Exam 5 Herbal Medicines

Question 1

What is an important screening question?

Answer 1

Do you use herbal supplement instead of or as an adjunct to conventional treatments?

Question 2

Most popular products used by adults for health reasons?

Answer 2

fish oil/omega 3/DHA
glucosamine
echinacea
flaxseed oil or pills
ginseng

Question 3

52% of respondents said they used what types of supplements?

Answer 3

multivitamins
vitamins E and C
calcium
B-complex vitamins

Question 4

Mean age of individuals taking supplements?

Answer 4

71.4 years

Question 5

What is polypharmacy?

Answer 5

taking more than 1 type of medication

Question 6

What is polyherbacy?

Answer 6

taking 2 or more herbal products

Question 7

Prevalence of polypharmacy?

Answer 7

72.3% (almost 3 quarter)

Question 8

Prevalence of polyherbacy?

Answer 8

16.2%

Question 9

What percentage at risk of having at least 1 possible drug and herbal-supplement interaction?

Answer 9

31.5% (almost a 1/3)

Question 10

Herbal products and dietary supplements used?

Answer 10

glucosamine
garlic
echinacea
gingko biloba
herbal tea
cod liver oil
St John's wort
ginseng
saw palmetto

Question 11

Most common reasons for older adults to take herbal stuff?

Answer 11

improve general wellness
help manage arthritis
prevent/manage colds
improve memory

Question 12

Greatest number of reported interactions with HDS?

Answer 12

warfarin (most)
insulin
aspirin
digoxin
ticlopidine

Question 13

HDS products containing ____ were more likely to have documented interactions with meds and contraindications than vitamins, minerals and other types of dietary supplements.

Answer 13

herbs

Question 14

Patients using medications that have a _____ = greater risk for adverse outcomes because of HDS-drug interactions?

Answer 14

narrow therapeutic range

Question 15

2 examples of meds with narrow therapeutic range?

Answer 15

warfarin

digoxin

Question 16

Many herbs act as ___ and ___ medications and patients are ___ of these effects?

Answer 16

anti-platelet
anticoagulant
unaware

Question 17

Common herbs: ginkgo, garlic, ginseng, ginger antagonize ___?

Answer 17

platelet activating factor

Question 18

What should be discontinued before surgery?

Answer 18

all herbal medicines

Question 19

How many days before surgery should all herbal meds be discontinued?

Answer 19

14 days

Question 20

When “g” is followed by a ____, the herb is associated with a bleeding effect?

Answer 20

vowel

Question 21

Neumonic for herbs and bleeding?

Answer 21

Few G’s

Question 22

Name some herbs linked to bleeding?

Answer 22

Few G's
feverfew
ginkgo biloba
ginger
garlic
ginseng

Question 23

Garlic components implicated with bleeding?

Answer 23

Ajoene
Allicin
Sulfur containing compounds

Question 24

Defined as inhibits production and/or release of chemical mediators?

Answer 24

antiplatelet

Question 25

MOA for garlic antiplatelet?

Answer 25

inhibits production and/or release of chemical mediators: platelet activating factor adenosine

Question 26

Ginkgo components implicated in bleeding?

Answer 26

Terpenoids

Question 27

MOA for ginkgo antiplatelet?

Answer 27

increase prothrombin time and decreases platelet activity

Question 28

What should you not use with ginkgo for the severe risk for spontaneous bleeding

Answer 28

aspirin and warfarin

Question 29

Ginseng component implicated in bleeding?

Answer 29

ginsenosides

Question 30

MOA for ginseng antiplatelet?

Answer 30

inhibit PAF, platelet aggregation, thrombin and thromboplastin

Question 31

Ginseng + __? = potential bleeding?

Answer 31

aspirin NSAIDS warfarin heparin

Question 32

Ginger components implicated in bleeding?

Answer 32

pungent principles volatile oils proteolytic enzymes

Question 33

MOA for ginger antiplatelet?

Answer 33

reduces platelet thromboxane, inhibits platelet aggregation

Question 34

Feverfew causes what?

Answer 34

irritation of oral mucosa and tongue

Question 35

Major active antidepressive constituents in St. John's wort?

Answer 35

hyperforin | hypericin

Question 36

St. John's other biologically active consituents?

Answer 36

flavonoids | tannins

Question 37

St. John's wort component implicated in bleeding?

Answer 37

hypericin

Question 38

MOA for St. John's wort?

Answer 38

induces some cytochrome P450 liver enzymes | reduces anticoagulant effect of warfarin (increases clotting) and lowers the INR

Question 39

Vitamin E use?

Answer 39

fat soluble vitamin

Question 40

Vitamin E is an ____?

Answer 40

antioxidant

Question 41

Vitamin E may alter what?

Answer 41

vitamin K's effect on clotting factors

Question 42

Echinacea use?

Answer 42

common cold, cough, and bronchitis

Question 43

Echinacea is ____, especially if used with other meds that are also ____.

Answer 43

hepatotoxic

Question 44

Echinacea may decrease effectiveness of ____?

Answer 44

corticosteroids

Question 45

Feverfew use?

Answer 45

``` migraine prophylaxis fever reducer anti-inflammatory RA muscle soreness ```

Question 46

Feverfew inhibits ____?

Answer 46

platelet activity

Question 47

Up to 15% of Feverfew users may develop ___?

Answer 47

aphthous ulcers

Question 48

Feverfew may cause irritation to ___?

Answer 48

oral mucosa/tongue

Question 49

When is Feverfew contraindicated?

Answer 49

pregnancy

Question 50

Kava-kava use?

Answer 50

anxiety stress relief minor tranquilizer skeletal muscle relaxant

Question 51

Kava-kava potentiates what?

Answer 51

CNS effects of other CNS depressants?

Question 52

Kava-kava may interfere with what drugs?

Answer 52

alcohol, BDZ's, barbituates, sedatives, general anesthesia

Question 53

Kava-kava contraindications?

Answer 53

pregnancy lactation Parkinson's disease

Question 54

Licorice use?

Answer 54

gastric disorders antitussive aphthous ulcers herpes simplex

Question 55

Licorice may cause ___?

Answer 55

hypertension

Question 56

Licorice may alter ___?

Answer 56

platelet aggregation

Question 57

Licorice contraindications?

Answer 57

pregnancy lactation liver or renal impairment

Question 58

Valerian use?

Answer 58

mild sedative mild anxiolytic: anxiety depression insomnia

Question 59

Valerian potentiates effects of ___ including ___?

Answer 59

CNS depressants | barbiturates

Question 60

Dentists must seek alternative analgesics because of synergistic effects with ___?

Answer 60

aspirin | NSAIDS

Question 61

Monitor patients taking ___?

Answer 61

warfarin

Question 62

Dentists must cross-reference all herbal and prescription medications prior to prescribing to ensure ___?

Answer 62

compatibility