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systemic pharmaco > Complementary & Alternative Medicine > Flashcards

Flashcards in Complementary & Alternative Medicine Deck (16):

Mechanism of action of ginkgo biloba

1. Dilate blood vessels & decrease blood viscosity - enhances blood flow
2. Scavenge free radicals & limits formation
3. Suppresses platelet-activating factor (which mediates bronchospasm & platelet agg)


Uses of ginkgo biloba (4)

1. CNS related (memory disorders - Alzheimer's, headache, tinnitus, vertigo, difficulty concentrating, mood disturbances, hearing disorders)
2. Peripheral vascular disorders (claudication, Raynaud's syndrome - painful response to cold)
3. Erectile dysfunction
4. Eye problems


Toxicity & drug interactions of ginkgo biloba (2+3)

1. GIT (nausea, constipation)
2. CNS (headache, dizziness, vertigo - increases with rapid increase in dosage)

1. Suppresses coagulation (do not take with antiplatelet/coagulants - will cause bleeding)
2. Affects isozymes of CYP450 enzymes - may promote seizures (do not take with drugs which reduce seizure threshold)
3. Interacts with St John's wort to increase irritability & nervousness


Contraindications of ginkgo biloba (2) + efficacy

1. Might cause early labour in pregnant women/extra bleeding
2. Should not be used if breastfeeding

1. No evidence of significant benefit in peripheral arterial disease
2. No significant benefit in dementia/cognitive impairment


Mechanism of action of garlic (Allium sativum)

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


Uses of garlic (4)

1. Lowers BP
2. Suppresses platelet aggregation
3. Decreases atherosclerotic plaque formation
4. Increases arterial elasticity


Toxicity & drug interactions of garlic (2+2)

1. GIT (nausea, vomiting, diarrhea, flatulence)
2. Burning sensation in the mouth

1. Risk of bleeding esp in patients w aspirin, warfarin, clopidogrel, ginkgo biloba
2. Increased breakdown of anti-HIV drugs eg efavirenz, nevirapine


Contraindications of garlic (2)

1. Inflammatory bowel disease (potential cause GIT irritation)
2. Asthma


Mechanism of action of glucosamine

- Orally - absorbed & distributed to joints - incorporated into glycosaminoglycans in the cartilage matrix & synovial fluid of joints

1. Stimulates activity of chondrocytes to generate more cartilage
2. Suppresses production of cytokines that mediate joint inflammation & cartilage degradation


Uses of glucosamine

1. Osteoarthritis of knees, hip, wrist joints


Toxicity of glucosamine (2)

1. GIT (nausea, heartburn, diarrhea, constipation)
2. Drowsiness, headache, skin reactions (uncommon)


Drug interactions & contraindications of glucosamine (2+3)

1. Avoid use with warfarin - increases its effects, slows clotting - bruising/bleeding
2. Anti-cancer drugs effectiveness might be decreased

1. Shellfish allergy
2. Asthma
3. Pregnancy/breastfeeding


Mechanism of action of St John's wort (Hypericum perforatum)

Hypericin & hyperforin increase brain levels of neurotransmitters (likely serotonin) that affect mood


Uses of St John's wort

1. Improve depressive symptoms in patients with mild to moderate dementia


Toxicity of St John's wort (5)

1. Allergic dermatitis (esp those allergic to plants of the same family)
2. CNS (anxiety, agitation, dizziness, insomnia, irritability, restlessness)
3. Dry mouth
4. GIT discomfort
5. Photodermatitis (high dose)


Drug interactions & contraindications of St John's wort (3+1)

1. Increases activity of cytP450 enzymes - increases breakdown, decreases effectiveness of oral contraceptives, cyclosporine, warfarin, anti-HIV drugs
2. Induction of P-glycoprotein in cells lining the intestine & renal tubules - transport protein - increase renal excretion of digoxin
3. Enhanced effects of serotonin when taken with conventional anti-depressant drugs which also increases serotoninergic transmission eg SSRIs, tricyclic anti-depressants, monoamine oxidase inhibitors

1. Safe in children <12 but doubtful in pregnancy (teratogenic in rats)