herbal

Question 1

How can you tell a supplement from medicine

Answer 1

Supplement is more gentle, diluted, and has less ADE. multichemical, and consistent quality and purity
Medicine has an active constituent, toxicity, and ADE;s

Question 2

What does the DSHEA legislation say

Answer 2

Allow structure and function statements
Permit FDA oversight in manufacturing process
Require ingredient list and amount
Applied to herbs, minerals, and vitamins

Question 3

The DSHEA legislation does NOT

Answer 3

allow medical claims
Require safety and efficacy data
require standardization

Question 4

What are the studied herbs

Answer 4

garlic 
ginkgo biloba
Ginseng 
Echinacea purpurea 
milk thistle 
st john's wort 
black cohosh 
saw palmetto 
ephedra 
feverfew
kavakava
valerian
marijuana

Question 5

What herbs have a narrow margin of safety

Answer 5

Aconite 
pheasant's eye 
Pasque flower 
arnica 
bryony
ipecac
cinchona bark 
lily of the valley 
datura 
foxglove 
male fern 
yellow jasmine 
henbane
blueflag
mandrake
indian snakeroot
bloodroot
scotch broom 
tansy ragwort 
squill 
false hellbore 
european mistletoe

Question 6

What herbs are potentially hepatotoxic

Answer 6

Chaparral 
Comfrey 
heliotrope 
germander 
pennyroyal 
liferoot (also venoocclusive dz)

Question 7

What herbs are potentially carcinogens

Answer 7

borage
calamus
coltsfoot
sassafras

Question 8

Are herbs safe?

Answer 8

most are safe with mild and infrequent ADE

ADE can occur and manufacturers have no regulatory responsibility to ensure safety of their products

Question 9

Do herbs ned to be regulated

Answer 9

legally, they do not need FDA approval
label claims are vague and confusing
products from different manufacturers vary considerably

Question 10

You are about to start a patient on warfarin but he/she tells you that they eat garlic with every meal and bate in it (wtf). What should you tell them in regards to the garlic soap (topical) before starting them on warfarin

Answer 10

Reduce the use of topical garlic!

Question 11

In what type of patient would a Ginkgo Biloba trial be appropriate

Answer 11

patient suffering from dementia

Question 12

What is not an appropriate use of ginseng

Answer 12

lupus

Question 13

why do many people use echinacea purpurea

Answer 13

to fight the common cold and URI’s

Question 14

what is a major contraindication for milk thistle

Answer 14

allergy to chamomile

Question 15

what is a potential ADE of st john’s wort

Answer 15

photosensitivity

Question 16

what lab test should you order prior to administering black cohosh

Answer 16

LFT’s

Question 17

which herb can be used to treat BPH

Answer 17

saw palmetto

Question 18

A 25-year-old female presents to the ED for evaluation after suffering a generalized tonic-clonic seizure. Seizure lasted 1 minute and was witnessed by her boyfriend. Patient did not lose bowel or bladder control during episode. She reports she is feeling better, but still feels like her heart is racing. Patient reports that for the past two weeks she has been taking a weight loss pill given to her by her friend in attempt to get ready for her upcoming pageant. What diet pill do you suspect the patient had been taking?

Answer 18

Ephedra (ma huang)

Question 19

what is a common use for feverfew and what is a possible side effect seen with use

Answer 19

used for migraine prophylaxis

common ADE: allergic contact dermatitis

Question 20

if a pt takes >250 mg of Kava per day (max daily dose), what is a serious ADE that can occur

Answer 20

Liver failure

Question 21

Valerian root extracts are used to induce sleep and improve sleep quality. valerian may enhance the ADE of what drug

Answer 21

Benzodiazepines

Question 22

Cannabidiol, an active chemical in marijuana, has been aproved by the FDA to treat what condition

Answer 22

specific seizure conditions in those 2+ y/o