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Summer Pharm (2016) ** > Herbals > Flashcards

Flashcards in Herbals Deck (25)
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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

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

3
Q

____ # of americans taking herbs

____% of patients use herbs do not report use preoperatively

A

70 million

70 %

4
Q

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

A

14

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

6
Q

Valerian

anesthetic considerations

A

Sedative, anxiolytic, sleep aid

Avoid with barbs, opioids, benzos

SE: headache, ataxia

Can develop withdrawal (cardiac abnormalities, delirium)

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)

8
Q

Gingko

anesthesia considerations

A

Inhibits platelet aggregation and platelet-activating factor

used to improve cognition

SE: BLEEDING, headache, dizzy

enhances other anticoagulants

9
Q

Garlic

anesthesia considerations

A

Inhibits platelet aggregation, increased fibrinolysis

SE: BLEEDING, especially with other anticoagulants, HYPOTENSION

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

11
Q

Saw Palmetto

anesthesia considerations

A

Inhibits COX and platelet dysfunction, BLEEDING

Used for BPH

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

13
Q

Echinacea

anesthesia considerations

A

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

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

14
Q

Melatonin

anesthesia considerations

A

Sedative effects, controls sleep-wake cycle

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

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

16
Q

Can cause hepatotoxicity

A

Kava Kava

Echinacea

17
Q

Can cause hypoglycemia

A

Ginseng

Echinacea

Melatonin

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

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

25
Q

avoid with MAOIs

A

St John’s Wort

Ephedra