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Clinical Methods > Herbal Medicines > Flashcards

Flashcards in Herbal Medicines Deck (33):
1

Dietary supplements a special category under dietary medicines. True or false?

False,

Dietary supplements a special category under food – NOT drugs.

2

The FDA is responsible for safety of dietary supplements.  True or false?

False.  

The manufacturer is responsible for safety.  The FDA is responsible for taking action if there is a problem.

3

What are considered dietary supplements? (5)

Vitamins
Minerals
Amino acids
Botanicals: herbals or extracts
Glandular extracts from animals or synthetics

4

What types of pts typically use herbals and dietary supplements? (8)

Female
Former or non-smokers
Higher incomes
Exercise regularly
Educated beyond high school
Generally good health
Presurgical patients
Patients with:  cancer, liver disease, HIV, asthma, rheumatologic disorders

5

What are the primary uses for aloe? (3)

digestion

cathartic (laxative properties)

burns, infections, wounds

6

What is the potential concern for those taking aloe?

Hypokalemia due to diarrhea.

7

What are two uses for echinacea? 

URIs

flu

8

What is the primary concern for those taking echinacea?

Drug toxicity!

It inhibits CYP3A4, so there is an increased risk for drug toxicity for drug metabolized by this enzyme.

 

9

What drugs put pts taking echinacea at risk for drug toxicity? (3)

Xanax (alprazolam)

Calcium channel blockers

Protease inhibitors (antiviral drugs for HIV, AIDS, and Hep)

10

What are the uses for garlic? (5)

HTN
hyperlipidemia
infections
cancer prevention
atherosclerosis

11

What are the potential concerns for those taking garlic? (2)

Inhibits platelete aggregation
Induces CYP 450 (decreasing the effectiveness of drugs)

12

What is the major drug interaction for a pt taking garlic?

Warfarin, increases INR which increases risk of bleeding.

13

What are the uses of ginkgo biloba? (6)

circulatory disorders
increased mental acuity
tinnitus
vertigo
respiratory disease
sexual dysfunction

14

What are the signs of ginkgo biloba toxicity? (4)

GI discomfort
dizziness
bleeding
seizures
 

15

What are the major drug interactions for those taking gingko? (2)

Warfarin--due to increased bleeding

MAOIs

16

What are the uses for ginseng? (4)

Immunostimulation
Improve strength and stamina
DM
Menopause

17

What are the potential concerns for those taking ginseng? (5)

HTN
Tachycardia
Bleeding
CNS stimulation
Hypoglycemia

18

What are the drug interactions for those taking ginseng? (3)

Warfarin
Insulin and sulfonylureas--increases hypoglycemia
MAOIs--increases manic-like episodes

19

What are the uses of saw palmetto? (3)

BPH (benign prostatic hyperplasia)
Chronic pelvic pain
Bladder disorders

20

What are the potential concerns for those taking saw palmetto? (2)

Intraop bleeding
N/V/D

21

What drugs adversly interact with saw palmetto?

Anticoagulants

22

What are the uses of St. John's wort? (5)

Depression
Anxiety
Sleep disorders
Seasonal affective disorder (SAD)
Pre-menstrual syndrome

23

What are the drug interactions of St. John's wort? 

St. John's wort INDUCES CYP 450, 3A4, 2C9.

It alters the effectiveness of many drugs.

24

What are the drugs of concern for anesthesia for those taking St. John's wort? (3)

Calcium channel blockers

Warfarin

Digoxin

25

For pts taking St. John's wort, there have been case reports of of cardiovascular collapse after induction with fentanyl, propofol, d-tubocurarine followed by maintenance with nitrous oxide, oxygen, and isoflurane.  True or false?

true

26

What are the uses of CoQ10? (7)

CHF
CAD
HTN
Hyperlipidemia
DM
Increases energy
Antioxidant

27

What are the potential concerns/drug interactions for pts taking CoQ10? (3)

Decrease effectiveness of warfarin
Hypoglycemia
Statins--can cause a decrease in natural amounts in body

28

What are the uses of dong quai? (2)

Menopausal symptoms
Gyn issues like dysmenorrhea

29

What is the potential concern for pts taking dong quai?

Possible inhibition of platelet aggregation

30

What are the drug interactions for pts taking dong quai? (2)

Increase INR with warfarin
Possible risks with hormone meds because may have estrogen-like effects

31

What dietary supplements increase the risk of bleeding? 

Ginkgo biloba
Dong quai
Vitamin E
Garlic
Ginseng

Most everything we studied affects bleeding and Jenny stated that things that start with "G".
 

 

32

In general, when should pts discontinue herbal medicins prior to surgery?

2-3 weeks prior

33

When should garlic, ginseng, and St. John's wort be discontinued prior to surgery?

7 days