Neutraceuticals and Herbal Medicines
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| Which type of prescription drug users are most likely to also take herbal supplements? What ethnic/sex groups are more likely to user supplements? | show 🗑
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| show | Healthy/good for you; arthritis, memory improvement, energy, immune booster, joint pain or flexibility, supplement diet, sleep aid, prostate, don't know, all others
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| show | high; 81% of patients on supplements admitted to using at least 1 medication in previous week, and women ages 65>, 12% reported taking >10 medications
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| * * What law states that herbal supplements are classified as dietary supplements? What does this mean? | show 🗑
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| * * According to the DSHEA, what 2 things is an herbal supplement manufacturer responsible for? | show 🗑
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| show | Does not provide a standard for the evidence needed; does not require submission of evidence to FDA; manufacturer permited to claim product affects structure of body though CAN'T CLAIM IT CAN TREAT SPECIFIC DISEASE + CAN'T SAY FDA APPROVED
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| * * If the FDA claims a product made by a manufacturer is unsafe, who has the burden of proof to show safety? Quality? Efficacy? | show 🗑
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| show | Contaminants, lack of formulary standardization (amounts of active ingredient vary greatly), interactions with prescription drugs (often increase metabolism or act synergistically); Side effects common
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| show | Pesticides, heavy metals, microorganisms, microbial toxins, prescription medications
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| What is ginkgo (Ginkgo biloba) used for? | show 🗑
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| What other drugs can ginkgo (Ginkgo biloba) interact with? What can result from each? | show 🗑
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| show | Hear palpitations, upset stomach, headache, dizziness, nausea, diarrhea, constipation; seizures in diabetics; fertility problems (CONTRAINDICATED IN PRG WOMEN + bleeding disorders or surgery); leaf ok, but seed may be toxic
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| What is kava kava (piper methysticum) used for? | show 🗑
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| What can kava kava interact with? | show 🗑
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| What are some of the possible side effects of kava kava? | show 🗑
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| What is saw palmetto (Serenoa repens) used for? | show 🗑
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| What is the proposed mechanism of action of saw palmetto? | show 🗑
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| What are the possible interactions of saw palmetto? | show 🗑
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| show | dizziness, diarrhea, fatigue, abdominal and headache; may cause impotence; ocassional ACUTE PANCREATITIS, LIVER FAILURE, FATAL PERIOPERATIVE HEMORRHAGING
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| show | insomina, anxiety; sleping aid (with less side effects); safe and gentle with some effectiveness; mechanism (?): increase GABA release, inhibit GABA reuptake, inhibit GABA-degrading enzyme and contains exogenous GABA (blood brain barrier, though...)
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| What are some of the possible interactions of valerian? | show 🗑
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| What are some of the possible side effects of valerian use? | show 🗑
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| What is echinacea used for? | show 🗑
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| show | May potentiate drugs metabolized by CYP3A4 or CYP1A2; interacts with econazole; may potentiate caffeine jitter by decreasing caffeine metabolism
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| What are the possible side effects of echinacea? | show 🗑
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| What are the uses of black cohosh (cimicifuga racemosa)? | show 🗑
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| show | Women with estrogen dependent medical condition (e.g. estrogen receptor positive cancer, ovarian cancer, uterine cancer, endometriosis, uterine fibroid); pregnant; breast feeding women; kidney transplant; protein S deficiency
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| show | Decreases metabolism activity of CYP2D6 substrate; atorvastatin (lipitor), cisplatin (chemo), hepatotoxic medication
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| What are some possible side effects of using black cohosh? | show 🗑
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| show | fat essential to humans; alzheimer's, gallbladder disease, elevated cholesteor, anxiety, depression, liver disease, eczema; literature says it's only good at decreaseing fat in liver and reducing hepatic fibrosis in cirrhosis
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| show | None have been recognized; generally safe, though some GI upset and abdominal pain documented
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| What is hawthorne (crataegus monogyma and C. oxyacantha) used for? | show 🗑
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| show | Monitor blood pressure and heart rate regularly; mild rash, nausea, headache, migraine, palpitations, sweating, dizzines, sleepiness, agitatio, soft stools; high doses can cause sedation, hypotension, cardiac arrthyas
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| What can hawthorne interact with? | show 🗑
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| What is creatine used for? | show 🗑
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| show | AVOID IN KIDNEY DISEASE, HIGH BP, OR LIVER DISEASE; may increase kidney damage with NSAIDs, cimetidine, probenicid, and diuretics; creatine, caffeine and ephedra may cause stroke
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| what are some possible side effects of creatine? | show 🗑
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| What is St. John's wort used for? | show 🗑
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| What is the proposed mechanism of action in St. John's wort? | show 🗑
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| show | Both by CYP3A4 AND CYP2C19
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| show | aminolevulinic acid, amitryptyline, contraceptives, cyclosporine, digoxin, fenfluramine, irinotecan, indinavir, midazolam, nefazodone, neviripine, paroxetine, sertraline, simvastatin, tacrolimus, theophylline, and warfarin, ANTI-DEPRESSANT
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| What are some possible side effects of using St. John's wort? | show 🗑
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| What should you do if a patient asks you about the proper dosage for an herbal supplement/nutraceutical? | show 🗑
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| What cytochrome do the following drug use to be metabolized: lovastatin, clarithromycin, cyclosporine, diltiazem, estrogens, indinavir, triazolam | show 🗑
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| show | CYP2D6
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| What cytochrome do the following drug use to be metabolized: clozapine, cyclobenzaprine, fluvoxamine, haloperidol, imipramine, mexiletine, olanzapine, pentazocine, propanolol, tacrine, theophylline, zileuton, zolmitriptan | show 🗑
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| show | CYP2C9
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| show | CYP2C19
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| What are the most worrying adverse effects that you should monitor with herbal supplements? | show 🗑
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| show | hepatotoxicity and renal toxicity
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| What do herbs rich in podophyllotoxin cause? | show 🗑
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| show | hepatotoxicity, neurotoxicity,
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| What does mahuang cause (ADR)? | show 🗑
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| show | hepatotoxicity, renal toxicity
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| What does aconite root tuber cause (ADR)? | show 🗑
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| What do herbs rich in colchicine cause (ADR)? | show 🗑
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| What does squirting cucumber cause (ADR)? | show 🗑
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Created by:
karkis77
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