Herbals

Question 1

glucosamine/chrondoiton negatives

Answer 1

higher doses enhance effects of warfarin, 2 year study showed no effect on pain compared to placebo

Question 2

Echinnacea interactions

Answer 2

possible CYP3A4 inhibitor, interfere with immunosuppressants; no difference in symptoms

Question 3

Ginseng side effects

Answer 3

Steven johnson syndrome, may lower blood glucose values, enhance effectiveness of anticoagulants, use only short term 3 months; decrease effectiveness of amitriptyline

Question 4

Gingko bilboa side effects

Answer 4

stomach disturbances, headaches, dizziness,palpitations, vertigo, allergic skin reactions, bleeding

Question 5

St. John’s wort side effects

Answer 5

inducer of CYP3A4, CYP2C9, CYP1A2, avoid in pregnancy or lactation

Question 6

Black cohosh

Answer 6

may inhibit CYP2D6, hepatotoxic drugs, avoid w/ breast cancer, liver function test monitoring, max of 6 months

Question 7

Saw palmetto

Answer 7

used for BPH, may take 1-2 months to show effectiveness

Question 8

melatonin interactions

Answer 8

minor bleeding with wafarin; fluvoxamine increses bioavilability, avoid with immunosuppressants

Question 9

Tools for Evaluating CAM

Answer 9

Natural Medecines, Alt MedDex, Natural Standard, Quackwatch.com