Herbal Preparations Flashcards

1
Q

What did the Dietary Supplement Health and Education Act (DSHEA) do?

A

Decreased regulation by FDA of herbals, minerals, vitamins

Before this, FDA could regulate, now regulation is limited

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2
Q

What restrictions are placed on herbals?

A

Basically advertising restrictions

  • -cant call it a drug
  • -cant make health claims
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3
Q

What did the Dietary Supplement and Non-Rx Drug Consumer Protection Act do?

A

required manufacturers to report serious adverse effects

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4
Q

What medical conditions can benefit from herbal medicine use?

A
Liver probs
Anxiety, insomnia
Common cold, infections
Stress, aging
Circulatory problems
Menopausal symptoms
Prostatic hypertrophy
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5
Q

Milk Thistle / Silybum marina

  • use
  • effectiveness
A

Used by alcoholics to prevent liver cirrhosis

Study in mice showed anti-inflammatory properties

  • -dec leukotrienes
  • -inhibit leukocyte migration

Clinical trials showed no decrease in liver pathology

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6
Q

Valerian / valerian officinalis

  • use
  • what form is it taken in
  • active ingredient
  • is it effective
A

Minor tranquilizer and sleep aid

Tea or extract from root

Active ingred - volatile oil, sesquiterpenes

Placebo controlled, double blind study showed effective

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7
Q

Kava / piper methystieum

  • use
  • taken as..
  • what drug does it act like
  • is it safe
A

anxiolytic, tranquilizer

tea form – water soluble

“kavalactones” bind to GABA receptor, like valium/diazepam

It is safe as a tea preparation. Some preparations use acetone to extract it. These forms are toxic to the liver

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8
Q

St. Johns Wort / hypericum perforatum

  • use
  • active ingredients
  • s/e?
  • metabolism?
A

for mild/moderate depression

active ingredients - hyperforin, hypericin
–affect brain NT like Prozac/Fluoxitene

Photosensitivity

Increases CYP3A4, 2C9, P-gp
–so some drugs will be metabolized too fast if taking this too

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9
Q

Echinacea

  • use
  • what does it do to body?
  • precautions
  • active constituents
  • s/e?
A

For common cold, flu, sore throat, etc.

Immunostimulant

  • -increases phagocytosis, stimulates T cell proliferation
  • dont use in kids or take longer than 10 days b/c can induce autoimmune conditions

active - polysaccharides, chicoric acid, alkamides

S/e minimal - GI upset, headache

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10
Q

Ginseng / panax ginseng

  • use
  • what does it do to body?
  • ingredients
A

Tonic for stress

Stimulates immune system

  • -dec incidence of colds
  • -stim B, T cells
  • -energizing effect
  • -antiplatelet

Contains triterpenoids, methylxanthines

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11
Q

Ginkgo / ginkgo biloba

  • use
  • ingredients
  • what does it do to body?
  • S/e
A

Tonic for dizziness, tinnitis
PVD (Buerger’s)
Improves circulation

Contains flavone glycosides, terpenoids

Antioxidant, antagonizes platelet activating factor, increases NO release

S/E - headache, GI upset, some bleeding

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12
Q

What do terpenes have?

A

repeating isoprene units

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13
Q

Garlic / allium sativum

  • use
  • actions
  • how is it taken?
  • inactivation
A

Used to improve circulation

Antiplatelet, fibrinolytic, antioxidant, decreases LDL oxidation

Admin - enteric coated tablets - this decreases odor and increases delivery of active ingredient

“tonic food” inactivated by heat

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14
Q

Describe the benefits of red wine

A

Contains polyphenols

Cardioprotective effect
Inc HDL, Dec LDL

Dec incidence of CHD, MI
Dec complications after MI
May vasodilate by inc NO

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15
Q

Black cohosh / cimicifuga racemosa

  • use and related benefits
  • ingredients/contents
  • safe?
A

For post menopausal symptoms

  • may prevent hot flashes, bone wasting, CV problems
  • estrogen like effect in liver, aorta, bone

Contains triterpene glycosides - “phytoesterogens”

Limit therapy to 6 mo b/c increase incidence of uterine cancer due to estrogen like effect

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16
Q

Isoflavenoids

  • use
  • what are the types?
  • benefit
A

For menopause

Types

  • phytoestrogens like genistein in red clover
    • -promensil
  • phytoestrogens in soy beans
    • -estroven

Good for blood lipids, bone

17
Q

Saw palmetto / serenoa repens

  • use (like what other drug)
  • contains?
  • MOA
A

BPH - may decrease prostate size and increase urine flow (like finasteride)

Berries contains sterols - ineffective as a tea

May inhibit 5alpha-reductase (T -> DHT)

18
Q

Cranberry / vaccinium macrocarpon

  • use
  • contains
A

Antibacterial in urinary tract

Contains cyanidins

19
Q

Vitamin C

A

Beneficial at high dose

Immunostimulant, antioxidant

20
Q

CoQ10

  • what do it do in body?
  • when do we use it?
  • what diseases does it benefit?
A

Electron carrier in mitochondria of all tissues, highest in heart, some in brain

Used in therapy of mitochondrial diseases
–e.g. Leigh’s encephalomyopathy

Some benefit in parkinson’s

21
Q

Omega-3 fatty acids

  • what does adding this to the diet do?
  • what actions does it have?
A

Decreases incidence of death from coronary events, decreases risk of stroke, beneficial in schizophrenia and depression

Membrane stabilization of heart, brain
Modulates actions of NT
Anti-inflammatory
Dec platelet aggregation

22
Q

Glucosamine

A

substrate for production of articular cartilage

23
Q

Chondroitin sulfate

A

proteoglycan may modify ECM to stabilize articular cartilage

24
Q

Used together, what do glucosamine and chondroitin sulfate do?

A

Cause a moderate improvement in pain and function in OA