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BioScience II > Test #2 Herbal and illicit drug PPt-Josh > Flashcards

Test #2 Herbal and illicit drug PPt-Josh Flashcards

1
Q

Herbal Supplements:

are they regulated by FDA?

A

NOpe

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2
Q

Herbal Supplements:

is there rigorus testing such as with Rx meds?

A

nope

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3
Q

Herbal Supplements:

are the adverse effects all know?

A

nope

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4
Q

Herbal Supplements:

should be stoped how long prior to Sx

A

2 weeks

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5
Q

Herbal Supplements:

what is the most popular herbal remedy in currently in the US

A

Echinacea

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6
Q

Herbal Supplements: Echinacea

is beleived to improve immune system by how?

A

modulation of cytokine signaling

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7
Q

Herbal Supplements: Echinacea

is used for tx of what?

A

viral, bacterial, and fungal infections (especially URI)

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8
Q

Herbal Supplements: Echinacea

Chronic use can resut in what?

A

immunosupression and hepatic faiuler

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9
Q

Herbal Supplements: Echinacea

what are some periop considerations?

A

avaoid hepatotoxic drugs

avoid in immunosupressed pts (transplant)

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10
Q

Herbal Supplements: Echinacea

other names

A

purple coneflower

coneflower

American coneflower

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11
Q

Herbal Supplements: Ephedra

other names?

A

ma Huang

Herbal ecstasy

Cloud 9

(sounds bad ass)

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12
Q

Herbal Supplements: Ephedra

Sale is restricted in the US to Chinese Herbal Medicine only d/t adverse effects r/t dietary suppliments. what are some of those SE

A
  • Palpatations
  • HTN
  • Tacjycardia
  • Stroke
  • Seizures
  • Cardiomyopathy
  • MI
  • Dysrhythmias
  • Acute hepatitis
  • psychosis
  • death
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13
Q

Herbal Supplements: Ephedra

it contains what alkaloids?

A
  • ephedrine
  • pseudoephedrine
  • methylephredrine
  • nor-pseudo-ephedrine
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14
Q

Herbal Supplements: Ephedra

has direct effect on ____ and ___ receptors and can indirectly increase the release of norepi for presynaptic neurons

A

alpha

beta

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15
Q

Herbal Supplements: Ephedra

Used for what 3 things

A

Weight loss

CNS stimulant

Asthma

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16
Q

Herbal Supplements: Ephedra

periop considerations

A
  • when combined with other sympathomimetics can cause
  • HTN
  • Dysrhythmias
  • Hyperthermia
  • CV instability
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17
Q

Herbal Supplements: Garlic

also called what?

A

Allium sativum

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18
Q

Herbal Supplements: Garlic

has been used for centuries to treat what?

A

CV disease

DM

Infections

Tumors

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19
Q

Herbal Supplements: Garlic

the _____ in garlic is beleived to decrease thromboxane formation and alter arachidonic metabolism

A

Cysteine

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20
Q

Herbal Supplements: Garlic

since it decreases thromboxane formation it can inhibit what?

A

platelet aggregation

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21
Q

Herbal Supplements: Garlic

can potentiate the anti-platelet effects of what drugs (2)?

A

Aspirin

NSAIDs

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22
Q

Herbal Supplements: Garlic

preop considerations

A
  • Assess bleeding risk
  • D?C 7 days b4 sx
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23
Q

Herbal Supplements: Ginger

also called what?

A

Ziingiber officinale

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24
Q

Herbal Supplements: Ginger

used to treat what?

A

Arthritis

GI d/o

Vertigo

antiemetic

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25
Q

Herbal Supplements: Ginger

the active component ______ is thought to inhibit prostaglandin and leukotriene sysnthesis

A

Gingerol

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26
Q

Herbal Supplements: Ginger

is also thought to inhibit ________ synthatase, thus decreasing platelet agregation

A

thromboxane

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27
Q

Herbal Supplements: Ginger

may ________ the effect of medications with anticoagulation properties

A

potentiate

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28
Q

Herbal Supplements: Ginger

periop considerations

A
  • assess for bleeding
  • Avoid in combination w/ other anticoagulants
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29
Q

Herbal Supplements: Gingko Biloba

is thought to do what?

A

protect vascular walls and nerve cells

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30
Q

Herbal Supplements: Gingko Biloba

is thought to protect vascular walls and nerve cells by acting as a _____-___ scavengers and ________ platelet activating factor

A
  • free-radical scavenger
  • inhibiting
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31
Q

Herbal Supplements: Gingko Biloba

was approved in Germany for the tx of ______

A

dementia

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32
Q

Herbal Supplements: Gingko Biloba

is also beleived to decrease blood viscosity and improve blood flow to tissues and is used to treat _____

A

PVD

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33
Q

Herbal Supplements: Gingko Biloba

periop considerations

A
  • Assess bleeding
  • Avoid w/ NSAIDs, Aspirin, Warfarin
  • D/C 36 hours prior to sx
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34
Q

Herbal Supplements: Ginseng

used in traditional Chinese medicine for what? (3 main things)

A

immunomodulation

Mood enhancement

aphrodisiac

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35
Q

Herbal Supplements: Ginseng

has mild sympathomimetic effect and may interact with what enzyme? tremors and mania have beenreported

A

Monoamine Oxidase Enzyme (MAO)

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36
Q

Herbal Supplements: Ginseng

does what to BGL

A

Hypoglycemia

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37
Q

Herbal Supplements: Ginseng

does what to platelet aggregation

A

interferes

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38
Q

Herbal Supplements: Ginseng

periop considerations

A
  • Monitor BGL
  • May increase bleeding (Assess)
  • D/c 7 days prior to sx
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39
Q

Herbal Supplements: Herbal Diuretics

what are 5 types

A
  • Dandelion
  • Green tea
  • Goldenseal
  • Saw Palmetto Berries
  • Spearmint
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40
Q

Herbal Supplements: Herbal Diuretics

the MOA is uncertain but it is thought to interfers with the _____ system

A

RAAS

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41
Q

Herbal Supplements: Herbal Diuretics

do to the diuretic effects significant ____ and _____ disturbances are associated with their use?

A

fluid and electrolyte

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42
Q

Herbal Supplements: Herbal Diuretics

periop considerations

A

monitor fluid and electrolytes

correct prior to sx

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43
Q

Herbal Supplements: KAVA

another name

A

Piper methysticum

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44
Q

Herbal Supplements: KAVA

derived for the dried root of the ___ plant family

A

pepper

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45
Q

Herbal Supplements: KAVA

what is it used for

A

anxiolytic and Sedative effects

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46
Q

Herbal Supplements: KAVA

the anxiolytic and seditive effect are mediated by potentiation of what?

A

GABA

Gamma-aminobutyric acid

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47
Q

Herbal Supplements: KAVA

potentiated effects of what drugs

A

barbs

Benzos

48
Q

Herbal Supplements: KAVA

SE are seen in what organ

A

hepatotoxicity

(LIVER)

49
Q

Herbal Supplements: KAVA

Perioperative considerations

A

may reduce MAC

Avaoid hepatotoxic drugs

D/C 24hrs prior to sx

50
Q

Herbal Supplements: St. John’s Wort

Another name

A

Hypericum perforatum

51
Q

Herbal Supplements: St. John’s Wort

is widely used in western societies as what?

A

antidepressant for mood disorders

52
Q

Herbal Supplements: St. John’s Wort

similar to more convential antidepressents , and it’s effects are thought to be b/c of thr inhibition of _______, ______, and _______ re-uptake by neurons

A

Serotonin

Noorepinephrine

Dopamine

53
Q

Herbal Supplements: St. John’s Wort

found to be equal to _______antidepressants (drug class) in the treatment of mild to moderate depressive d/o

54
Q

Herbal Supplements: St. John’s Wort

periop considerations

A
  • can lead to serotonergic syndrome
  • may increase metabolism of Drugs (d/t potent inducer of CYP450)
  • reduces anticoagulation effect of drugs
  • Sedative properties may prolong anesthestic drugs
  • D/C 5 days b4 sx
55
Q

Herbal Supplements: Valerian

another name?

A

Valeriana Officnialis

56
Q

Herbal Supplements: Valerian

has been used as what?

A

Anxiolytic sedative

57
Q

Herbal Supplements: Valerian

produces dose dependent sedation and hypnosis, possiably d/t inhibition of _____ breakdown and re-uptake

58
Q

Herbal Supplements: Valerian

acutly stopping will cause what?

59
Q

Herbal Supplements: Valerian

periop considerations

A
  • Decrease MAC
  • Benzo like withdrawl if sudden stop
60
Q

Illicit Drug Use:

what are signs that indicate illicit drug use?

A

Track marks

thrombotic veins

Phlebitis

Tattoos

ablation of venous return (unilateral edema)

Sub Q abcess

61
Q

Illicit Drug Use: Opthalmologic Changes

opiods

A

constriction (miosis)

62
Q

Illicit Drug Use: Opthalmologic Changes

Amphetamines

A

Dilation (Mydriasis)

63
Q

Illicit Drug Use: Opthalmologic Changes

PCP

64
Q

Illicit Drug Use:

malnourishment is usually seen in what obusers opiod or amphetamines?

A

Amphetamines

65
Q

Illicit Drug Use:

Poor dentation is usually associated with abusers of what drugs

A

Amphetamines

66
Q

Illicit Drug Use:

nasal perforation is isually from what drug abuse

67
Q

Illicit Drug Use:

S/S of withdrawl (abstinence)

A

HTN

Tachycardia

Abdominal pain Cramping

Diahrrea

Tremors anxiety

irritability

Lacrimation

Mydriasis

algid sweating

yawning

68
Q

Illicit Drug Use:

suspection of Drug abuse should be followed up with what?

A

urine drug screen

69
Q

Illicit Drug Use: Marijuana
other names

A

pot

hash

grass

weed

THC

70
Q

Illicit Drug Use: Marijuana

obtained from what plant

A

Cannabis Sativa

71
Q

Illicit Drug Use: Marijuana

What is the active ingrediant

A

Delta-9-tetrahydrocannabinol (THC)

72
Q

Illicit Drug Use: Marijuana

effects

A

possible antiemetic

analgesia

anticonvulsant

appatite stimulant

73
Q

Illicit Drug Use: Marijuana

1/2 life

A

56 hours for occasional users

28 hrs for chronic users

74
Q

Illicit Drug Use: Marijuana

why is the tissue half life so long? (1 weeks)

A

d/t sequestering in adipose tissue

75
Q

Illicit Drug Use: Marijuana

complete elimination of a single dose may take up to how many days

76
Q

Illicit Drug Use: Marijuana

metabolized by the _____ into more than 20 metabolites (most w/ psychoactive properties)

77
Q

Illicit Drug Use: Marijuana

frequent use can lead to what?

A
  • cognative impairment
  • Shorted memory span
  • Confusion
  • altered time perception
  • Dulled reflexes
  • diff with ADLs
78
Q

Illicit Drug Use: Marijuana

low or moderate doses _______ sympathetic activity and ________ parasympathetic activity. which results in what?

A
  1. increases
  2. decreases
  3. tachycardia and increased CO
79
Q

Illicit Drug Use: Marijuana

High doses ______ sympathetic activity but not parasympathetic activity, leading to what

A
  • inhibit
  • Hypotension & bradycardia
80
Q

Illicit Drug Use: Marijuana

combination with other sedatives (ETOH, Benzo) may enhance _____ Depression

81
Q

Illicit Drug Use: Marijuana

effects on CV

  • Myocaridal depression and and HR
  • BP and HR drugs
  • What drugs should you avoid
A
  • increased Myocadial depression and tachycardia
  • Potentiates BP and HR drugs
  • Avoid drugs that increase HR (ketamine, panc, atropine, ephedrine)
82
Q

Illicit Drug Use: Marijuana

respiratory effects

A
  • Upper airway irritability
  • Cough/bronchitits/ COPD/ bronchospasm
  • Upper airway edema
83
Q

Illicit Drug Use: Marijuana

some reccomend administration of what drug as prophylaxis from airway edema and irritation prior to GA

A

Dexamethasone

84
Q

Illicit Drug Use: Opioids

S/S of opioid craving

A

lacrimation

Rhinorrhea

yawning

Piloerection

85
Q

Illicit Drug Use: Opioids

S/S of opiod overdose

A
  • Slow RR
  • Increased TV
  • Miotic pupils
86
Q

Illicit Drug Use: Opioids

s/s of withdrawl

A
  • restlessness
  • insomnia
  • mydriasis
  • tachycardia
  • tachypnea
  • HTN
  • Dysphoria
  • Unconciousness
    *
87
Q

Illicit Drug Use: Opioids

when does withdrawl occur? when does it peak?

A

4-6 hours post last intake

peaks 48-72 hours

88
Q

Illicit Drug Use: Opioids

treatment for withdrawl

A

Opioids

Methadone

Clonidine

89
Q

Illicit Drug Use: Opioids

what drugs do you want to avoid, bc they can cause withdrawl

A

Nubain

Narcan

90
Q

Illicit Drug Use: Opioids Anesthestic considerations

Acute opiiod intoxication does what to MAC

91
Q

Illicit Drug Use: Opioids Anesthestic considerations

Chronic opioid abuse does what to MAC

A

increases it

92
Q

Illicit Drug Use: Opioids Anesthestic considerations

why do abusers usually have exaggerated pain post op?

A
  • decreased pain tolerance
  • decreased productionof endogenous opioids (endorphins, Enkephalins)
  • increased post op Opioid requirement
93
Q

Illicit Drug Use: Cocaine

extracted from the leaves of what plant?

A

Erythroxylon coca

94
Q

Illicit Drug Use: Cocaine

available in what hydrochloride forms

A

powder

granules

crystals

95
Q

Illicit Drug Use: Cocaine

alkalinizide form (highly addictive) is called what

A

Crack

rock

free base

96
Q

Illicit Drug Use: Cocaine

When Smoked injected, snorted or ingested orally inhibits _________ uptake of sympathomimetic NT (AKA NE, Serotonin, Dopamine)

A

Presynaptic

97
Q

Illicit Drug Use: Cocaine

produces a pwerful euphoria lasting ____-___ min as a result of free catecholamines stimulation

98
Q

Illicit Drug Use: Cocaine

blood flow to arteries in areas like the ___ & ____may be compromised as the vessels vasoconstrict or vasospasm temporarily, severly compromising oxygenation and supply; this may lead to irreversable brain damage, stroke, and MI

A

Heart and brain

99
Q

Illicit Drug Use: Cocaine metabolism

_____ _____ across lipid membranes d/t low molecular weight and High lipid solubility

A

Easilly diffused

100
Q

Illicit Drug Use: Cocaine metabolism

metabolised to water soluble metabolites abd excreted in _____

101
Q

Illicit Drug Use: Cocaine metabolism

biological 1/2 life?

A

0.5-1.5 hr

102
Q

Illicit Drug Use: Cocaine metabolism

______ cholenesterases metabolizes 75-90% of cocaine into ____ INACTIVE metabolites, which can be detected 15-60 min after intacke!

Also name the metabolites

A
  • Plasma
  • 2
  • ecgonine methyl ester & Benzolecgonine
103
Q

Illicit Drug Use: Cocaine metabolism

_____ cholinesterase metabolizes 10% of cocaine into ______, an ACTIVE metabolite that produce similar actions as cocaine

A

LIver

norcocaine

104
Q

Illicit Drug Use: Cocaine metabolism
Plasma cholinesterase deficiences results in greater liver cholinesterase metabolism whch can ______ the effects of cocaine and increase the risk of complications

105
Q

Illicit Drug Use: Cocaine metabolism

only 1-1.5% is cleared unmetabolized in the urine allowing ots detection only ___ hours after its use

106
Q

Illicit Drug Use: Cocaine Anesthesia considerations:

although rare acute aortic dissection can occur, perhaps a consequence of abrupt, sever HTN, from ______ release

A

catecholamine

107
Q

Illicit Drug Use: Cocaine Anesthesia considerations:

Why must you be careful with regional

A

Cocain induced thrombocytopenia can occur form cocaine use

108
Q

Illicit Drug Use: Cocaine Anesthesia considerations:

why may HTN occur with regional

A

peripheral vasoconstriction

109
Q

Illicit Drug Use: Cocaine Anesthesia considerations:

Regional

Ephdrine resitant Hypotension may occur. what drug may correct this

A

Phenylephrine

110
Q

Illicit Drug Use: Cocaine GETA

What drugs are contraindicated to treat Severe HTN an dCardiac arrhythmias

111
Q

Illicit Drug Use: Cocaine GETA

why is hydralazine good for HTN in these ots?

A

vasodilation effects and decreased SVR

(watch for tachycardia relfex)

112
Q

Illicit Drug Use: Cocaine GETA

VAAs and especially _______ may produce arrhythmias

113
Q

Illicit Drug Use: Cocaine GETA

why is ketamine avoided

A

CNS stimulat effects- increases catecholamines

114
Q

Illicit Drug Use: Cocaine GETA

why shoud etomidate be avoided

A

myoclonus

seizures

hyperreflexia

115
Q

Illicit Drug Use: Cocaine GETA

what may happen to SCh duration and why?

A

prologation

d/t depletion of cholinesterase by cocaine metabolism

116
Q

Illicit Drug Use: Cocaine GETA

what drug may delay cocain induced seizure activity and increase the cumulative doses of cocaine necessary to produce seizures

A

Dexmedetomidine

BioScience II (39 decks)

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