Test 4: 50 herbals Flashcards
pts with kidney disease should use caution when using
parsley- can irritate/damage renal epithelium
licorice root: mineralocorticoid effects: sodium and water retention and potassium loss (leading to HTN, edema and hypokalemia)
What herbals not for pt with autoimmune disease
echinacea, reishi & maitake mushrooms, astragalus
pt with liver disease should not use — herbal
eucalyptus: – Induces liver enzyme activity
Used for respiratory tract inflammation
pts with thyroid disease should avoid
Kelp: may contain iodine and result in either hyper OR hypothyroidism
Bugleweed (gypsy wort): may cause a potentially harmful decrease in thyroid function
pyrrolizidine alkaloids result in — disease
hepatovenocclusive
(cause closing of small veins in the liver)
what can make senecio’s pyrrolizidine more toxic
time of year
geography
storage conditions and length (decreases over time)
pyrrolizidine alkaloids: cause hepatovenocclusive disease
what is white willow bark similar to
Aspirin
do not give to cats
what are adulterants
meds added to “herbals” and not put on list of ingredients
garlic, ginkgo and ginseng can interact with
warfarin and cause increased bleeding
kava can interact with
alprazolam and cause sedation
st john’s wart can interact with
Paroxetine: serotonin syndrome
Warfarin: decrease in clotting activity
Digoxin: reduced plasma concentrations
pennyroyal oil works by
Causes direct damage to target cellular proteins and depletes hepatic glutathione levels
used for:
* orally: abortifacient, digestive tonic, diuretic;
* topically: insect repellant, antiseptic
clinical signs of pennyroyal oil toxicity
Depletes hepatic glutathione levels and causes direct cellular damage similar to acetaminophen toxicity
Large doses: miscarriage, irreversible kidney damage, hepatic damage, and death
Topically, pennyroyal can cause a urticarial rash and dermatitis
treatment of pennyroyal toxicity
decontamination and symptomatic supportive care.
Possibly n-acetylcysteine. (NAC)
white willow bark works by
may have analgesic, anti- inflammatory, and antipyretic effects. Willow bark inhibits platelet aggregation, but to a lesser degree than aspirin.
clinical signs of white willow bark toxicity
GI upset, salicylate poisoning (e.g., CNS toxicity, acid-base disturbances, fluid and electrolyte imbalances, coagulopathy)
Cats are especially sensitive to salicylates (aspirins)
CNS depression, vomiting, GI hemorrhage, hyperpnea, pyrexia
treatment for white willow bark toxicity
decontamination, symptomatic supportive care, sodium bicarbonate
garlic MOA
inhibits platelet function, increases fibrinolytic activity, decreases blood lipid levels, lowers blood sugar
herbal use: infections, heartworm treatment, flea repellant (po), general health tonic
clinical signs of garlic toxicity
affect GI, hematopoietic
system → GI irritation, platelet dysfunction (bleeding)
Cats are especially at risk for Heinz body anemia
treatment of garlic toxicity
decontamination and
symptomatic supportive care
clinical signs of tea tree oil (melaleuca) toxicity
ataxia, incoordination, weakness, tremors, altered behavior
MOA of comfrey
binds to proteins, DNA and RNA
causing cell damage and death. May be carcinogenic.
Uses: (topically): wound healing, joint inflammation; GI upset, cough, cancer
pyrrolizidine alkaloid that oral use was banned by FDA
clinical signs of comfrey toxicity
hepatic failure
treatment of comfrey toxicity
decontamination and symptomatic supportive care. Early use of n-acetylcysteine may be of benefit.
MOA of st johns wort
natures prozac
inhibits monoamine oxidase and serotonin reuptake (similar to SSRIs or MAOIs); topically: inhibits epidermal inflammatory response
Uses: anti-inflammatory (topically), phobias, anxiety, depression
st john’s wort toxicity
affects uptake of serotonin and monoamine oxidase
photosensitivity, serotonin syndrome (muscle rigidity, confusion, diarrhea, HTN, tachycardia)
Many drug interactions
MOA of kava kava
may act as a central dopaminergic receptor antagonist; local anesthetic
used for anxiety
acts as sedative
clinical signs of kava kava toxicity
hepatic failure (unknown mechanism), alteration of CNS transmission
ataxia, sedation, extrapyramidal effects, jaundice, fatigue, elevated LFTs
germany, UK and Canada have banned kava due to risks of liver toxicity
treatment of kava kava toxicity
decontamination and
symptomatic supportive care
Germany, UK and Canada have banned kava due to risks of liver toxicity
