Non-prescription Medications Flashcards
Therapeutic effect of garlic
Anti-atherogenic
Difference between an extract and a tincture
Extract is 1:1 or 1:2, tincture is weaker than 1:2
Adaptogen (define and give two examples)
An herb prescribed to enhance the patient’s resilence and resistance to stress. Ashwaganda (Withania) and eleuthero
Mills’s rule
Credibility is increased when two cultures, separated geographically develop similar use of a medicinal herb
Valerian
For insomnia, restlesness, and anxiety. Affinity of phytochemical components to GABA, benzo, and barbituate receptors
Astragalus
Leukopenia, chemotherapy, hepatitis. Enhances cytotoxicity of NK cells, protective against parainfluenze in mice, modaultes mito oxygen consumption, hepatoprotective
Peppermint
For IBS. An intestinal smooth muscle relaxant
Dietary Supplement Health and Education Act of 1994 (DHSEA) (an amendment to the Federal FDCA)
Regulates the supply of herbal products
What substance was banned from dietary supplements in 2004 and what are its side effects?
Ephedrine. Aes include increase in HR, increase in BP, dysrhythmias, MI, stroke, sudden death, insomnia, nervousness, tremors, headache, and seizures
Herbs that decrease drug absorption from the gut:
Tannins, mucilages, saponins, resins
What CYP does St. John’s Wort affect and does it induce or inhibit?
Induces CYP3A4 (which metabolizes carbamazapine, cyclosporin, digoxin, diazepam, fluoxetin, indinavir, nifedipine, quinidine, verapamil, warfar among others)
What herb can increase AEs from warfarin?
Gingko Biloba
Hyper-serotonin syndrome (hypertension, hyperthermia, muscle jerking, altered mentation) can result from taking SSRIs with what herb?
St. John’s Wort
What herb can protect from the hepatotoxic effects from some pharmaceuticals?
Milk thistle
What herb may mitigate chemoterapy side effects of nausea and constipation?
Ginger
What herb may ameliorate some of the sexual side effects of SSRIs?
Gingko biloba
What natural substance contains naturally ocurring statins?
Red yeast rice
What percentage of americans have taken OTCs and perscription meds respectively in the last 6 months?
59% OTCs, 54% Rxs
Three criteria required for OTC status
1) Indication for use, 2) Safety profile, 3) Practical for OTC use
Ceiling effect
Above a certain dose no additional effects are seen but side effects increase disproportionately
Three examples of antihistamines
Diphenhydramine, chlorphenaramine, loratadine
Mechanism of Action of decongestants
Alpha and beta adrenergic receptor agonists (decrease nasal congestion by constricting nasal BVs and reducing swelling)
Three examples of nasal decongestants
Phenylephrine, pseudoephedrine, oxymetazoline
AEs of nasal decongestants
Insomnia, nervousness, tachycardia, adrenergic overstimulation
Rhinitis medicamentosa
Rebound congestion (can occur 3-5 days after topical decongestants)
In what patients are decongestants contraindicated?
Pts with CV disease, narrow angle glaucoma, diabetes, hyperthyroidism
What is an example of a mast cell stabilizer?
Cromolyn sodium
What do mast cell stabilizers do and what is their MoA?
Prevent and treat allergic rhinitis. Inhibit release of mediators from mast cells
AEs of mast cell stabilizers
Burning and stinging in nares
Ketotifen fumarate
Ocular antihistamine and mast cell stabilizer. Pregnancy category C
