Pharmacology Flashcards

1
Q

What is pharmacokinetics?

A

The absorption, distribution, metabolism and elimination of substances from a biological system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What enzyme is responsible for most metabolism of drugs?

A

Cytochrome P450 - expressed in liver, intestines, kidneys and brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is microbial metabolism?

A

Microbiome and host metabolism converting phenolics into smaller metabolites that reach systemic circulation that may return to the GIT to be further metabolised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is reinforcement in terms of herbal synergy?

A

Herbs used together produces greater efficacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is potentiation in terms of herbal synergy?

A

One herb is the principal herb in the mix, which another herb is an adjunct herb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is restraint and detoxification in terms of herbal synergy?

A

Where a potentially toxic herb is combined with another herb to offset or mitigate the toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is counteraction in terms of herbal synergy?

A

Where an action of one herb is diminished by another herb

e.g. Raphanus sativus (radish) seed weakens the effect of Panax ginseng

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is pharmacodynamics?

A

The mechanism of action of a medicinal substance on a biological system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List 2 cellular defence pathways

A

Nrf2, NF-kB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define inverse agonist

A

Causes target to do the opposite of its usual function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the 6 tissue state model?

A

Assesses states of:

Metabolism: hot to col
Internal moisture: damp to dry
Tissue tone: tense to relaxed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is one example of a heating remedy?

A

Ginger - stimulates vanilloid receptor mediated noradrenaline release -> increase uncoupling protein 1 activity -> increases mitochondrial energy expenditure -> thermogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is hormesis?

A

The adaptive response to stress.

Each organism has an individual capacity to respond, and given sufficient stress intensity, can be overwhelmed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does mild stress in the hormetic zone induce?

A

A beneficial adaptive response - eg increase in anti-oxidant activity in a plant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is allostatic load?

A

The load produced by survival activities which organisms use to maintain homeostasis, including obtaining food, reproducing, and adapting to unexpected stress

Allostatic load prompts adaptation to stress on cellular and systemic levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a chemotype?

A

The same botanical species but producing a different phytochemical profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the two types of plant metabolites?

A

Primary - molecules that plants depend on to exist

Secondary - produced by plants as needed for survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are examples of primary metabolites?

A

Macronutrients, enzymes, nucleic acids, vitamins, chlorophyll

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are examples of secondary metabolites?

A

Terpenoids, sterols, saponins, flavonoids, anthocyanins, iridoids, tannins, phenolic acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which biosynthetic pathways produce primary metabolites?

A

MVA - mevalonic acid
MEP - methyl-D-erythritol 4-phosphate

Shikimic acid

Acetate and glutamate via krebs cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which biosynthetic pathways create secondary metabolites?

A

MVA
MEP
Terpenoid
Shikimic acid
Phenylpropanoid
Polyketide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does the shikimic acid pathway produce?

A

amino acid precursors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does the MVA and MEP pathways produce?

A

precursor molecules to the terpenoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does the terpenoid pathway produce?

A

molecules with 5 carbons and beta-carotene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does the phenylpropanoid pathway produce?

A

Precursors to larger phenolics like flavonoids and anthocyanins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does the polyketide pathway produce?

A

Condenses acetyl units to form stilbenes, xanthones and anthraquinones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does glycosylation involve?

A

Adding a sugar molecule to secondary metabolites

eg. saponins are triterpenoid glycosides

Involves betaglycosidic bonds that resist human digestive enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are decorations?

A

Prenylation (addition of isopentene), methylation (addition of methyl), acetylation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is polymerisation?

A

eg dimers, trimers, tetramers

Depsides (phenolic polymers)
Condensed tannins (flavanol polymers) -> AKA proanthocyanidins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are compound molecules?

A

Complex tannins - combinations of flavonoids with ellagic and/or gallic acid

Terpenophenols (cannabinoids) - combo of polyketide and monoterpenoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is a standardised extract?

A

one that is: “manufactured to contain a consistent level of one or more phytochemical constituents which are derived from the original starting material.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What type of bond is C-H?

A

non-polar covalent bond

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What type of bond is C-O?

A

polar covalent bond

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What type of bond is O-H bond?

A

polar covalent bond

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Two solvents used in herbal manufacturing

A

Hexane - no oxygen present, non-polar

Oleic acid - fatty acid, contains oxygen and a polar end

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What polarity is hypericin and what plant is it from?

A

Hypericum perforatum (st johns wort)
Naphthodianthrone
Non-polar

Anti-inflammatory, antimicrobial, neuroprotective, anti-oxidant (scavenges free radicals)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What polarity and class is pseudohypericin and what plant is it from?

A

Non polar
Naphthodianthrone
St johns wort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What polarity and class is hyperforin and what plant is it from?

What is its main action?

A

Non-polar
Naphthodianthrone
St johns wort - hypericum perforatum

Anti-depressant - reduces uptake of serotonin and dopamine

Neuroprotective - neurogenesis

Anti-inflammatory - COX inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What polarity and class is rutin?

A

Flavonoid
Polar

Found in crataegus monogyna (hawthorn berries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What polarity is DHA? where is it found?

A

non-polar lipid
algae and animal products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What class and polarity is glycyrrhizin?

A

A saponin from Glycyrrhiza glabra (liquorice)

Balanced non-polar and polar (amphipathic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What class and polarity is hyperoside and what plant is it found in?

A

More polar than non-polar, but dissolves best in an ethanol/water mix (amphipathic)

Flavonoid

St johns wort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What class and polarity is caffeine and what plant is it found in?

A

Alkaloid
Polar
Coffea arabica (coffee) and Camellia sinensis (tea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

How does Nrf2 activation help in protecting against toxicity?

A

Nrf2 activation protects cells against oxidative stress and inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What happens when oxidative stress exceeds a certain level?

A

Excessive oxidative stress induces an inflammatory response, and if it is even higher, it leads to apoptosis (cell death).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What effect does mild to moderate oxidative stress have on Nrf2?

A

Mild to moderate oxidative stress induces the Nrf2 response, which helps to mitigate the stress before inflammation or apoptosis occur.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What pathway is activated by oxidative stress to protect cells?

A

The KEAP1-Nrf2-ARE pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What happens when oxidative stress activates KEAP1?

A

KEAP1 activation causes the release of Nrf2, which then travels to the nucleus to bind with ARE (antioxidant response elements).

The binding activates ARE, which initiates the expression of proteins that help the cell better handle oxidative stress.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What does Nrf2 stand for?

A

Nuclear factor erythroid 2-like factor 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is Quercetin?

A

A flavonoid and phenolic phytochemical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the major action of antioxidant phytochemicals like Quercetin?

A

The activation of the Nrf2 pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Name some antioxidant herbs.

A

Bacopa, Bilberry, Cats Claw, Chaparral, Elderberry, Garlic, Ginkgo, Grapeseed, Green Tea, Hawthorn Leaf and Berry, Olive Leaf, Oregano, Rhodiola, and Rosemary.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the role of Ginkgo as an antioxidant?

A

Ginkgo primarily supports the nervous system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the role of Rosemary as an antioxidant?

A

Rosemary supports the nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is Naringin?

A

A flavonoid that exerts hepatoprotective through activation of the Nrf2 pathway (protection against oxidative stress) and downregulation of the NF-kB pathway (reducing inflammation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

How does Naringin protect the liver?

A

Activates the Nrf2 pathway, reducing liver cell death and decreasing the leakage of liver enzymes (ALP, ALT) into the blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is a neuro-trophorestorative?

A

Triggers signalling pathways in the cell to help them grow, divide and repair
Can promote restorative action in tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Five risks of toxicity during pregnancy:

A

Toxicity to the mother which can indirectly affect the foetus
Toxicity to the foetus
Teratogenesis (malformations)
Increased risk of miscarriage
Poor neonatal health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Pregnancy categories TGA

A

A - human evidence, safe
B1 - limited human evidence, animal evidence, save
B2 - limited human evidence, limited animal evidence, safe
B3 - limited human evidence, safe, animal evidence unsafe
C - not safe, may harm neonate but no malformations
D - not safe, evidence of malformations
X - not safe, high risk of permanent damage, contraindicated in all stages of pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Lactation categories

A

ND - no data
C - compatable with breast feeding
CC - compatible but use caution
SD - strongly discouraged
X - contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is a practitioner only product?

A

No claim of therapeutic activity on the product label
Must have label attached for personalised dosage instructions
Cannot be casually available to the public

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is a product for Extemporaneous Dispensing?

A

Must be formulated and dispensed after a consultation
Cannot be pre-made in anticipation of people coming in and needing that product
eg Fluid Extracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What group do the majority of essential oils belong to?

A

Phenylpropanoids or terpenoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What are the 4 pathways essential oils are produced through?

A

MVA, MEP
Terpenoid
Phenylpropanoid
Lipid derivatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are 3 things plants use volatile oils for?

A

Defence
Communication with other plants
Attraction of polinators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is the absorption of EE’s like?

A

Variable across skin, extensive orally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is the distribution of EE’s like?

A

Accumulation of toxic constituents possible

eg thuja oil causes seizure after 20 drops daily for 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is the metabolism of EE’s like??

A

Extensive phase I and II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is the elimination of EEs like?

A

Mostly via kidneys as water soluble metabolites, then GI elimination

Small amounts of unmetabolised EE are eliminated via the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What 3 main actions are EEs?

A

Carminitive, spasmolytic and antimicrobial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is the structure of a phenylpropanoid?

A

6 member benzene ring (phenyl group) attached to propane chain (C3H8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What essential oils are phenylpropanoids?

A

Cinnamaldehyde, eugenol, elemicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What essential oils are terpenoids?

A

Menthol, thymol, linalool, citronellal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is a carminitive?

A

A substance that relieves flatulence and soothes intestinal spasm and pain, by relaxing intestinal mucsle and sphincters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is a spasmolytic?

A

A substance that reduces or relieves smooth muscle spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

How do essential oils reduce smooth muscle spasm?

A

Essential oils increase the activity of cyclic AMP (cAMP), decrease intracellular calcium (Ca2+) and decrease intracellular potassium (K+) which together decrease the contractility of smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

4 causes of IBS

A
  1. enhanced visceral perception
  2. low grade inflammation
  3. altered GIT motility
  4. Dysbiosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What factors contribute to the pathogenesis of IBS?

A

Dysbiosis, increased intestinal permeability, altered signalling in enteric cells, sensitisation of the enteric nervous system, impaired bile acid metabolism and function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is the mechanism of visceral hypersensitivity in IBS?

A

Pro-nociceptive signalling in the enteric NS activates transient receptor potential receptors like TRPV1 and 4 (vanilloid 1 and 4), serotonin (5-HT) and histamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

How does mentha x piperita (peppermint) help IBS?

A

Calcium channel blockade antagonises cholinergic and serotonergic signalling

It also: Reduces inflammation, influences the microbiome, alters sensitivity of git mucosa through transient receptor potential ion channels

anti-emetic, analgesic, antibacterial, antifungal, carminative

Contains menthol - flavonoid (terpenoid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What two plants contain carvacrol and thymol?

A

Thymus vulgaris
Origanum vulgare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What plant contains arbutin and what is it?

A

Bearberry
A phenolic glycoside (glucose + hydroquinone) that undergoes hydrolysis to release hydroquinone that is antimicrobial - particularly in the urinary tract

83
Q

What action does Cinnamonum verum have?

A

antifungal - cinnamaldehyde

Disruption of cell membrane structure, synthesis and function

84
Q

4 Bacterial virulence factors

A
  1. Quorum sensing - bacterial comms using signalling molecules
  2. Biofilm - colonies protected by ECM
  3. Movement - form adhesive structures and flagella
  4. Metabolites - lipopolysaccharides, pigments, cell lysing molecules cause host cell destruction
85
Q

Anthelmintic mechanisms

A

Paralysis and death of helminth - acetylcholinesterase inhibition

Damage cells - denature proteins

Disrupt reproduction - inhibit cell division, interefere with larval transformation from egg

Interfere with physiology - inhibit antioxidant enzymes

86
Q

2 herbs that are anthelmintic

A

Artemisia absinthium (wormwood)

Andrographis paniculata

87
Q

Artemisia absinthium (wormwood) MOA

A

EE contains thujone that causes helminth paralysis

Sesquiterpenes inhibit neurotransmission causing paralysis

88
Q

Andrographis paniculata active consituent

A

Diterpene lactones (andrographolides)
Immune enhancing

89
Q

2 pathways herbs act upon to reduce anxiety

A

Neurotransmission - GABA, serotontin, dopamine, noradrenaline, opioid signalling

Stress response modulation - balance HPA axis to reduce adrenaline and cortisol

90
Q

Key signalling pathway in anxiolytic herbs

A

GABA pathway
Voltage gated calcium channels also play a role

91
Q

Herbs for anxiety and their active constituents

A

Lavandula angustifolia - linalool
Matricaria recutita (chamomile) - flavanoids and apigenin and GABAergic
Piper methysticum (kava) - kavalactones

92
Q

What do flavonoids do?

A

Protect plants from UV, regulate hormones and attract polinators

Antioxidant

Isoflavones (subgroup) are phytoestrogenic

93
Q

5 examples of flavonoids

A

Quercetin - Ginkgo biloba
Luteolin
Rutin - Crataegus monogyna
Chrysin - Passiflora incarnata
Hyperoside - Crataegus monogyna

Crataegus monogyna - hawthorn berries

93
Q

Structure of flavonoids

A

3 rings
Classified on their functional groups in the C ring (middle one)

94
Q

What polarity are flavonoids?

A

With increasing levels of hydroxylation and glycoslyation are more hydrophilic

Extracted with 25-45% ehtanol

95
Q

What is the absorption of flavonoids?

A

Flavonoid glycosides may undergo active transport with SGLT1

Otherwise host and microbiome liberate flavanoid itself and it is passively diffused

The absorbed glycosides encounter cytosolic betaglucosidases for deglycosylation

96
Q

Metabolism of Chrysin (flavonoid) and plants it is found in

A

Hydroxylation via phase I enzymes (CYP450s)

Glucuronidation and sulfation via phase II enzymes

Found in passionflower, chamomile (passiflora incarnata and matricaria chamomilla) and is anxiolytic and anti-inflammatory

97
Q

What flavonoid produces phenolic breakdown products that can be absorbed and have an effect?

A

hesperitin - during breakdown by human and microbial enzymes creates phenolic breakdown products

98
Q

What actions are flavonoids?

A

Antioxidant
Antiinflammatory

Tissue protective - cardiovascular, hepatoprotective, neuroprotective, topical wound healing, cancer protective

99
Q

4 types of resins

A

oleoresins - resin + EE
Gum resins - resin + gum
Oleo-gum-resin
Balsams - cinnamic acid and its esters

100
Q

Polarity of resins

A

lipophilic

101
Q

Action of resins

A

antimicrobial, anti-inflammatory and vulnerary

102
Q

the pathways that create the molecules in resins:

A

Sikimic acid
Terpenoid
Polyketide
Flavonoid
Polymerisation and compound molecules

103
Q

Resinous phytochemicals that are commonly encountered:

A

Triterpenoids
Gingeroids and Curcuminoids (polyketides)
Cannabinoids (terpenophenols)
Capsaicinoids (alkaloids)

104
Q

ethanol concentration to extract resins

A

65-90%
Insoluble in water and hexane

105
Q

Sources of resins

A

Boswellia serrata (frankincense) - boswellic acids

Canniabis spp. - terpenophenols

Cucurma longa - curcuminoids

Propolis

Zingiber officinale (ginger) - gingeroids

106
Q

Activation of the immune response:

A

Tissue damage (infectious or sterile) causes PAMPs and DAMPs to bind to pattern recognition receptors (PRRs) that cause an inflammatory immune response

Resolution-associated molecular patterns (RAMPs) and specific pro-resolving mediators (SPMs) reduce inflammation

107
Q

m1 vs m2 macrophages

A

M1 - pro-inflammatory
M2 - pro-resolution

108
Q

Describe the mitochondrial Dysfunction and Cell Injury Pathway

A
  1. Cell injury and mitochondrial dysfunction cause activation of the NLRP3 inflammasome, and the release of DAMPs
  2. DAMPs activate an immune response via activation of toll-like receptors (TLRs) and nuclear factor kappa B (NF-κB) signalling
  3. Interferons and interleukins are released which cause an immune response
109
Q

What are specialised pro-resolving mediators derived from?

A

both omega-6 (arachidonic acid) and omega-3 (EPA, DHA) essential fatty acids

SPMs exert their actions via specific pro-resolving G protein-coupled receptors on polymorphonuclear cells and cells local to tissues.

110
Q

4 mechanisms associated with inflammation resolution

A

Reduced endothelial activation
- Dampened neutrophil recruitment
- Neutrophil apoptosis
- Macrophage efferocytosis

111
Q

What is the NLRP3 inflammasome? What is it reduced by?

A

A protein complex which regulates inflammation

Activated by PAMPs and DAMPs

Phytochemicals (e.g. flavonoids and resins) and other substances can reduce factors which activate NLRP3, including reducing oxidative stress, thereby reducing inflammation.

112
Q

What are sirtuins and what do they do?

A

Influence inflammation by

  • Regulating transcription factors (e.g. NF-κB)
  • Modulating cytokine production (e.g. interleukins)
  • Influencing immune cell function (e.g. proliferation of T cells)
  • Regulating inflammasome activity (e.g. NLRP3)
  • Regulating mitochondrial function (dysfunctional mitochondria trigger inflammation).
113
Q

What can sirtuins be regulated by?

A

Phytochemicals including flavonoids and stilbenes

114
Q

3 Anti-inflammatory Mechanisms

A

Downregulation of nuclear factor kappa-B (NF-κB)

Inhibition of cyclooxygenase (COX) and lipoxygenase (LOX)

Regulating Sirtuin activity, in turn regulating inflammatory transcription factors and enzymes.

115
Q

Physiology of nausea and vomiting

A

Coordinated response between:

  1. An area of sensory nerve cells called the chemoreceptor trigger zone (CTZ), located in the floor of the fourth ventricle of the brain
  2. The vomiting centre, or emetic centre, located in the medulla
116
Q

What can stimulate the ctz?

A
  • sense of smell
    • severe pain
    • strong emotion
    • motion sickness
    • raised intracranial pressure
    • endocrine disturbances
    • gastrointestinal disease
    • toxic reactions to drugs
    • chemotherapy and radiotherapy
117
Q

Pathway from CTZ to nausea

A
  1. The CTZ sends input to the emetic centre through the neurotransmitters acetylcholine (ACh), serotonin (5-HT), histamine (H) and dopamine (DA).
  2. Sympathetic and parasympathetic nervous systems activated
  3. Salivation, sweating, rapid breathing and cardiac dysrhythmias.
118
Q

How do anti-emetics work? What are the classes of drugs?

A

By blocking neurotransmission in the CTZ, the vomiting centre, vestibular apparatus, and/or the cerebral cortex

Dopamine antagonists, anticholinergics (antimuscarinics), antihistamines and neurokinin-1 (NK1) receptor antagonists are the most used classes of drugs as antiemetics

119
Q

How is zingiber officinale anti-emetic?

A

Oleoresin of ginger contains phenylpropanoid derivatives, gingerols and shogaols, and sesquiterpenes (zingiberene)

Gingerols are antagonists of 5-HT3 in the CNS and GIT, reducing vomiting response

The oleoresin is also anticholinergic and antihistamine, and inhibits substance P and NK1 receptor expression

120
Q

Contributing factors of hypertension

A
  • Sympathetic nervous system activation (stress), endothelial response, sodium and water retention, and inflammation
  • RAAS -> endothelial dysfunction, salt sensitivity, vascular injury
  • Endothelium -> responsible for vascular tone, salt sensitivity and NO release to decrease BP
  • SNS -> activates, catecholamine release, increase renal sympathetic activity, increase sodium avidity and BP increases
121
Q

Antihypertensive / hypotensive mechanism of herbs:

A
  • Balancing stress response,
  • Balancing inflammatory cascade (prostaglandins and decreasing inflammatory markers),
  • Increased NO availability
  • Increased cellular antioxidants
  • Inhibits ACE
  • Decreased angiotensin II
  • All reduce oxidative stress, enhance vasodilation or decrease vasoconstriction to assist with hypertension
122
Q

How does Crataegus monogyna (hawthorn) assist with hypertension

A

Cardioprotective flanonoids:

reduce BP - enhance NO production

123
Q

What would be a target for reducing inflammation?

124
Q

What is an anti-inflamatory herb?

A

Boswellia serrata - resin decreases NF-kB

Frankincense

125
Q

What is a hepatoprotective herb and its mechanism?

A

Silybum marianum - st marys thistle

The silymarin (flavonoid) activates nrf2 pathway

126
Q

What is an anti-emetic herb and its mechanism?

A

Cynara scolymus (globe artichoke leaf)

Active -> phenolic acids (cynarin)

Stimulates bitter receptors and enhances liver function

127
Q

What is a neuroprotective herb and its mechanism?

A

Ginko biloba

Active - flavonoids (gingko-flavones) and flavonol glycosides (quercetin)

Activates nrf2 pathway to upregulate endogenous antioxidant defences

Increase BDNF

128
Q

What is an anxiolytic herb and its mechanism?

A

Matricaria chamomilla
GABAergic
Flavonoids

129
Q

Q. What is the distinguishing chemical characteristic of plant glycosides?

A

A. presence of glycosidic bonds. These bonds link a sugar molecule (glycone) to a non-sugar molecule (aglycone).

130
Q

Q. List classes of plant secondary metabolites:

A

Terpenoids
Phenolics
Alkaloid
Polyketides
Flavonoids
Iridoids

131
Q

Q. List classes of plant primary metabolites:

A

Carbohydrates
Lipids
Proteins
Nucleic acids

132
Q

Q. Define the term “molecular decorations” as it applies to the creation of secondary metabolites in plants:

A

The term “molecular decorations” refers to the various chemical modifications that occur during the biosynthesis of secondary metabolites in plants

133
Q

Q. Summarise the purpose and organisation of the Standard for the Uniform Scheduling of Medicines and Poisons (the Poisons Standard):

A

To provide a uniform approach to the classification, labelling, and packaging of medicines and poisons throughout Australia.

It aims to ensure that substances are made available to consumers in a manner that protects public health and safety

134
Q

Q. List the requirements for Good Manufacturing Practices (GMP)

A

A. validation of equipment and processes·
documented standard operating procedures covering every aspect of manufacture
· documented cleaning and calibration logs for equipment
· control of the manufacturing environment, air and water
· quarantining and unique identification and testing of raw
· materials, labels and packaging discrete batch identification
· comprehensive batch record documentation
· reconciliation of raw materials, product, packaging and labels
· quarantining and testing of finished products
· documented release-for-sale procedures
· testing of stability of finished product
· documentation of customer complaints and recall procedures.

135
Q

Q. Define herbal medicine standardisation:

A

A. Herbal medicine standardisation refers to the process of ensuring batch to batch consistency in one or more phytochemical constituents or classes of constituents.

136
Q

Q. List possible benefits of herbal medicine standardisation:

A

Consistency in the quality, safety, and efficacy of herbal products
regulatory compliance, as standardised products are more likely to meet established standards and regulations
maintaining the reliability and reproducibility of herbal medicines, which is essential for scientific research and clinical trials.

It allows researchers to accurately assess the efficacy and safety of herbal products, leading to more robust and credible findings

137
Q

Q. List possible limitations of herbal medicine standardisation:

A

complexity and variability of herbal products. Unlike synthetic drugs, herbal medicines are composed of multiple active compounds, which can vary depending on factors such as the plant’s growing conditions, harvesting time, and processing methods
lack of comprehensive scientific data

138
Q

Q. Contrast Good Manufacturing Practices with herbal medicine standardisation:

A

GMP is a comprehensive system that encompasses various aspects of manufacturing, including quality management, personnel, premises and equipment, documentation, production, quality control, complaints and recalls

Standardisation is simply about controlling the amount of constituents present per dose.

139
Q

Q. Define herbal synergy:

A

Herbal synergy refers to the phenomenon where multiple herbs work together to enhance each other’s therapeutic effects, resulting in a more potent remedy than any single herb could provide on its own.

140
Q

Q. Describe the pharmacokinetics of plant glycosides:

A

The pharmacokinetics of plant glycosides involves the study of how these compounds are absorbed, distributed, metabolized, and excreted in the body.

Absorption -> some are hydrolysed by gut microflora human enzymes

Distribution -> once hydrolysed the aglycones (actives) are lipophilic and can be absorbed or bound to plasma proteins

Metabolism -> Phase I and II

Excretion -> once hydrophilic enough, urinary excretion, or if still hydrophobic biliary excretion via GIT

141
Q

essential oils primarily serves the purposes of:

A

[defence against microbes], and [attraction of pollinators].

142
Q

Essential oils are commonly known for the herbal actions of

A

[carminative], and [spasmolytic].

143
Q

Common safety issues or side effects of essential oils include

A

[high potency], and [skin sensitisation].

144
Q

Examples of herbs known to contain essential oils which have these actions and safety issues are

A

[Mentha × piperita], and [Melissa officinalis].

145
Q

Two example constituents within essential oils are:

The solubility of essential oils is in:

A

[menthol], and [citronellal].

[lipophilic solvents].

146
Q

resins primarily serves the purposes of

A

[defence against microbes], and [healing of wounds].

147
Q

Resins are commonly known for the herbal actions of

A

[antimicrobial], and [vulnerary].

148
Q

Common safety issues or side effects of resins include

A

[dermatitis], and [GIT upset].

149
Q

Examples of herbs known to contain resins which have these actions and safety issues are

A

[Boswellia serrata], and [Commiphora myrrha].

150
Q

Two example constituents within resins are:

The solubility of resins is in:

A

[boswellic acids], and [mansumbinone].

[lipophilic solvents].

151
Q

flavonoids primarily serves the purposes of

A

[attraction pollinators], and [protection from sunlight].

152
Q

Flavonoids are commonly known for the herbal actions of

A

[antioxidant], and [tissue protective].

153
Q

Common safety issues or side effects of flavonoids include

A

[bruising/bleeding], and [pro-oxidant at very high doses].

154
Q

Examples of herbs known to contain flavonoids which have these actions and safety issues are

A

[Ginkgo biloba], and [Crataegus monogyna].

155
Q

Two example constituents within flavonoids are:

The solubility of flavonoids is in:

A

[ginkgo flavones], and [quercetin].

[hydrophilic solvents].

156
Q

isoflavones primarily serves the purposes of

A

[discouraging herbivores], and [protection from sunlight].

157
Q

isoflavones are commonly known for the herbal actions of

A

[oestrogen modulating], and [antioxidant].

158
Q

Common safety issues or side effects of isoflavones include

A

[pro-oxidant at very high doses], and [thyroid antagonism].

159
Q

Examples of herbs known to contain isoflavones which have these actions and safety issues are

A

[Glycine max], and [Trifolium pratense].

160
Q

Two example constituents within isoflavones are:

The solubility of isoflavones is in:

A

[genistein], and [formononetin].

[hydrophilic solvents].

161
Q

anthraquinone glycosides primarily serves the purposes of

A

[discouraging herbivores], and [defence against microbes].

162
Q

anthraquinone glycosides are commonly known for the herbal actions of

A

[stimulating laxative], and [antiviral].

163
Q

Common safety issues or side effects of anthraquinone glycosides include

A

[dehydration], and [electrolyte imbalance].

164
Q

Examples of herbs known to contain anthraquinone glycosides which have these actions and safety issues are

A

[Rheum palmatum], and [Senna alexandrina].

165
Q

Two example constituents within anthraquinone glycosides are

A

[aloe-emodin-8-O-glucoside], and [sennoside A].

166
Q

The solubility of anthraquinone glycosides is in

A

[hydrophilic solvents].

167
Q

iridoid glycosides primarily serves the purposes of

A

[discouraging herbivores], and [defence against microbes].

168
Q

iridoid glycosides are commonly known for the herbal actions of

A

[bitter], and [anti-inflammatory].

169
Q

Common safety issues or side effects of iridoid glycosides include

A

[nausea], and [vomiting].

170
Q

Examples of herbs known to contain iridoid glycosides which have these actions and safety issues are

A

[Rehmannia glutinosa], and [Harpagophytum procumbens].

Rehmannia and Devils Claw

171
Q

Two example constituents within iridoid glycosides are:

The solubility of iridoid glycosides is in:

A

[aucubin], and [harpagoside]

[hydrophilic solvents].

172
Q

aloe-emodin-8-O-glucoside class and solubility

A

anthroquinone glycoside
hydrophilic

173
Q

sennoside A class and solubility

A

anthroquinone glycoside
hydrophilic

174
Q

Linalool class and solubilty

A

essential oil - monoterpene alcohol
lipophilic

175
Q

Menthol class and solubility

A

Essential oil - monoterpene alcohol
lipophilic

176
Q

Linalyl acetate class and solubility

A

Essential oil - monoterpene ester
lipophilic

177
Q

Thymol class and solubility

A

Essential oil - monoterpene phenol
lipophilic

178
Q

Anethol class and solubility

A

Essential oil - phenylpropnaoid
lipophilic

179
Q

Citronellal class and solubility

A

essential oil - monoterpene aldehyde
lipophilic

180
Q

Apigenin class and solubility

A

flavonoid
hydrophilic

found in chamomile, gingko and thyme

181
Q

Gingko flavones (quercetin, kaempferol)

A

Flavonoid
hydrophilic

182
Q

cyanidin 3-O-glucoside class and solubility

A

Flavonoid (Anthocyanin glycoside)
Hydrophilic

183
Q

Silymarin class and solubility

A

Flavonoid (flavanolignan)

Lipophilic/hydrophilic (needs about 50% ethanol)

184
Q

Vitexin class and solubility

A

flavonoid glycoside
Hydrophilic

Found in passionflower, skullcap, lemon balm - apigenin+glucose

185
Q

Harpagoside class and solubility

A

Iridoid glycoside
Hydrophobic

Anti-inflammatory - inhibits NF-kB
Analgesic - COX, LOX, Prostaglandin

Devils claw, ginseng

186
Q

Aucubin class and solubility

A

Iridoid glycoside
Hydrophilic

Hepatoprotective - prevents oxidative stress and promotes regeneration

Less anti-inflammatory than harpagoside

187
Q

Formononetin class and solubilty

A

Isoflavonoid
Lipophilic

Phytooestrogenic - found in soy (glycine max)

188
Q

Genistein class and solubility

A

Isoflavonoid (flavonoid subclass)
Lipophilic

189
Q

Hypercerin class and solubility

A

Naphthodianthrone
Lipophilic

190
Q

Phenol class and solubility

A

Phenol
lipophilic

191
Q

echinacoside class and solubility

A

Phenylpropanoid glycoside
Hydrophilic

192
Q

Lentinan class and solubility

A

Polysaccharide
Hydrophilic

193
Q

Kavalactones (kavain) class and solubility

A

Resin
Lipophilic

194
Q

mansumbinone class and solubility

A

resin
Lipophilic

195
Q

Boswellic acid class and solubility

A

Resin
Lipophilic

196
Q

agrimoniin class and solubility

A

Tannin (hydrolysable)
Hydrophilic

197
Q

ginkgolide B class and solubility

A

Terpene lactone (indicated by the many cyclic ester groups which is what a ‘lactone’ is)

hydrophilic

198
Q

glycyrrhizin class and solubility

A

Triterpene saponin
Hydrophilic

amphipathic

199
Q

What is Arctostaphylos uva-ursi used for?

A

Antimicrobial
Disrupts membranes
Simple phenols

200
Q

What is an anti-depressant herb and its mechanism?

A

Hypericum perforatum

  1. Increase monoamine transmission - naphthodianthrones
  2. Reduces neuroinflammation - flavonoids (hyperoside, quercetin)
201
Q

Which herb is hypotensive and what is its mechanism?

A

Crateagus monogyna
Increase NO
Flavonoids

202
Q

What is Arctostaphylos uva-ursi and its mehcanism?

A

an antimicrobial simple phenol

disrupts membranes