Exam 5 Herbal Medicines Flashcards by Sel M

What are the indications for garlic? (4)

1) Anti-lipidemic
2) Antimicrobial
3) Anti-asthmatic
4) Anti-inflammatory

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What are the indications for Ginkgo? (3)

1) Prevent decreased cerebral function
2) Peripheral vascular insufficiency associated w/ Alzheimer’s disease or age-related dementia
3) Improve memory and cognition

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What are the indications for Ginseng? (7)

1) Anti-cancer
2) Slows aging
3) Prevent heart attack
4) Improve digestion
5) Reduce hypertension
6) Strengthen immunity
7) CNS stimulant

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What are the indications for Ginger? (3)

1) Relieve motion sickness and morning sickness
2) Decrease arthritis pain and inflammation
3) Relieve upset stomach

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What are the indication for Feverfew?

1 ) Anti-inflammatory (rheumatoid arthritis)

2) Fever reduction
3) Preventative for migraine headache (prophylaxis)

4) Muscle soreness
- -Abrupt discontinuation: rebound headaches, joint pain and stiffness, anxiety.

5) Active: sesquiterpene lactone, parthenolide

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What are the indications for Fish Oils?

1) Skin disorders
2) Cardioprotection
3) Diabetes
4) Headache
5) Immune support
6) Memory
7) PMS
8) Ulcerative colitis

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What are the indications for St. John’s Wort?

1) Reduce mild to moderate depression
2) Most widely studied herb with demonstrated efficacy
3) Weed-like plant
4) Renders oral contraceptives ineffective in some users

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Major active antidepressive constituents in St. John’s wort are________ and ___________.

Other biologically active constituents: ___________ and __________

hyperforin
hypericin
flavonoids
tannins

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What is the mechanism for St. John’s Wort?

The exact mechanism = unclear

- Mechanism is believed to involve inhibition of serotonin (5-HT) reuptake

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Hyperforin is the major constituent for St. John’s Wort. It has been to _______ the uptake of _______, ________, _________ , __________ and _________

inhibit
5-HT
dopamine
norepinephrine
GABA
glutamate

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What are the indications for Vitamin E?

1) Use: fat soluble vitamin

2) Antioxidant
■ Prevents oxidation of vitamins A & C
■ Protects polyunsaturated fatty acids in membranes from free radical damage
■ Protects RBCs against hemolysis

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What is the uses for Echinacea?

dangers?

■ common cold
■ cough
■ bronchitis

○ Limit use to 10 days
○ Hepatotoxic, when used with other hepatotoxic meds

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What are the indications for Kava-Kava?

1) anxiety
2) stress relief; acts like a minor tranquilizer, skeletal muscle relaxant
- FDA monitoring for hepatotoxicity

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What are the indications for ● Licorice (Glycyrrhiza glabra)?

1) Gastric disorders
2) Antitussive
3) Aphthous ulcers
4) Herpes simplex

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What are the indications for Valerian ?

1) Mild sedative
2) Mild anxiolytic
3) Anxiety
4) Depression
5) Insomnia

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When the “g” is followed by a __________ (ex: ginkgo) the herb is associated w/ a __________ effect
○ Includes: _______, _______, ginger, _______, and __________

vowel
bleeding
feverfew,
ginkgo biloba
garlic
ginseng

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What are Garlic’s components implicated w/ bleeding?

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1) Ajoene
2) Allicin-strong odor and flavor; platelet effect is irreversible
3) Sulfur containing compounds

○Effect: Antiplatelet= inhibits production and/or release of chemical mediators:
■ Platelet activating factor
■ Adenosine (decreases platelet function)

What is Ginkgo’s components implicated in bleeding?

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1) Terpenoids
2) Potent antagonist of platelet activating facor
3) Long-lasting and rapid onset w/ oral dosing

–Effect: Antiplatelet= INCREASES prothrombin time and DECREASES platelet activity

○ Risk for severe spontaneous bleeding w/ concurrent use of aspirin + warfarin

What is Ginseng’s components implicated in bleeding?

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■ Ginsenosides

–Effect: Antiplatelet = inhibit PAF, platelet aggregation, thrombin and thromboplastin

What is Ginger’s components implicated in bleeding?

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1) Pungent principles
2) Volatile oils
3) Proteolytic enzymes
- -Effect: Antiplatelet= reduces platelet thromboxane, inhibits platelet aggregation

○ Mixed reports in literatiere
○ Most significant effects w/ raw ginger

What is Feverfew’s components implicated in bleeding?

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Effect: inhibits platelet aggregation

What is John’s Wort components implicated in bleeding?

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hypericin
Increases clotting and lowers the INR
Decreased efficacy of anticoagulants

What is Vitamin E’s components implicated in bleeding?

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May alter the effect of vitamin K on clotting factors

- Increases risk for spontaneous hemorrhage

What is Licorice’s components implicated in bleeding?

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May alter platelet aggregation

``` Fish Oils Effects: __________ platelet aggregation and________bleeding time _________fibrinolysis may ________ von Willebrand factor ________ fibrinogen _______ factor V levels _________ thrombin generation in plasma . ```

- Decrease - prolong - increase - reduce - reduce - reduce - reduce

Fish Oils: Intake of _________ or greater of omega-3 fatty acids may ________ risk of bleeding -Very large intakes of ______oil/omega-3 may ___________risk of hemorrhagic (bleeding) _________ High doses have also been associated with ______and blood in __________

- 3 grams/day - increase risk of bleeding - fish - increase - stroke - nosebleed - urine

Medications with a ______therapeutic range (ex: ______, _______) = ______ risk for adverse outcomes b/c of HDS-drug interactions -Important for patients on _________ (warfarin) who concomitantly took ______ products that had ______ or __________effects

- narrow - (warfarin, digoxin) - greater - anticoagulants (warfarin) - HDS products - antiplatelet - anticoagulant

How does Ginkgo alter effect of Warfarin?

○ Antiplatelet = increases prothrombin time and decreases platelet activity ○ Risk for severe spontaneous bleeding w/ concurrent use of aspirin and warfarin

How does Ginseng alter effect of Warfarin?

○ Antiplatelet = inhibit PAF, platelet aggregation, thrombin and thromboplastin ○ Potentiates bleeding w/ aspirin, NSAIDs, warfarin, heparin

How does St. John's Wort alter effect of Warfarin?

1) Induces cytochrome P450 liver enzymes | 2) Reduces anticoagulant effect of warfarin (increases clotting) and lowers INR

How does Vitamin E alter effect of Warfarin?

-Interacts with warfarin: increases -hypoprothrombinemia= delays clotting and increases risk for spontaneous hemorrhage

Dental considerations: Synergistic drug effects w/ ______, _________: seek _________ analgesics ● Monitor patients on _______ for herbal use and ______ appropriately ● Cross-reference all herbal and prescription medications to _____ ___________________using a database (LexiComp for Dentistry)

``` -aspirin NSAIDS -alternative -warfarin -counsel -ensure - compatibility ```

What is the dental implication of | Echinacea?

May decrease effectiveness of corticosteroids

What is the dental implication of | Feverfew ?

○ Up to 15% of users may develop aphthous ulcers ○ May cause irritation of oral mucosa/tongue ○ Contraindicated in pregnancy ○ Increases risk for photosensitivity

What are the dental implication of | Feverfew ?

- Potentiates CNS effects of other CNS depressants: alcohol, BDZs, barbituates, sedatives, general anesthesia = caution w/ sedation dentistry - Contraindicated in pregnancy lactation and Parkinson’s disease (may cause dopamine antagonism)

What are the dental implication of Licorice??

1) May cause hypertension: (monitor vital signs) | 2) Contraindicated in pregnancy, lactation, liver or renal impairment

What are the dental implication of St. John's Wort??

○ General anesthetics= patient difficult to awaken ○ Increases photosensitivity or tetracyclines ○ Reduces effect of glucocorticoids

What are the dental implication of Valerian?

○ Causes drowsiness and sedation | ○ Potentiates the effects of CNS depressants, including barbiturates

What are the dental implication o Vitamin E

○ May alter the effect of vitamin K on clotting factors | ○ hypoprothrombinemia

What is the rationale for discontinuing herbal supplement use 2 weeks prior to surgical procedures?

● All herbal medicines should be discontinued for 14 days prior to surgery (including oral surgery) ● Common herbs: ginkgo, garlic, ginseng, ginger -Antagonize platelet activating factor

Describe the rationale for discontinuing herbal supplement like John’s Wort?

1) DECREASES effects of many medications 2) Multiple drug interactions 3) General anesthetics= patient difficult to awaken 4) DECREASED efficacy of anticoagulants

Exam 5 Herbal Medicines Flashcards

(41 cards)