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71 Cards in this Set
- Front
- Back
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Depression herbals
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st john, SAMe
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memory improvement herbals
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ginkgo
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blood circulation herbals
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gingko
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anxiety herbals
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kava, passion flower
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sleeplessness herbals
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valerian, hops
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part of st jon
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stem, leaves, flower
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st john wort name
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Hypericum perforatum
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rubbing petals of st john
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becomes red, active hypericin
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where is hypericin?
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in dots on leaves
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who used st johns in past?
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dioscurides, pliny, hippocrates
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other uses of st johns
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wound-healing, diuretic, sedative, analgesic, painkiller, anthelmintic
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standardizaiton of st jon
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flavonoids (12%) (flavonols, flavones, biflavonoids)
hypericin 0.3% hyperforin 3% |
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What extract of st johns wort is used in trials?
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LI 160 in methanol
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What was wrong with st jon wort vs imipramine study?
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too low dose of imipramine
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what is common problem of study with st john wort?
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including severe depression
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what is rec dose of st jon wort?
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900mg/day (div TID?)
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DI of st john
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digoxin, amitriptyline, nortriptyline, SSRI, phenprocoumon, indinavir, cyclosporin, ethinylestradiol+desogestrel
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MOA of DI st jon
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increase PGP, induce 3a4
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what compound determines extent of DI with st john wort?
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hyperforin (still works fine)
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What is external SJW used for?
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wound healing, increases epithelization
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SE of SJW
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insomnia, vivid dreams, anxiety, agitation, GI upset, fatigue, dry mouth
photosens if OD |
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SE vs synthetics for SJW
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10x less with SJW
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when to d/c SJW before surgery?
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72 hrs
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what is SAMe?
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s-adenosynl L methionine, transfers methyl group and causes >100 biochem rxns, decreased linked to depression, needs to be enteric coated
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uses for SAMe
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depression, arthritis/joint conditions, fibromyalgia, liver diseases, sz, migraine
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agency for healthcare research and quality review concluded on SAMe
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3 wks tx sign. improvement in depressions vs placebo
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when do benefits of SAMe appear?
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2-4 wks
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dosage SAMe
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400-1600 mg/day in div doses
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SAMe DI
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levodopa decreases effectiveness, serotonergic drugs increases risk of serotonin syndrome
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SAMe AE
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generally well tol, SE more with higher doses, hypomania in pts with bipolar d/o, hyperhomocysteinemia
constip, N/V/D, nervous sweat, insomnia |
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SAMe CI
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pregnancy/lactation, bipolar, elevated homocysteine
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part of gingko
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leaves
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key compounds of gingko
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terpene lactones: ginkgolides, biolobalide
flavonoids: quercetin glycosides, kaempferol, isohamnetin gonkgolic acids (allergies) |
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how much ginkgolic acids allowed?
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<5 ppm (extracts should be free)
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historical use of gingko
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HTN, anti-asthma, antitussive, bladder inflammation, impotence (men)
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past part of gingko used
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fruits and nuts
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Present use of gingko
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delay of age related dementia, inhibits platelet activating factor
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stardardized extract of gingko
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EGb 761:
24% flavonoids, 6% terpenoides, 5-10% organic acids (acetic acids, shikimic acid, 4-hydroxybenzoic acid) |
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Problem with new studies on gingko
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can't use severe dementia pts
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how long for gingko to be effective?
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6m
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what test used for gingko?
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psycometric
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benefit of gingko vs snthetic
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sign. lower SE (1.69% vs 5.42%)
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MOA of gingko
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releases vasodilators (NO), decreases blood viscosity, increases microcirculation
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herbal used for intermittent claudicaiton
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gingko
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herbal used for tinnitus
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gingko
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ginkgo's effect on PAF
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balances overproduction that comes from poor food selection, stress
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other positive efffects of gingko
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increase NT release, antioxidant, prevent free rads
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dosage of ginkgo
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120-240mg div into 2-3 doses
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DI with ginkgo
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Asa, coumadin, vioxx, desyrl (trazadone)
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SE of gingko
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bleeding (esp eye), stop 72 hrs before surgery
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what is vinpocetine
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synthetic derivative of vincamine, which is found in periwinkle (vinca minor), but is manipulated in lab!
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DI with vinpocetine
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blood thinners
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use of vinpocetine
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studying (alertness)
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use of hyperzine A
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AD
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MOA of hyperzine A
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Inhibits acetylcholinesterase
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huperzine A vs synthetics
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huperzine lasts 3h longer
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Dose of huperzine a
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AD: 50-200 mcg BID
memory improvement: 100 mcg BID |
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isomer to use of huperzine A
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negative
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Herbal only studied in china and saftey being studied now
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huperzine A
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DI with huperzine A
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MAOI: HTN crisis
other AcEI |
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AE of huperzine A
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cholinergic: SLUDGE, sz, hrt rthym changes
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CI of huperzine A
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bradycardia, MI, PD, asthma
(may worsen bladder conditions, BPH, bronchitis, emphysema,ulcers), pregnancy & lactation |
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science name of kava kava
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Piper methysticum
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parts of kava use
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roots
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ingredients of kava
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kavalactones: kavain, yangonin, mthysticin
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how is kava supplied?
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capsule, dried root powder/extract, tab
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use for kava
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anxiety, stress, insomnia, restlessness
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as effective as BZD?
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yes
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MOA of kava
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binds BZD receptor, GABA
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long use of kava may cause
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skin discoloration or allergy
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Concern of kava
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liver tox
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