Midterm Exam Study Guide Herbals

Question 1

HERBALS

Answer 1

• Drug interactions, SE:
• ◦Black Cohosh- hepatotoxic, decreases LH, used for menopausal symptoms
• ◦Flax seed –can increase triglycerides; may slow absorption of meds
• ◦Green tea- kidney stones if more than 5 cups per day; lots of drug interactions
• ◦Aloe vera- orally can cause pain & diarrhea; lowers blood sugar; inhibits deep wound healing
• ◦Stevia-drug interaction with Lithium

Question 2

St. John’s wort

Answer 2

• lowers blood levels of protease inhibitors
• acts like MAOI (tyramine-free diet);
• may decrease effectiveness of oral contraceptives, opioids, statins
• Herbal products metabolized by same cytochrome enzyme system as psychotropics; may increase or decrease therapeutic drug levels

Question 3

KAVA

Answer 3

• Kava proposed to have anxiolytic, sedative, and muscle relaxant properties
• Onset of action within 2-4 weeks
• Chronic overuse combined with alcohol or other drugs and preexisting liver conditions may contribute to severe liver damage

Question 4

VALERIAN

Answer 4

• Herbal product for insomnia
• Side effects: potentiation of other CNS depressants, blurred vision, headache, nausea, excitability
• Small studies have shown can improve sleep latency and restorative sleep in mild to moderate insomnia

Question 5

KUDZU

Answer 5

• Kudzu has been studied for its effects on alcoholism
• Kudzu may reduce the desire to drink and prevent a slip from becoming a relapse

Question 6

GINKGO BILOBA

Answer 6

• Studied for its cognitive-enhancing effects, specifically in Alzheimer disease
• Meta-analysis of ginkgo for age-related cognitive impairment and dementias showed modest but inconsistent benefits:
  
  • activities of daily living
  • Mood
  • cognitive function

DEMENTIA GINKGO BILOBA

• May act by dilating blood vessels and
• increasing blood supply, reducing blood viscosity, decreasing free radicals, altering neurotransmitter levels
• May have results in 4-6 weeks
• Side effects: GI upset, skin reactions, headache, dizziness
• May interact with anticoagulants and aspirin to increase bleeding risk

Question 7

S-ADENOSYLMETHIONINE (SAMe)

Answer 7

• Dietary supplement used to treat mild to moderate depression
• Naturally occurring; found in living cells
• A few randomized, double-blind, placebo-controlled studies found SAMe more effective than placebo and as effective as several TCAs (older antidepressants) to treat depression

Question 8

SLEEP HYGIENE

Answer 8

• Relax before bed
• Make bed comfy
• Turn lights off
• Use bed for only Sleep and Sex!!

Question 9

BASIC

PSYCHOTHERAPIES

Answer 9

• Containment: consistent limit setting essential for impatient care; time-outs, specified observation periods, special precautions
• Support: help patients feel better, enhance self-esteem, unconditional acceptance of patient but not the behavior, promote security and comfort while lessening anxiety
• Communication: empathy, offering encouragement and reassurance, education
• Engagement in activities: exercise, yoga, meditation
• Group therapy: help patient meet peers who are experiencing similar difficulties
• Structure: dependability in activity, staff, environment; predictable timetable of activities; setting limits by using contracts, token economies, expecting attendance at meetings and groups