Alternative Therapies

Question 1

natural coumarin derivatives

Answer 1

anise, celery, chamomile, fenugreek, red clover

Question 2

natural salicylates

Answer 2

meadowsweet, poplar, willowbark

Question 3

antiplatelet action

Answer 3

garlic, ginkgo biloba

Question 4

hypocoagulability- short lived fibrinolytic action

Answer 4

capiscum

Question 5

inhibits 3A4

Answer 5

bitter orange

Question 6

inhibits 1A2 and intestinal 3A4; induces 3A4

Answer 6

echinacea

Question 7

inhibits 1A2 and 2D6

Answer 7

ginkgo biloba

Question 8

inhibits 2D6

Answer 8

ginseng

Question 9

induces 1A2, 3A4, 2C9

Answer 9

St. Johns Wort

Question 10

This list of drugs is impacted by which CYP?:

duloxetine, fluvoxamine, frovatriptan, mexiletine, olanzapine, ropinirole, tacrine, tizanidine and zileuton

Answer 10

1A2

Question 11

This list of drugs is impacted by which CYP?:

amitriptyline, codeine, desipramine, dextromethorphan, metoprolol, oxycodone, tamoxifen, timolol

Answer 11

2D6

Question 12

This list of drugs is impacted by which CYP?:

verapamil, cyclosporine, protease inhibitors, midazolam, simvastatin, atorvastatin, tacrolimus, tamoxifen, triazolam

Answer 12

3A4

Question 13

This list of drugs is impacted by which CYP?:

ARBs, NSAIDs, oral hypoglycemics, warfarin

Answer 13

2C9

Question 14

antagonize immunosuppressants like azathioprine, corticosteroids, cyclosporine, tacrolimus

Answer 14

echinacea and ginseng

Question 15

stimulant effects may oppose sedatives and produce additive actions with epi, phentermine, pseudoephedrine, nicotine or amphetamine

Answer 15

caffeine and green tea

Question 16

contains estrogen-like compounds; long-term use could increase the risk of women developing cancer of the lining of the uterus

Answer 16

red clover

Question 17

increased mean PSA doubling time (effective in treatment of prostatic cancer); CYP3A4 inhibitor; increase rhabdomyolysis with statins

Answer 17

pomegranate juice

Question 18

prevent/treat UTI or H. pylori infections, or prevent dental plaque (antioxidant/anticancer activity); side effects: GI upset or diarrhea

Answer 18

cranberry

Question 19

which vitamins antagonize warfarin?

Answer 19

E and K

Question 20

potent antioxidant (role in maintaining healthy muscle, low serum levels in Parkinsons); hypertension; ischemic heart disease (improvements observed in HDL cholesterol, exercise tolerance); structural similarity with vit. K resulting in possible reduction in warfarin activity

Answer 20

Coenzyme Q10

Question 21

serves as a cartilage nutrient; used for pain associated with knee osteoarthritis; sulfate and hydrochloride forms are available (hydrochloride is ineffective); clinical trials inconclusive

Answer 21

glucosamine

Question 22

serotonin derivative; re-sets body “clock” after jetlag; metabolized by CYP1A2; decrease M/F fertility and breast milk production; interacts with SSRIs and antagonizes effects of antipsychotics

Answer 22

melatonin

Question 23

good evidence of decreasing BPH symptoms w/o shrinking prostate

Answer 23

beta-sitosterols

Question 24

may provide benefit in CV disorders, lower LDL, lower blood sugar, boost immune system and antimicrobial agents and enhance response to flu vaccine

Answer 24

ginseng

Question 25

supplement for mental health: combine with antidepressant; wont work alone

Answer 25

folic acid

Question 26

supplement for mental health: modestly effective in slowing decline---equivalent to AchE inhibitor; additive with AchE inhibitors

Answer 26

ginkgo biloba

Question 27

supplement for mental health: as effective as older TCAs; boost effectiveness of SSRIs

Answer 27

SAMe (s-adenosyl-L-methionine)

Question 28

supplement for mental health: fewer adverse effects than BNZs; useful for sleep/anxiety in children with ANHD

Answer 28

valerian

Question 29

supplement for mental health: boost effectiveness of antidepressants; may trigger mania in bipolar disorder-use with mood stabilizer

Answer 29

omega 3 FA

Question 30

supplement for mental health: works in mild/moderate symptoms of depression; possible alternative medication in children/adolescents

Answer 30

St Johns wort

Question 31

supplement for mental health: improves sleep quality in patient with schizophrenia, major depression and seasonal affective disorder; alternative to drugs in children/elderly

Answer 31

melatonin

Question 32

mineral: enhances insulin action, carb fat and protein metabolism; no proven effects in diabetes, lipid metabolism or body weight/composition; B blockers, corticosteroids, insulin, nicotinic acid and NSAIDs may be enhanced or may increase absorption

Answer 32

chromium (found in broccoli)

Question 33

mineral: important antioxidants preventing free radical damage; cancer: some studies show beneficial effects in prostate, colorectal, lung; HIV: deficiency associated with reduced immune function-may by a significant predictor of survival

Answer 33

selenium (found in brazil nuts)

Question 34

mineral: important cofactor for >300 enzymes, including SOD, involved in protein and carb metabolism; lowers severity of childhood diarrhea in 3rd world; increased healing of gastric ulcers; decreases symptoms of sickle cell anemia

Answer 34

zinc (found in beef, fish, spinach)