Herbals Flashcards

1
Q

Because herbals are FDA regulated as a food instead of a drug, what is not regulated (what do consumers lack info on)?

A

If there are active ingredients

If ingredients are bioavailable

If dosage is appropriate

If each bottle has the same components

If the pill has any contaminants or additives

Safety studies aren’t required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are classes 1-4 of herbal safety and toxicity in the American Herbal Product Association?

A

Class 1: safe

Class 2: restrictions about pregnant/nursing

Class 3: only should be used under supervision of expert

Class 4: not enough data

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

____ # of americans taking herbs

____% of patients use herbs do not report use preoperatively

A

70 million

70 %

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

We tell patients to d/c herbals ___ days prior to surgery

A

14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Kava Kava

anesthetic considerations

A

CNS depressant, sedative, anxiolytic

Potential for addiction, tolerance, withdrawal

SE: headache, dizzy, sluggish reflex, less coordinated, HEPATOTOXICITY with long term use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Valerian

anesthetic considerations

A

Sedative, anxiolytic, sleep aid

Avoid with barbs, opioids, benzos

SE: headache, ataxia

Can develop withdrawal (cardiac abnormalities, delirium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

St Johns Wort

anesthetic considerations

A

Treats depression, like Prozac

SE: allergy, headache, dizzy, restless, additive effects with anesthesia

Interacts with MAOIs

Inducer of CP450 (interacts with indinovir, cyclosporins, digitalis, CCB, B-blockers, barbs, benzos, birth control, lidocaine, steroids, NSAIDs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Gingko

anesthesia considerations

A

Inhibits platelet aggregation and platelet-activating factor

used to improve cognition

SE: BLEEDING, headache, dizzy

enhances other anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Garlic

anesthesia considerations

A

Inhibits platelet aggregation, increased fibrinolysis

SE: BLEEDING, especially with other anticoagulants, HYPOTENSION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ginseng

anesthesia considerations

A

Lowers blood glucose, inhibits platelet aggregation, mood/energy enhancer

SE: excitation, tachycardia, headache, HTN, BLEEDING esp with other anticoags, electrolyte disturbance, HYPOGLYCEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Saw Palmetto

anesthesia considerations

A

Inhibits COX and platelet dysfunction, BLEEDING

Used for BPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ephedra

anesthesia considerations

A

Direct/indirect sympathomimetic effects, CNS stimulant, for weight loss and energy

SE: HTN, tachycardia, arrhythmias, MI, stroke, seizures, panic attack, psycosis, develop tachyphylaxis

lifethreating interaction with MAOIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Echinacea

anesthesia considerations

A

Short-term immune system stimulation, treats infections (URIs)

SE: allergic reaction, prolonged use can cause immunosuppression, HYPOGLYCEMIA, HEPATOTOXICITY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Melatonin

anesthesia considerations

A

Sedative effects, controls sleep-wake cycle

Can interact with anticoagulants, immunosuppressants, diabetic meds, birth control pills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What Carrie said to focus on:

  1. Know Barash Table
  2. Know pregnancy categories
  3. Know DEA classifications
  4. EXACTLY what is on inpatient order writing
  5. Who is responsible for what measures
  6. Needle slide Don’t worry about history stuff
  7. Know role of IRB
  8. Purpose of 3 phases, how many people in each
A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Can cause hepatotoxicity

A

Kava Kava

Echinacea

17
Q

Can cause hypoglycemia

A

Ginseng

Echinacea

Melatonin

Coenzyme Q10-increases insulin sensitivity

18
Q

can cause syndrome of central serotonin

A

St John’s Wort

avoid w/ MAOIs

19
Q

increase the effects of coumadin

A

Gingko

Garlic

20
Q

decrease the effects of coumadin

A

Ginseng

Co-Enzyme Q-10

St. John’s Wort

21
Q

can cause hypertension

A

Ephedra

Ginseng

22
Q

can cause hypotension

A

Garlic

maybe Ephedra - pts are unpredictable

23
Q

increase the risk of bleeding

A

Ginko

Ginseng

Garlic

Saw Palmetto

24
Q

prolong anesthetic effects

A

Kava Kava

Valerian

St John’s Wort

Melatonin

25
Q

avoid with MAOIs

A

St John’s Wort

Ephedra