Medical Pharmacology – Intro to Herbal Med (Test IV)

True or False

Currently, 40% of > 250,000 plant species have been evaluated for therapeutic potential

False (only 10%)

Define PHARMACOGNOSY
The study of natural product medicines (mostly herbs)

True or False

Synergism can be used as a case, both, FOR and AGAINST Herbal Medicine

True

For = multiple ingredients work together to give better results

Against = risk of herb-drug interactions and potentiation or potency/efficacy reduction

Which Herb-Drug interactions lead to PROLONG BLEEDING TIME?
Gingko, Garlic, Ginger, Feverfew

w/ Coumadin

Which Herb-Drug interactions lead to REDUCED INR?
Ginseng

w/ Warfarin

Which Herb-Drug interactions lead to BP FLUCTUATION?
Ginseng

Which Herb-Drug interactions lead to PROLONGED ANESTHESIA EFFECTS?
Kava, St. John’s Wort, Valerian

**stop TWO WEEKS prior to surgery

Which Herb-Drug interactions lead to LOWER BLOOD LEVELS of various meds?
St. John’s Wort

Which herb has LIVER TOXICITY side effects?
Kava

How does DSHEA dictate the FDA’s involvement in regulating herbal remedies?
Herbal products are legally food/dietary supplements, and thus OUTSIDE of FDA regulation

FDA must prove herbal products are UNSAFE to take it off the market

What are herbal remedy labels allowed and not allowed to say? What MUST they say?
Allowed to say:
– usage, effect, safety information

Not allowed to say:
– curative/specific health claims

**Must say that the product has NOT been evaluated by the FDA, and that they are not intended to treat/diagnose/cure

True or False

Toxicity is regulated by DOSAGE

False (DOSAGE and TIME)

Echniacea

Function:
Side Effects:
Caution:

Function
– immune stimulant for colds, flu

Side Effects
– nausea, hypersensitivity, headache

Caution
– avoid autoimmune states, immunosuppresant
drug use, PREGNANCY

Saw Palmetto

Function:
Side Effects:
Caution:

Function
– prostatic obstructive symptoms of BPH

Side Effects
– nausea, diarrhea, headaches

Caution
– take with meals
– avoid with hormonal therapy

Gingko Biloba

Function:
Side Effects:
Caution:

Function
– mental alertness

Side Effects
– hypersensitivity, bleeding, nausea

Caution
– Aspirin
– avoid w/ anticoagulants (Warfarin)

Kava

Function:
Side Effects:
Caution:

Function
– anxiety, stress reduction

Side Effects
– DEC reflexes and judgement
– Kava dermatitis

Caution
– HEPATIC FAILURE

St. John’s Wort

Function:
Side Effects:
Caution:

Function
– antidepressant (MILD depression only)

Side Effects
– photosensitivity
– nausea, dry mouth, restlessness

Caution
– SSRI, MAO B interactions
– Pregnancy
– induces metabolism of other drugs (CYP3A4)

Black Cohosh

Function:
Side Effects:
Caution:

Function
– phytoestrogen for menpause (suppress LH)

Side Effects
– hypotension, nausea, abortion

Caution
– contraindicated in PREGNANCY
– **can INC incidence of breast cancer

Phytoestrogens

Source:
Function:
Commercial Preparations:

Source
– naturally occurring plant sterols

Function
– helps lipids and cardiac risk
– modest estrogen effect (depresses LH)
– provide minimal vasomotor system relief in
menopause

Commercial Preparations
– Promensil
– Estroven

Aloe Vera

Function:
Side Effects:
Caution:

Function
– used for burns, superficial wounds
– antiinflammatory, antibiotic, antipruitic

Side Effects
– rare dermatitis

Caution
– avoid INJECTIONS (death)
– avoid INTERNAL USE (severe diarrhea)

Ginger

Function:
Side Effects:
Caution:

Function
– antiemetic, antispasmodic

Side Effects
– heartburn

Caution
– **anticoagulants
– pregnancy controversial

Garlic

Function:
Side Effects:
Caution:

Function
– lipid reduction, antibacterial, antifungal
– *plaque reduction

Side Effects
– dermatitis, odor, nausea

Caution
– **anticoagulants
– ulcer/reflux
– pregnancy

Ginseng

Function:
Side Effects:
Caution:

Function
– for decreased stamina, fatigue

Side Effects
– elevated BP
– nervousness, insomnia

Caution
– HTN, CV disease, diabetes
– PREGNANCY
– DEC INR

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Echinacea Description and uses Immunostimulant, anti-inflammatory, antiviral, andtibacterial Used to prevent and treat colds, flu, wound healing, UTI Echinacea Side effects/contraindications immune suppression, tingling sensation, unpleasant taste on tongue, N/V, allergic reactions – watch airway and give antihistamines if allergic …

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