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Anesthesiology > Herbal Supplements > Flashcards

Flashcards in Herbal Supplements Deck (10):
1

Garlic

- inhibits platelet aggregation
- can increase the risk of perioperative bleeding, especially if the patient is taking other anticoagulants or NSAIDs.
- recommended that garlic be discontinued 1 week before surgery due to potential for irreversible inhibition of platelet function.

2

Valerian

- Used to assist in sleep
- potentiates benzodiazepine effect
- Abrupt discontinuation can lead to a withdrawal syndrome similar to that associated with chronic benzodiazepine use.
- Suggested that valerian be tapered over several weeks.
- If tapering is not possible, it should not be discontinued until the day before surgery.

3

Herbal supplements that increase the risk of bleeding:

garlic
gingko
ginseng
ginger
saw palmetto

4

Saw palmetto

- Used to treat symptoms associated with BPH
- Has been associated with excessive intraoperative bleeding
- attributed to its anti-inflammatory effects and platelet dysfunction.

5

St John's Wort

- Used to treat mild to moderate depression.
- Believed to be a MAOi and inhibits the reuptake of monoamines.
- A Cyp2c19 inducer and can prolong effects of anesthesia
- Can prolong the effect of clopidogrel in nonresponders
- Reduces the effect of warfarin and heparin

6

Gingko biloba

Associated with excess bleeding. Contains compounds that alter vasoregulation, act as antioxidants, modulate neurotransmitter and receptor activity, and INHIBIT platelet activating factor.

7

Ginger

Has been used to treat nausea, but has antiplatelet effects and may cause perioperative bleeding, especially when combined with aspirin or NSAIDs.

8

Kava

An anxiolytic or sedative widely used as a CNS depressant, potentiates the effects of benzos and may prolong effects of anesthesia

9

Ginseng

Decreases postprandial glucose levels and can cause hypoglycemia, potentially irreversible effect on platelets

10

Ephedra

Stimulant and bronchodilator, dose dependent increase in HR and BP