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PBS 603 MEDCHEM > Module 7 Alternative Medicines > Flashcards

Module 7 Alternative Medicines Flashcards

1
Q

Ginkgo biloba

A
  • Ginkgolides
  • ginkgo improves blood circulation by opening up blood vessels. widely used in Europe for treating dementia, and to prevent migraine
  • Can increase bleeding when coadministered with warfarin and clopidogrel
  • Can cause seizures
  • interacts woth anticonvulsants and seizure threshold lowering drugs
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2
Q

St. John’s Wort

A
  • Active constituent - Hyperforin (bicyclic monoterpenoid) and Hypericin (Anthraquinone derivative)
  • Hyperforin inhibits the reuptake of norepinephrine, dopamine, and serotonin in vitro.
  • John’s wort should not be used in combination with antidepressants or psychiatric medications to avoid an additive effect known as “serotonin syndrome”
  • Decrease the efficacy of other prescription agents such as

– digoxin, theophylline,

– cyclosporin, warfarin, indinivir, and

– ethinylestradiol/desogestrel (birthcontrol pills)

  • It may induce cytochrome (CYP) P450 enzymes such as (decrease levels)

– CYP2C9 (metabolizes warfarin),

– CYP1A2 (metabolizes theophylline)

– CYP3A4 (metabolizes indinivir, ethinyl estradiol and cyclosporin)

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3
Q

Garlic (Allium sativum)

A
  • Allicin is the main constituent
  • Garlic lowers serum cholesterol, triglycerides, and lowdensity lipoprotein (LDL) while increasing high-density lipoprotein (HDL).
  • Lowers BP
  • Garlic ear drops for otitis media (ear infection) in naturopathic ear drops
  • UTI
  • Can decrease efficacy of Ocs, HIV drug blood level
  • Can increase bleeding when coadministered with warfarin & clopidogrel & interactes with birthcontrol
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4
Q

Echinacea

A
  • Echinacoside is a natural phenol.
  • Alleviate symptoms of upper respiratory tract infection (URI).
  • prevent migraines and headaches
  • For allergic rhinitis and for common colds and flu
  • Patients with ragweed allergies not to take echinacea
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5
Q

Saw Palmetto (Serenoa repens)

A
  • Saw palmetto is derived from the berries of Serenoa repens or Sabal serrulata and contains phytosterols, aliphatic alcohols, polyprenes, and flavonoids ( fatty acids and streroids)
  • Saw palmetto is most often used to alleviate symptoms associated with benign prostatic hyperplasia (BPH).
  • MOA similar to 5-alpha reductase inhibitorsassociated with benign prostatic hyperplasia (BPH) - finasteride
  • Adverse Effects and Drug Interactions : Abdominal pain with gastrointestinal distress, decreased libido, headache, and hypertension occur
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6
Q

Black Cohosh (Cimicifuga racemosa)

A
  • Used for hot flashes and night sweats
  • German Commission E: for Premenstrual discomfort, Dysmenorrhea, and Menopausal neurovegetative symptoms
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7
Q

Ginger

A
  • Main Constituent : Zingiber officinale
  • Used for nausea and morning sickness, helpful for colds and flu
  • Inhibits COX, lypooxygenase, and TNFalpha
  • Can be used for pain, osteoarthritis and dysmenorrhea.
  • Can interact with warfarin and clopidogrel
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8
Q

Milk Thistle

A
  • Silybum marianumo
  • It is also used for diabetes, lowers cholesterol and triglycerides
  • It can cause laxative effect
  • Possibly cause allergic reactions in people allergic to similar plants including ragweed
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9
Q

Feverfew

A
  • Used to prevent migraine and for cluster headaches
  • Reduces migraine frequency and acute attack
  • Inhibits platelet aggregation, serotonin release, leukotiens, and prostaglandins synthesis
  • Not recommended for patients with allergies to similar plants including ragweed
  • Increases risk of bleeding with warfarin and clopidogrel
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10
Q

Noni Juice

A
  • Main constiuent is Potassium, contains essential oils esters of alcohols, anthraquinones an alkaloid called xeronine (proxeronine).
  • It has an antiiflammatory and antioxidant activities
  • Topically used to reduce signs of aging, for arthritis, and headaches
  • Can interfere with clinical lab test (color-dependant urine tests
  • Noni juice contains significant amounts of potassium
  • Causes Hyperkalemia if taken with ACE inhibitors
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11
Q

Pomegranate Juice

A

• The juice has high levels of antioxidants and may be helpful for heart disease and prostate cancer

  • Main constituent : Punicalagin

• Pomegranate juice inhibits CYP2D6 and CYP2C9 in animal models and in vitro and might increase levels of some Benzodiazepines (BDZ), statins, sulfonylureas, and warfarin (increase levels)

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12
Q

What drug interaction is commonly observed with G. biloba use?

A

increase the risk of bleeding in individuals taking aspirin, ibuprofen, or warfarin and increase the risk of sedation in patients taking trazodone.

Plasma concentrations of nifedipine may be elevated with ginkgo use, increasing therapeutic and adverse reactions. Conversely, Ginkgo biloba may reduce plasma concentrations of omeprazole and tolbutamide, decreasing the therapeutic effects

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13
Q

St. John’s Wort

A

hypericin and hyperforin : main constituents that treat mild depression

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14
Q

What herbal drug is an effective treatment for peptic ulcers, though with unwanted side effects?

A

Licorice

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15
Q

Valerian

A
  • Valerenic acid is a sesquiterpenoid constituent of the essential oil of the Valerian plant
  • Used for depression, anxiety, and to prevent migraines
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16
Q

Licorice

A
  • Glycyrrhizin (or glycyrrhizic acid or glycyrrhizinic acid) is the chief sweet-tasting constituent of Glycyrrhiza glabra (liquorice) root. Structurally it is a saponin and has been used as an emulsifier and gel-forming agent in foodstuff and cosmetics.
  • Antiviral. Historically licorice and its extracts have been used in China and Japan to treat chronic viral hepatitis.
  • Interacts with Hydrochlorothiazide/ ACE inhibitors
  • Remedy for gastric ulcer and allergy
  • Can induce edema, hypertension, and hypokalemia in patients treated with higher doses and long-term administration.
  • possess mild antiinflammatory properties.
  • stimulate gastric mucus secretion.–> antiulcer
17
Q

Ginseng

A
  • found exclusively in the plant genus Panax (ginseng) = Asian ginseng (active constituents : Ginenosides and saponins)
  • Used for colds & flu, improve athletic performance, for chronic fatigue syndrome, ADHD, and to maintain healthy blood glucose
  • Include diabetes mellitus, immunostimulant, anticancer, and cognitive (American and Chinese) actions.
  • interacts with bp lowering drugs –> Avoid
18
Q

Capsicum

A
  • Capsicin is the active ingredient
  • Works by depleting substance P and desensitizing nervous tissues
  • Used for treatment of mild to moderate pain relief, migraine and cluster headaches
  • Can aggravate the side effect (dry cough) of ACE inhibitors
19
Q

Bitter Orange

A
  • Synephrine - a stimulant - is an alkaloid, occurring naturally in some plants and animals. It is a vasoconstrictor, structurally similar to epinephrine and ephedrine.
  • combination of bitter orange with other stimulants such as caffeine prolonged the QT interval
  • Some drugs that prolong the QT interval include amiodarone (Cordarone), disopyramide (Norpace), dofetilide (Tikosyn), ibutilide (Corvert), procainamide (Pronestyl), quinidine, sotalol (Betapace), thioridazine (Mellaril), and many others
20
Q

Kava

A
  • Kavain - main constituent
  • Kavain has anticonvulsive properties
  • Uses: Kava has mild sedative effects and is used for nervous anxiety, stress, and restlessness
  • Patients with depression, liver disease, and Parkinson disease should avoid using kava.
  • Interactions: CNS adverse reactions of alprazolam. Avoid concomitant use of kava and alprazolam. Worsening of Parkinson symptoms was reported in a patient during coadministration of kava and levodopa. Avoid with hepatotoxic drugs
  • Adverse Reactions: Heavy kava use can cause visual disturbances and a scaly skin rash.
21
Q

Comfrey

A
  • Symphytum officinale a homeopathic first aid remedy is also knows as comphrey, knitbone and bone-set in herbal medicine
  • Pyrrolizidine Alkaloids in Comfrey: Acetyl lycopsamine, Acetyl intermedine Lycopsamine, Symphytine, Symlandine, Symviridine, Echimidine, Lasiocarpine, Uplandicine, and 7-and 9- angeloylretronecine
  • liver toxicity
22
Q

Borage

A
  • products containing pyrrolizidine alkaloids
  • Anti-inflammatory; diuretic
  • SE: hepatotoxicity
23
Q

Coltsfoot

A
  • Tussilago farfara
  • treat Upper respiratory tract infections
  • Toxic Agent : Pyrrolizidine alkaloids ; SE: hepatotoxicity
  • Avoid ingestion of any parts of plant; leaves may be used topically for anti-inflammatory effects for up to 4–6 weeks
24
Q

Grapefruit

A
  • specifically bergamottin and dihydroxybergamottin, selectively inhibit CYP3A4 in the gut wall
  • inhibition of hepatic CYP3A4.The inhibition of CYP3A4 by grapefruit can last for up to 24 hours therefore separating administration of grapefruit and drugs will not help.
25
Q

CoQ10

A
  • Used for: heart failure, statin myalgia, hypertension, type 2 diabetes, and migraine prophylaxis; Cardiotoxicity associated with doxorubicin
  • Coenzyme Q 10 is also known as ubiquinone. Structurally similar to Vitamin K, can decrease the effects of Warfarin.

PBS 603 MEDCHEM (5 decks)

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