Melatonin, Coenzyme Q-10, Ephedra, Echinacea

Question 1

Melatonin use

Answer 1

treats insomnia

Question 2

melatonin anest concern

Answer 2

hepatotoxicity
rapidly crosses BBB
increased sedative effects (hypnotics, benzos)
may interact with anticoagulants, immunosuppresants, diabetic meds, BCP

Question 3

melatonin other info

Answer 3

hormone that controls sleep wake cycle

studies as preop anxiolysis drug

Question 4

Coenzyme Q-10 use

Answer 4

increased insulin sensitivity in diabetics

antioxidant/anticancer med

Question 5

coenzyme q-10 anest concern

Answer 5

increased clotting risk

decreased response to Coumadin/other anticoags

Question 6

coenzyme q-10 other info

Answer 6

natural anti-inflammatory
used for HF, migraines
increases athletic performance

Question 7

Ephedra use

Answer 7

weight loss
increased energy
asthma treatment

Question 8

ephedra anest concern

Answer 8

direct/indirect sympathomimetic effects

CNS stimulant

Question 9

ephedra side effects

Answer 9

HTN
tachycardia
arrhythmias
vasoconstriction
vasospasm
life-threatening interaction with MAOIs
tachyphylaxis: from depleted endogenous catecholamine stores (hemodynamic instability)

Question 10

ephedra dangers include:

Answer 10

CVA
seizures
agitation, shaking
anxiety, nervousness, panic attack
insomnia
psychosis

MI
myocarditis

Question 11

ephedra other info

Answer 11

must use direct acting sympathomimetics (phenylephrine)

short term ban after baseball player died

Question 12

Echinacea use

Answer 12

immune system support

common as prophylaxis/treatment of infections, URIs

Question 13

echinacea anest concern

Answer 13

allergic reactions (asthmatics)
decreased effectiveness of immunosuppressive meds (corticosteroids)
prolonged use - increased stimulation of immune system and immunosuppression
worsen metabolic control in diabetic pts - hypoglycemia
hepatotoxic

Question 14

echinacea other info

Answer 14

contraindicated in pts with systemic disorders

TB, leukosis, MS, HIV, autoimmune diseases