Wk 15. Herbal Therapy

Question 1

1. Which panel is considered the expert on herbals?

Answer 1

German Commission E

Question 2

2. What are some adulterants found in herbal mixtures?

Answer 2

Lead, arsenic, mercury, ephedra, chlorpheniramine, androgens

Question 3

3. Under the Dietary Supplement Health and Education Act of 1994, botanical products can be sold as what?

Answer 3

Dietary supplements

Question 4

4. What are two statements which must be placed on the label of herbal preparations?

Answer 4

This product is not intended to diagnose, treat, cure, or prevent any disease.
This statement has not been evaluated by the FDA.

Question 5

5. In what way can labels make therapeutic claims?

Answer 5

Favorably influences body structure or function

Question 6

6. What are three standards proposed by the FDA in the Current Good Manufacturing Practices?

Answer 6

No adulterants, contaminants, or impurities
Accurate labeling of active and inactive ingredients
Quality control procedures

Question 7

7. Why is the seal of approval from the U.S. Pharmacopeia, ConsumerLab, Natural Products Association, or the NSF International important?

Answer 7

This seal denotes that the product meets the quality standards.

Question 8

8. What are five herbs that can suppress platelet aggregation and increase the risk of bleeding with anticoagulants or antiplatelet drugs?

Answer 8

Ginkgo biloba, garlic, ginger root, glucosamine, feverfew

Question 9

9. How does St. John’s wort influence the metabolism of other drugs?

Answer 9

Accelerates metabolism of other drugs

Question 10

10. Why is black cohosh used?

Answer 10

Menopause symptoms, PMS, menstrual cramps

Question 11

11. Why is black cohosh contraindicated in pregnancy?

Answer 11

Estrogenic effects

Question 12

12. Why is coenzyme Q-10 used?

Answer 12

To protect the muscles from injury from HMG-CoA reductase inhibitors (statins) and to protect muscle and nerves from damage due to deranged mitochondrial metabolism.

Question 13

13. Why is cranberry used?

Answer 13

To prevent urinary tract infections and to reduce urine odor.

Question 14

14. Why is echinacea used?

Answer 14

Oral - stimulate immune function, suppress inflammation, treat viral infections
Topical – wounds, burns, skin ailments

Question 15

15. Hic herbal remedies are related to the daisy or ragweed family?

Answer 15

Echinacea, feverfew, St. John’s wort

Question 16

16. Why is feverfew used?

Answer 16

Prevents and treats migraines.

Question 17

17. What are the lipid alterations caused by fresh garlic?

Answer 17

Decreased triglycerides, decreased LDL, increased HDL

Question 18

18. How does garlic affect blood pressure?

Answer 18

Modestly reduces blood pressure.

Question 19

19. Why is ginger used?

Answer 19

To suppress vomiting, nausea, and vertigo. To reduce pain and inflammation from chronic inflammatory conditions.

Question 20

20. What brain and gut receptors are blocked by ginger root?

Answer 20

Serotonin receptors

Question 21

21. Why is ginkgo biloba used?

Answer 21

To increase pain-free walking distances with peripheral arterial disease.

Question 22

22. How do changes in the vascular system provide ginkgo’s effects?

Answer 22

Vasodilation, decreased capillary fragility and thrombosis

Question 23

23. Why is glucosamine used? How does it work?

Answer 23

Osteoarthritis of the hip, knee, and wrist. Stimulates chondrocytes and acts as a substrate for cartilage and synovial fluid.

Question 24

24. Which salt of glucosamine is effective?

Answer 24

Glucosamine sulfate

Question 25

25. Why is green tea used?

Answer 25

Weight loss, concentration, and to prevent or slow cancers.

Question 26

26. How does green tea affect warfarin (Coumadin)?

Answer 26

The vitamin K in green tea counteracts the effects of warfarin (Coumadin)

Question 27

27. How does the replacement of gut normal flora with probiotics affect diarrhea, irritable bowel disease, and ulcerative colitis?

Answer 27

Decreases diarrhea from rotaviruses and antibiotics in children. Reduces pain and bloating in irritable bowel disease. Induces remission in ulcerative colitis.

Question 28

28. Why is saw palmetto used?

Answer 28

Relieves urinary symptoms associated with benign prostatic hypertrophy

Question 29

29. How does saw palmetto work? What is a gender-based recommendation?

Answer 29

May block androgen and alpha-adrenergic receptors or suppress inflammation. Pregnant women should not ingest.

Question 30

30. Why is soy used? What percentage of women is able to convert soy to an estrogenic compound?

Answer 30

To reduce the risk of cancer and to treat hot flashes and osteoporosis. 50%.

Question 31

31. How do soy’s effects vary in relation to women’s estrogen levels?

Answer 31

Antiestrogenic effect in women with normal estrogen levels. Estrogenic effect in postmenopausal women.

Question 32

32. Why is St. John’s wort used?

Answer 32

Relieves mild to moderate depression

Question 33

33. How does St. John’s wort affect three neurotransmitters?

Answer 33

Increases serotonin, norepinephrine, and dopamine by decreasing reuptake

Question 34

34. St. John’s wort may cause what syndrome if taken with amphetamines, cocaine, or antidepressants?

Answer 34

Serotonin syndrome

Question 35

35. Why is valerian used?

Answer 35

Promotes sleep, reduces anxiety-associated restlessness

Question 36

36. Valerian increases the availability of what neurotransmitter?

Answer 36

Gamma-aminobutyric acid (GABA) at CNS synapses. Also may act as a GABA agonist.

Question 37

37. Why should people avoid comfrey, kava, and ma huang (ephedra)?

Answer 37

Comfrey – liver damage and carcinogenic effects. Kava – liver damage. Ma huang – stroke, myocardial infarction, and death.