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32
Q

beneficial effects of flavonoids and terpenoids

A

scavenge free radicals implicated in cell damage in Alzheimers

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33
Q

beneficial effects of ginkgolide B (a terpenoid)

A

inhibits platelet aggregation and slows blood clotting

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34
Q

2 adverse reactions to ginkgo

A
  1. increased tendency to bleed and potentiate action of blood thinners
  2. flavinoids inhibit CYP-1A2
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35
Q

time to peak plasma ginkgo

36
Q

half life ginkgo

37
Q

Egb-761 extract may act on processes involved in ___, resulting in (2)

A

homeostasis of inflammation and oxidative stress

results in membrane protection and neurotransmission modulation

38
Q

EEG studies show increased __ from ginkgo

A

increased alpha wave activity

39
Q

according to DeKosky et al, daily doses of ginkgo had what effect on alzheimer’s?

A

none; no reduced incidence

40
Q

findings of yancheva et al rel to ginkgo, ACHE inhibit

A

all three treatments resulted in improved intellectual functioning and emotional states

41
Q

conclusion of ginkgo studies

A

modestly improved cognitive functioning associated with cerebrovascular impairments, but does not prevent incidence of alzheimer’s

42
Q

improvement in cog functioning with ginkgo accounted by __

A

ability to reduce ‘stickiness’ of blood platelets

43
Q

3 ginkgo side effects

A
  1. mild GI upset
  2. mild headaches
  3. exacerbate bleeding problems (spontaneous intracranial hemorrhage)
44
Q

ginkgo pregnancy effects

A

antiplatelet function may put fetus at risk for hemorrhage

45
Q

most interesting agent in kava; where is it found?

A

kava lactones; fat soluble portions of kava root

46
Q

lactone is a __

A

cyclic ester

47
Q

kava inhibits what enzyme?

48
Q

the action of kava is similar to __

49
Q

kava pyrones may bind to (2)

A
  1. GABA receptors

2. benzodiazepine binding site

50
Q

kava lactones block ___, causing an anesthetic like effect

A

sodium channels

51
Q

kava lactones block sodium channels, causing an ___

A

anesthetic like effect

52
Q

in animals, kava acts like a __

A

anti convulsant

53
Q

low dose kava effect

A

anxiolytic

54
Q

high dose kava effects (3)

A

drowsiness, sedation, intoxication

55
Q

5 kava side effects

A
  1. drowsiness
  2. nausea
  3. muscle weakness
  4. blurred vision
  5. yellow skin
56
Q

hepatoxicity

A

liver failure

57
Q

what 3 NTs does ephedrine release?

A

epinephrine, NE, DA

58
Q

ephedrine is pharmacologically similar to ___

A

amphetamine

59
Q

ephedrine shorter or longer action than amphetamine?

60
Q

2 benefits of ephedrine

A
  1. reduces appetite

2. stimulates cardiac function

61
Q

3 adverse effects of ephedrine

A
  1. increase BP
  2. increase HR
  3. cardiac contraction (fatal arrhythmias)
62
Q

what does mixing ephedrine with caffeine do?

A

increases cardiovascular toxicity

63
Q

why did the FDA ban ephedrine?

A

155 deaths, heart attacks and strokes

64
Q

pseudoephedrine

A

in decongestants

65
Q

2 major omega 3s

A
  1. eicosapentaenoic acid (EPA)

2. docosahexaenoic acid (DHA)

66
Q

omega 3s are found in (5)

A
  1. wild ocean fish
  2. flax seeds
  3. olive oil
  4. walnuts
  5. dark leafy veg
67
Q

EPA and DHA are generally deficient in (3)

A
  1. western diets
  2. during pregnancy
  3. normal brain maturation in children/adolescents
68
Q

EPA/DHA deficiencies linked to (2)

A
  1. mood disorders

2. chronic pain syndromes

69
Q

negative effect of O3

A

GI symptoms

70
Q

because O3s are involved in neural development, there is some efficacy in (3)

A
  1. autism spectrum
  2. reduction of allergy
  3. reduction of developmental behaviors
71
Q

children with ADHD consume __% less omega3 rich foods

72
Q

effects of O3 on adolescents with sub threshold psychosis

A

reduced rate of transition to psychotic disorder

73
Q

why are O3s beneficial for inflammation and neuropathic pain?

A

omega 6 acids promote production of inflammatory mediators; O3 inhibits production

74
Q

O3s specifically block ___

A

arachidonic acid; so do NSAIDs

75
Q

what 2 things are produced by O3 that stop inflammatory mediators?

A

resolvins, protectins

76
Q

ideal ratio of O3 to O6

77
Q

most western diets have ratio of ___ O3:O6

78
Q

up to __% of american adult population experiences chronic pain

79
Q

O3, esp __, has what 4 beneficial cognitive effects?

A

DHA

  1. reduces incidence of dementia/cog decline
  2. improves synaptic and NT function
  3. enhances learning/memory
  4. has neuroprotective properties
80
Q

healthy daily intake of O3

A

500 mg/day

81
Q

adding O3 to low dose aspirin reduces ___

A

platelet adhesion to diseased coronary arteries

82
Q

low O3 index may be risk factor for ___

A

sudden cardiac death

83
Q

3 beneficial effects of O3 in pregnancy

A
  1. development of neural and retinal tissues
  2. reduce susceptibility to allergies
  3. prevents depressive symptoms
84
Q

recommended O3 pregnancy dose

85
Q

6 conditions turmeric and curcumin help with

A
  1. inflammation
  2. cardiovascular
  3. cancer
  4. digestive system
  5. antibacterial/antifungal
  6. alzheimers
  7. memory

Psychopharmacology (22 decks)

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