Complementary & Alternative Medicine Flashcards
1
Q
Mechanism of action of ginkgo biloba
A
- Dilate blood vessels & decrease blood viscosity - enhances blood flow
- Scavenge free radicals & limits formation
- Suppresses platelet-activating factor (which mediates bronchospasm & platelet agg)
2
Q
Uses of ginkgo biloba (4)
A
- CNS related (memory disorders - Alzheimer’s, headache, tinnitus, vertigo, difficulty concentrating, mood disturbances, hearing disorders)
- Peripheral vascular disorders (claudication, Raynaud’s syndrome - painful response to cold)
- Erectile dysfunction
- Eye problems
3
Q
Toxicity & drug interactions of ginkgo biloba (2+3)
A
- GIT (nausea, constipation)
- CNS (headache, dizziness, vertigo - increases with rapid increase in dosage)
- Suppresses coagulation (do not take with antiplatelet/coagulants - will cause bleeding)
- Affects isozymes of CYP450 enzymes - may promote seizures (do not take with drugs which reduce seizure threshold)
- Interacts with St John’s wort to increase irritability & nervousness
4
Q
Contraindications of ginkgo biloba (2) + efficacy
A
- Might cause early labour in pregnant women/extra bleeding
- Should not be used if breastfeeding
- No evidence of significant benefit in peripheral arterial disease
- No significant benefit in dementia/cognitive impairment
5
Q
Mechanism of action of garlic (Allium sativum)
A
Affects CVS
- blocks steps in cholesterol synthesis
- inhibits thromboxane synthesis, inhibiting clot formation
- interferes with calcium-dependent processes
- suppresses platelet agg
- stimulates fibrinolysis
- stimulates NO synthase - vasodilation
6
Q
Uses of garlic (4)
A
- Lowers BP
- Suppresses platelet aggregation
- Decreases atherosclerotic plaque formation
- Increases arterial elasticity
7
Q
Toxicity & drug interactions of garlic (2+2)
A
- GIT (nausea, vomiting, diarrhea, flatulence)
- Burning sensation in the mouth
- Risk of bleeding esp in patients w aspirin, warfarin, clopidogrel, ginkgo biloba
- Increased breakdown of anti-HIV drugs eg efavirenz, nevirapine
8
Q
Contraindications of garlic (2)
A
- Inflammatory bowel disease (potential cause GIT irritation)
- Asthma
9
Q
Mechanism of action of glucosamine
A
- Orally - absorbed & distributed to joints - incorporated into glycosaminoglycans in the cartilage matrix & synovial fluid of joints
- Stimulates activity of chondrocytes to generate more cartilage
- Suppresses production of cytokines that mediate joint inflammation & cartilage degradation
10
Q
Uses of glucosamine
A
- Osteoarthritis of knees, hip, wrist joints
11
Q
Toxicity of glucosamine (2)
A
- GIT (nausea, heartburn, diarrhea, constipation)
2. Drowsiness, headache, skin reactions (uncommon)
12
Q
Drug interactions & contraindications of glucosamine (2+3)
A
- Avoid use with warfarin - increases its effects, slows clotting - bruising/bleeding
- Anti-cancer drugs effectiveness might be decreased
- Shellfish allergy
- Asthma
- Pregnancy/breastfeeding
13
Q
Mechanism of action of St John’s wort (Hypericum perforatum)
A
Hypericin & hyperforin increase brain levels of neurotransmitters (likely serotonin) that affect mood
14
Q
Uses of St John’s wort
A
- Improve depressive symptoms in patients with mild to moderate dementia
15
Q
Toxicity of St John’s wort (5)
A
- Allergic dermatitis (esp those allergic to plants of the same family)
- CNS (anxiety, agitation, dizziness, insomnia, irritability, restlessness)
- Dry mouth
- GIT discomfort
- Photodermatitis (high dose)
