Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
346 Cards in this Set
- Front
- Back
|
cynara scolymus = ?
|
artichoke
|
|
|
what part of the artichoke plant is used medicinally?
|
leaves
|
|
|
what is the modern medicinal use of artichoke (2)?
|
1. digestive complaints
2. mild to moderate hyperlipidemia |
|
|
key compound in artichoke?
|
caffeoylquinic acids = cynarin
|
|
|
what is the proposed MOA of artichoke to lower cholesterol levels?
|
indirect inhibition of HMG-CoA reductase
|
|
|
T/F: artichoke should be dosed once daily
|
false - it should be dosed in 2-3 divided doses. No studies have shown a benefit with once daily dosing
|
|
|
what is the dose of artichoke?
|
1800-1920 mg/d in 2-3 divided doses
|
|
|
the isolated constituent of artichoke ____, has also been used to lower cholesterol in doses of ___ to ___ mg/d
|
isolate constituent: cynarin
doses of 60 - 1500 mg/d |
|
|
Does artichoke have GRAS status?
|
yes
|
|
|
how long must one treat with artichoke to see effects?
|
4-6 weeks
|
|
|
what are the significant drug interactions seen with artichoke?
|
none reported
|
|
|
crataegus species = ?
|
hawthorn
|
|
|
which parts of the hawthorn plant are used medicinally?
|
leaves and flowers
|
|
|
what is the modern medicinal use for hawthorn?
|
Heart failure
|
|
|
the flowers and leaves of hawthorn are very high in which flavenoid?
|
vitexin
|
|
|
what are the 3 important flavenoids in hawthorn?
|
1. vitexin - leaves and flowers
2. rutin 3. hyperoside |
|
|
International standardization recommends __ to __% flavenoids of hawthorn, typically calculated as ____ (which flavenoid)?
|
0.6% - 1.5%
typically calculated as hyperoside |
|
|
besides the flavenoids, what is another key compound in hawthorn?
|
proanthocyanidins
|
|
|
what is the purpose of the proanthocyanidins in hawthorn?
|
color the flowers and fruits in the blue/red/purple spectrum
|
|
|
are the proanthocyanidins in hawthorn water- or oil-soluble?
|
water-soluble
|
|
|
the hawthorn preparations are based on ____ extracts
|
hydroalcoholic
|
|
|
Which NYHA Functional Classification is hawthorn shown to be useful in?
|
Class II
|
|
|
can hawthorn be used safely with diuretics and laxatives?
|
yes
|
|
|
what potential does hawthorn have to cause arrhythmias?
|
none
|
|
|
T/F: hawthorn is safe enough for patients with HF to self treat
|
false - they need to be treated by a licensed physician
|
|
|
which prescription medication is the MOA of hawthorn similar to?
|
digoxin
|
|
|
MOA of hawthorn:
1. increasing the force of contraction and lengthening the ___ period 2. increasing coronary blood flow and cardiac output and reducing ____ consumption 3. increased membrane permeability for ___ and ___ inhibition 4. increase in c___ to increase coronary blood flow, vasodilation and positive inotropic effects |
increasing the force of contraction and lengthening the refractory period
2. increasing coronary blood flow and cardiac output and reducing oxygen consumption 3. increased membrane permeability for calcium and phosphodiesterase inhibition 4. increase in cAMP to increase coronary blood flow, vasodilation and positive inotropic effects |
|
|
what is the recommended dose of HAWTHORN extract?
|
240-480mg/d
|
|
|
hawthorn extracts should be standardized to ___% of oligomeric procyanidines
|
18.75%
|
|
|
how long does one need to use hawthorn to see a benefit?
|
4-6 weeks
|
|
|
can hawthorn be used in pregnancy?
|
no
|
|
|
aesculus hippocastanum = ?
|
horse (ippos) chestnut (castanon)
|
|
|
what are the two main uses for horse chestnut?
|
1. chronic venous insufficiency
2. anti-edemic |
|
|
what are the 2 key compounds in horse chestnut?
|
1. terpenoid - escin
2. coumarin derivatives - aesculin |
|
|
horse chestnut products are made from the ___
|
seeds
|
|
|
horse chestnut seed extract products are normally standardized to contain __% to __% triterpene glycosides calculated as ___ content
|
16-20% triterpene glycosides calculated as escin content
|
|
|
what is the normal dose of HORSE CHESTNUT seed extract?
|
300-900 mg of a 16% extract calculated as ESCIN given in 2-3 doses
|
|
|
T/F: patients do not need any other medication or medical devices when taking horse chestnut seed extract for venous insufficiency
|
false - they must continue to wear supportive elastic stockings
|
|
|
does the FDA consider horse chestnut seed extract a safe herb?
|
no - poisonings seen in children
|
|
|
what is the toxicity of horse chestnut attributed to?
|
glycoside aesculin - causes dilation of pupils, diarrhea, vomiting, paralysis
|
|
|
do not use horse chestnut with other herbs that may affect ___ ___ because of a theoretical increase in bleeding
|
platelet aggregation
|
|
|
hypericum perforatum = ?
|
st. johns wort
|
|
|
what part of the st. john's wort plant is used medicinally?
|
flowering parts -stems, leaves and flowers
|
|
|
when rubbed between the fingers, the flowers of st. johns wort release ___ which is a ___ color
|
hypericin is a red color
|
|
|
why is st. john's wort used medicinally?
|
mild to moderate depression as an antidepressant
|
|
|
st johns wort preparations are standardized to which 3 properties?
|
1. flavenoids (12%)
2. hypericin (0.3%) 3. hyperforin (3%) |
|
|
how does st. john's wort affect the Cmax and AUC for most medications like: digoxin, amitriptyline, indinavir, cyclosporin, estrogens and warfarin?
|
decreases Cmax and AUC
|
|
|
what is the proposed MOA of St. Johns Wort?
|
increase in P-glycoprotein expression and CYP3A4 expression
|
|
|
which content of st. johns wort is responsible for the drug interactions?
|
hyperforin
|
|
|
T/F: st. john's wort is still physiologically active without hyperforin
|
true
|
|
|
which content of st. johns wort may be benefically used TOPICALLY for skin cancer?
|
hypericin
|
|
|
how effective is SJW for HIV when given orally? When used IV?
|
no efficacy shown when used either orally or IV
|
|
|
which content of SJW was studied for its role as an anti-retroviral agent for HIV?
|
hypericin
|
|
|
what is the SE seen if SJW is overdosed?
|
phototoxicity
|
|
|
dose of SJW?
|
300mg TID capsules and tablets standardized to 0.3% hypericin, and less than 3% hyperforin
|
|
|
T/F: SJW should only be given TID
|
false - it can be given QD to increase compliance
|
|
|
Can SJW be given concurrently with other antidepressants?
|
no
|
|
|
what is a consequence that may be seen when using SJW with other SSRIs?
|
serotonin syndrome
|
|
|
if a patient is undergoing surgery, how many days in advance should they stop taking SJW?
|
5 days before surgery
|
|
|
in what dosages is phototoxicity seen with SJW?
|
>900 mg/d
|
|
|
why would a patient choose to take SJW vs. a synthetic SSRI or TCA?
|
less side effects and lower cost
|
|
|
ginkgo biloba = ?
|
gingko biloba
|
|
|
ginkgo biloba extracts are made from what part of the plant?
|
dried, green whole leaves
|
|
|
gingko trees are dioecious. what is the significance of this feature?
|
separate male and female trees. only female trees produce fruit
|
|
|
which herbal plant is considered a living fossil and why?
|
ginkgo biloba - resistant to harmful insects, microorganisms, environmental toxins and radiation
|
|
|
what are the 3 key compounds of gingko biloba?
|
1. terpene lactones
2. flavenoids 3. ginkgolic acids |
|
|
what are the 4 terpene lactones found in gingko biloba?
|
ginkgolides A, B, C, J
|
|
|
which key component of gingko is responsible for the allergic responses?
|
gingkolic acids - extracts should be free of them
|
|
|
present use of gingko biloba in medicine?
|
1. delay of age-related dementia
2. inhibit platelet-activating factor 3. improve blood flow to the brain, sharpen mental focus, diabetes-related circulatory disorders and vertigo |
|
|
the chemical composition of gingko biloba should be ___% flavenoids and ___% terpenoides. It should be free of ___ ___ due to its ability to cause allergic reactions
|
24% flavenoids
6% terpenoids (ginkgolides) free of ginkgolic acids to avoid allergic reactions |
|
|
which intrinsic vasodilator does gingko biloba release that may increase blood flow and oxygen to the brain?
|
nitric oxide
|
|
|
gingko biloba has also been shown in some studies to be useful in which 2 disease states? (besides dementia)
|
1. intermittent claudication
2. tinnitus and hearing loss |
|
|
what is the recommended dosage of ginkgo biloba extract?
|
40mg TID (120mg/d)
|
|
|
T/F: it is ok to recommend using ginkgo QD instead of TID
|
false
|
|
|
ginkgo biloba extract is sometimes referred to as ___ or ___
|
GBE or GBX
|
|
|
somewhere on the ginkgo biloba label, it should read, "__:__ concentrate" and "___-free"
|
50:1 concentrate - refers to the 50 pounds of leaves needed to produce 1 pound of extract
tannin-free |
|
|
what are 4 significant drug interactions seen with ginkgo?
|
1. acetylsalicylic acid (aspirin)
2. coumadin 3. rofecoxib (Vioxx) 4. trazodone (deseryl) bleeding |
|
|
what is hyphema and with which herbal product is it seen as an adverse effect that is reversible upon d/c?
|
hyphema = bleeding in the eye. seen with ginkgo biloba
|
|
|
how long before undergoing surgery should patients stop taking ginkgo?
|
at least 36 hours
|
|
|
piper methysticum = ?
|
kava kava
|
|
|
what part of the kava kava plant is used medicinally?
|
roots
|
|
|
active ingredient in kava kava?
|
kavalactones
|
|
|
is kava kava still available on the market
|
no
|
|
|
what is kava kava used for?
|
1. treat anxiety disorders
2. stress 3. insomnia 4. restlessness |
|
|
what is the proposed MOA of kava kava?
|
alpha pyrones bind to GABA receptors similarly to benzos which leads to sedation
|
|
|
can kava kava be taken concurrently with BZDs?
|
no
|
|
|
prolonged use of kava kava can result in which skin conditions?
|
rash and discolored skin
|
|
|
the FDA is advising consumers not to take kava kava - even in small doses - due to the risk of developing severe ___ injury
|
severe liver injury
|
|
|
T/F: all forms of kava kava plants are hepatotoxic
|
false - mostly just the wild and false kava kava plants and some manufacturers do not discriminate in which plant they use
|
|
|
traditionally, only which part of the kava kava plant should be used medicinally? which part of the plant may contain harmful substances?
|
traditionally, the roots are used medicinally. the stems may contain harmful substances
|
|
|
what is the toxic substance found in kava kava stems?
|
pipermethystine
|
|
|
dose of kava kava?
|
200mg/d for extracts with about 30-80% kavalactones
|
|
|
how many mg of kavalactones are desired per dose of kava kava?
|
70mg
|
|
|
patients should avoid doses of >___ mg kava kava
|
>300mg
|
|
|
valeriana officinalis = ?
|
valerian
|
|
|
what part of the valarian plant is used medicinally?
|
root
|
|
|
medicinal uses for valerian?
|
1. insomnia
2. restlessness 3. nervous tension |
|
|
what is the key constituent in valerian?
|
valepotriates
|
|
|
valepotriates, the key constituent in valerian, is (stable/unstable) and thermolabile. it decomposes under (acid/alkaline/both) conditions
|
valepotriates are unstable and thermolabile under both acidic and alkaline conditions
|
|
|
what is the characteristic odor of valerian?
|
smells like old gym socks due to isovaleric acid
|
|
|
there are a few different species of valerian. which constituent is unique to valernia officinalis?
|
valerenic acid - used an as analytical marker
|
|
|
proposed MOA of valerian?
|
lignans from valerian bind to A1 (adenosine) receptors to induce slumber
|
|
|
how long before bedtime should valerian be dosed?
|
30-60 minutes
|
|
|
what is the anti-anxiety dose of valerian? what is the sleep dose of valerian?
|
anxiety: 100-200 mg
sleep: 400-600mg |
|
|
does valerian have GRAS status?
|
yes
|
|
|
theoretically, which medications should not be used with valerian due to possible interactions
|
1. BZD
2. CNS depressants |
|
|
humulus lupulus = ?
|
hops
|
|
|
what is hops used for?
|
restlessness and sleep disturbances
|
|
|
which part of the hops plant is used medicinally?
|
female flowers - hop strobiles
|
|
|
hops strobiles contain 2 bitter principles: ___ and ____
|
1. humulone
2. lupulone |
|
|
which herb may be associated with an antibiotic effect and can help with diarrhea?
|
hops
|
|
|
which herb may have estrogenic effects?
|
hops
|
|
|
what is the dose of hops?
|
0.5g as an infusion 2-4 times a day
|
|
|
passiflora incarnata = ?
|
passion flower
|
|
|
what are the medicinal use of passion flower (3)?
|
1. restlessness
2. sleep disturbances 3. generalized anxiety disorder |
|
|
what are the active compounds in passion flower?
|
unknown!
|
|
|
dose of passion flower?
|
0.5 - 2g of the drug as an infusion 3-4 times a day
|
|
|
lycopene is a carotenoid with no vitamin ___ activity
|
vitamin A
|
|
|
lycopene may be used to prevent ____
|
cancer
|
|
|
dose of lycopene?
|
30mg
|
|
|
how can lycopene affect established prostate cancer?
|
may worsen it
|
|
|
xanthophylls = ?
|
lutein
|
|
|
lutein is usually used to prevent which condition?
|
macular degeneration and prevent cataracts
|
|
|
how does beta carotene affect lycophene? lutein?
|
increases lycopene, decreases AUC of lutein
|
|
|
dose of lutein?
|
10mg/d x 12 months
|
|
|
camellia sinensis = ?
|
green tea
|
|
|
dose of green tea recommended (w/caffeine)
|
<250mg/d
|
|
|
what pregnancy category is green tea?
|
category C
|
|
|
which antioxidant regulates the body's circadian rhythm?
|
melatonin
|
|
|
how dose melatonin regulate the circadian rhythm?
|
increases GABA binding in the brain
|
|
|
what is melatonin usually used for? how is it taken?
|
jet lag; when traveling east, take 2 mg the first night and then for 3-4 days take 0.5mg
|
|
|
can melatonin be used in pregnancy?
|
no - it is CI
|
|
|
which antioxidant induces apoptosis?
|
selenium
|
|
|
how do SSRIs affect melatonin?
|
increase both endogenous and exogenous melatonin
|
|
|
what is the antioxidant that is a cofactor for DNA, RNA and protein synthesis?
|
zinc
|
|
|
dose of zinc?
|
<40mg/d
|
|
|
zinc should not be administered intra____
|
nasally
|
|
|
morinda citrifolia = ?
|
noni
|
|
|
noni contains a significant amount of ___+
|
K+
|
|
|
garcinia mangostana = ?
|
mangosteen
|
|
|
what are the 6 herbs used for weight loss?
|
1. caffeine
2. ephedra 3. guarana 4. mate 5. spirulina 6. hoodia |
|
|
dose of caffeine for weight loss
|
200 mg TID
|
|
|
how much caffeine is in a regular coca-cola? how much in a 8 oz black coffee?
|
1. coca cola = 34mg
2. black coffee = 135 mg |
|
|
which part of the ephedra plant is used for manufacturing products?
|
stem and leaf
|
|
|
another name for ephedra?
|
ma huang
|
|
|
dose of ephedra for weight loss?
|
15-20mg TID
|
|
|
paullinia cupana = ?
|
guarana
|
|
|
which part of the guarana plant contains the active ingredient?
|
seeds
|
|
|
spirulina comes from what plant?
|
blue-green algae; not effective in weight loss
|
|
|
how does hoodia cause weight loss?
|
decreases appetite
|
|
|
vitamin B1 = ?
|
thiamine
|
|
|
vitamin B2 = ?
|
riboflavin
|
|
|
vitamin B3 = ?
|
niacin
|
|
|
what vitamin deficiency can result in pellagra?
|
niacin (vitamin B3)
Pellagra - dermatitis, diarrhea and dementia |
|
|
vitamin B3 can be toxic to the ___ at high doses
|
liver
|
|
|
which water-soluble vitamin can cause flushing?
|
niacin (vitamin B3)
|
|
|
vitamin B5 = ?
|
pantothenic acid
|
|
|
vitamin B6 = ?
|
pyridoxine
|
|
|
vitamin B7 = ?
|
biotin
|
|
|
vitamin B9 = ?
|
folate
|
|
|
deficiency in folate leads to what disease state?
|
megaloblastic anemia
|
|
|
RDA for folate for men and women?
|
400 mcg/d
|
|
|
vitamin B12 = ?
|
cyanocobalamin
|
|
|
deficiency in vitamin B12 can lead to what disease state?
|
pernicious anemia
|
|
|
RDA of vitamin B12 for men and women?
|
2.4 mcg/d
|
|
|
how is cyanocobalamine usually administered?
|
IM
|
|
|
vitamin C = ?
|
ascorbic acid
|
|
|
dose of vitamin C for common colds?
|
1-3g/d
|
|
|
how does vitamin C affect warfarin levels?
|
can decrease warfarin response
|
|
|
the retinoids are which class of vitamins?
|
vitamin A
|
|
|
warfarin + vitamin A can lead to what AE?
|
increase risk of bleeding
|
|
|
vitamin D = ?
|
ergocalciferol
|
|
|
which vitamin is used to help treat Fanconi syndrome?
|
vitamin D; ergocalciferol
|
|
|
vitamin E = ?
|
alpha-tocopherol
|
|
|
vitamin K = ?
|
phytonadione
|
|
|
which amino acid is converted to nitric oxide by nitric oxide?
|
L-arginine
|
|
|
matricaria recutita = ?
|
chamomile
|
|
|
proposed MOA of chamomile for GI disoders?
|
inhibits histamine release
|
|
|
dose of chamomile?
|
400-1600mg/d in divided doses
|
|
|
glycyrrhiza glabra = ?
|
licorice
|
|
|
key compound in licorice?
|
glycyrrhizic acid
|
|
|
main use of licorice in GI?
|
canker sores, ASA-induced stomach ulcers, PUD
|
|
|
MOA of licorice for GI disorders?
|
increases mucous production and increases blood supply to the stomach
|
|
|
licorice can cause (a decrease/an increase) in K+ and (a decrease/an increase) in Na+
|
decrease in K+
increase in Na+ |
|
|
use of licorice should be limited to how many weeks?
|
4-6 weeks
|
|
|
mentha x piperita = ?
|
peppermint oil
|
|
|
key compound in peppermint oil?
|
menthol
|
|
|
MOA of peppermint oil for GI disorders
|
relaxes GI smooth muscle by decreasing Ca2+ influx
|
|
|
there is Grade B evidence for the use of peppermint oil in which GI disorders?
|
IBS and dyspepsia
|
|
|
what product used for GI disorders is a probiotic?
|
lactobacillus acidophilus
|
|
|
zingiber officinale = ?
|
ginger
|
|
|
what are the key compounds in ginger?
|
ginger oils and gingerols
|
|
|
main GI uses for ginger?
|
chemotherapy induced nausea, post-op nausea, motion sickness and morning sickness
|
|
|
general dose of ginger?
|
1-4g in divided doses
|
|
|
key compound in aloe?
|
aloin
|
|
|
aloe has grade A evidence for its use for which GI disorder?
|
constipation
|
|
|
what is the maximum length of time a patient can use aloe for constipation?
|
7 days
|
|
|
vaccinium myrtillus = ?
|
bilberry
|
|
|
active compound in bilberry?
|
anthocyanosides
|
|
|
bilberry is used for which GI disorders?
|
1. diarrhea
2 PUD |
|
|
which herbal supplement product can be used for Crohn's Disease?
|
DHEA; dehydroepiandrosterone
|
|
|
MOA of DHEA for Crohn's Disease?
|
inhibits secretion of IL-6 and IL-12 (pro-inflammatory cytokines)
|
|
|
vaccinium macrocarpon = ?
|
cranberry
|
|
|
MOA of cranberry for GI disorders?
|
inhibit adhesion of H. pylori to gastric mucosa
|
|
|
a patient with a h/o ___ should not receive cranberry tablets for H. pylori infection
|
kidney stones
|
|
|
linum usitatissimum = ?
|
flaxseed
|
|
|
what is flaxseed used for (GI-related)
|
as a laxative
|
|
|
why does flaxseed need to be taken with plenty of water when used as a laxative?
|
to prevent gastric obstruction
|
|
|
silybum marianum = ?
|
milk thistle
|
|
|
MOA of milk thistle for GI disorders
|
regulates TNF, nitric oxide and IL-6. it increases lymphocyte proliferation, interferon gamma, IL-4 and IL-6
|
|
|
milk thistle is used for disorders of what GI organs?
|
liver and gallbladder
|
|
|
key compound in milk thistle?
|
silymarin
|
|
|
eucalyptus globulus = ?
|
eucalyptus
|
|
|
which part of the eucalyptus plant is used medicinally?
|
leaves' oils
|
|
|
what are the modern medical uses for eucalyptus?
|
adjuvant treatment of bronchitis. Symptomatic treatment of URI
|
|
|
what is the volatile oil of eucalytpus called?
|
eucalyptol
|
|
|
how much of the eucalyptol oil should a eucalyptus leaf contain?
|
about 70-85%
|
|
|
can eucalyptus be used internally? why or why not?
|
no - it may cause inflammation of the GI tract or gallbladder
|
|
|
in which patient population should eucalytpus oil not be applied to faces?
|
babies and very young children
|
|
|
mentha x piperita = ?
|
peppermint
|
|
|
which part of the peppermint plant is used medicinally?
|
the fresh overground parts - steam distillation reveals the oil
|
|
|
what are the ways that peppermint oil can be used?
|
1. orally
2. topically 3. as an inhalant |
|
|
why is peppermint used medicinally?
|
coughs and common cold - external use only
HA, myalgias - topically |
|
|
what are the 3 principle components of peppermint oil?
|
1. menthol
2. menthone 3. menthyl |
|
|
which of the 3 principle components of peppermint oil is the most abundant?
|
menthol (30%)
|
|
|
why should peppermint oil not be applied to the faces of children?
|
it has been known to cause apnea
|
|
|
menthol (peppermint oil) has been shown to cause ___ in newborn babies
|
jaundice
|
|
|
cinnamomum camphora = ?
|
camphor
|
|
|
is camphor highly lipo- or hydrophilic?
|
lipophilic
|
|
|
what is the form of camphor that is used medicinally?
|
white crystalline powder
|
|
|
what are the 3 indications for the use of camphor?
|
1. cough
2. pain 3. pruritis |
|
|
preparations of camphor for cough are used ___ and are in concentrations of less than __%
|
topical antitussive with concentrations less than 11%
|
|
|
camphor is FDA-approved for ___ (dosage form) use as an analgesic and anesthetic in concentrations of ___% to ___%
|
topical use in concentrations of 3% to 11%
|
|
|
camphor is FDA-approved for ___ (dosage form) use as an antipruritic agent in concentrations of __% to __%
|
topical use in concentrations of 3% to 11%
|
|
|
what are the ingredients of Vick's VaporRub?
|
1. 4.8% camphor (cough suppressant and topical analgesic)
2. 2.6% menthol (cough suppressant and topical analgesic) 3. 1.2% eucalyptus oil (Cough suppressant) |
|
|
why should camphor not be used orally?
|
it can cause significant toxicity within 5-90 minutes of ingestion
|
|
|
what are some symptoms of camphor toxicity?
|
1. burning of the mouth
2. visual symptoms such as mydriasis and darkening of vision 3. seizures - may be the first sign of toxicity |
|
|
can Vick's VaporRub be heated in the microwave?
|
No! it may cause severe burns and eye injuries
|
|
|
sambucus nigra = ?
|
elderberry
|
|
|
which part of the elderberry plant is used?
|
flowers and berries
|
|
|
what is elderberry used medicinally for?
|
orally for sinusitis, cold, influenza and bronchitis
|
|
|
what is the key flavonoglycoside is elderberry?
|
isoquercitrin
|
|
|
patients with which types of diseases need to avoid using elderberry?
|
autoimmune diseases like MS, lupus, and rheumatoid arthritis
|
|
|
thymus vulgaris = ?
|
thyme
|
|
|
thymus zygis = ?
|
thyme
|
|
|
what part of the thyme plant is used medicinally?
|
flowers and leaves
|
|
|
what are the 2 key compounds in thyme?
|
1. carvacrol
2. thymol |
|
|
which key compound of thyme is more abundant?
|
thymol 30-70%
|
|
|
what is thyme used medicinally for orally?
|
1. bronchitis (thymol)
2. pertussis 3. sore throat 4. counterirritant and antiseptic in mouthwash (oil) |
|
|
althaea officinalis = ?
|
marshmellow root
|
|
|
what are the key compounds in marshmellow?
|
mucilage polysaccharides
|
|
|
marshmallow contains rich stores of various vitamins and minerals such as ___ and ___
|
vitamin A and C
|
|
|
what is marshmellow used for medicinally?
|
1. dry cough
2. irritation of the oral, pharyngeal or gastric mucosa |
|
|
what is the specific way to prepare marshmellow?
|
cold maceration
|
|
|
for which type of herbs is cold maceration recommended for?
|
herbs with high mucilage content to soften the cellular structure
|
|
|
what is a significant drawback of preparing herbs via cold maceration?
|
hygenic problems; may contain germs
|
|
|
which herbs used for cough/cold have GRAS status
|
1. marshmellow
2. elderflower |
|
|
why should marshmellow herb not be taken with other medications?
|
it may delay the absorption of other drugs when taken at the same time
|
|
|
harpagophytum procumbens = ?
|
devil's claw
|
|
|
what part of the devil's claw plant is used medicinally?
|
tubers
|
|
|
what are the medicinal uses of devil's claw?
|
1. rheumatic conditions
2. arthritic conditions 3. low back pain |
|
|
what are the 2 key compounds of devil's claw?
|
1. harpagoside
2. harpagid |
|
|
MOA of devil's claw?
|
inhibit COX-2 (NOT COX-1) and nitric oxide synthetase (modulators of inflammation)
|
|
|
dose of devil's claw?
|
oral; 2400mg/d with 60 mg/d of harpagoside
|
|
|
can devil's claw be used in pregnancy?
|
no! may have oxytocic effects
|
|
|
what are the CI to using devil's claw?
|
gastric and duodenal ulcers and gallstones
|
|
|
what is the most common SE of devil's claw?
|
diarrhea
|
|
|
salix species = ?
|
willow bark
|
|
|
key compounds of willow bark?
|
salicin; salicylic acid
|
|
|
use of willow bark?
|
1. relief of low back pain
2. symptomatic relief of mild osteoarthritic and rheumatic complaints |
|
|
dose of willow bark?
|
120 - 240 mg of an aqueous extract
|
|
|
with which other medications should willow bark not be used with?
|
those with anti-platelet and anti-coagulant effects
|
|
|
boswellia serrata = ?
|
boswellia
|
|
|
what part of the boswellia plant is used medicinally?
|
resin
|
|
|
key compounds in boswellia?
|
boswellic acids (alpha and beta)
|
|
|
medical uses of boswellia?
|
1. osteoarthritis
2. rheumatoid arthritis |
|
|
dose of boswellia used for osteoarthritis?
|
boswellia extract 333mg TID
|
|
|
uncaria tomentosa = ?
|
cat's claw
|
|
|
uncaria guianesis = ?
|
cat's claw
|
|
|
which parts of the cat's claw plant is used medicinally?
|
1. roots
2. stem bark |
|
|
key compounds in cat's claw?
|
oxindole alkaloids
1. tomentosa - tetracyclic 2. guianesis - pentacyclic |
|
|
uncaria (tomentosa/guianesis) is used for OA and uncaria (tomentosa/guianesis) is used for RA
|
OA = guianesis
RA = tomentosa |
|
|
uncaria (tomentosa/guianesis) is freeze dried
|
freeze dried = guianesis
|
|
|
what is the dose of uncaria guianesis used for OA?
|
100mg QD
|
|
|
what is the dose of uncaria tomentosa used for RA?
|
60mg QD free of tetracyclic oxindole alkaloids
|
|
|
how does cat's claw affect BP?
|
lowers blood pressure
|
|
|
how does cat's claw affect the immune system?
|
stimulates it
|
|
|
capsicum annum = ?
|
cayenne pepper
|
|
|
How is cayenne pepper used medically?
|
EXTERNALLY for treatment of painful muscle spasms in the shoulder, arm and spine
arthritis, rheumatism |
|
|
what are the key compounds in cayenne pepper?
|
capsaicinoids
|
|
|
most topical creams for pain contain ___% to ___% capsaicin concentrations
|
0.025% to 0.075%
|
|
|
can capsaicin cream be used in pregnant women?
|
yes - when used topically
|
|
|
chondroitin sulfates are similar to which synthetic medication?
|
heparin
|
|
|
what is chondroitin normally used to treat?
|
1. TMJ
2. OA of the lower back |
|
|
what is the supposed MOA of chondroitin?
|
enhances endogenous synthesis and prevents enzymatic degredation of joint glycosamnioglycans
|
|
|
after how long are significant changes in joint mobility seen when using chondroitin?
|
minimum of 1-2 months
|
|
|
concommitant use of chondroitin with ___ results in a significant decrease in the use of ___
|
NSAIDS
|
|
|
for OA, what is the typical dose of chondroitin sulfate?
|
200-400mg BID to TID or 1000-1200 QD
|
|
|
what is the main supplement-drug interaction with chondroitin?
|
warfarin (increase in bleeding)
|
|
|
What are the 4 herbs that are considered immunostimulants/adaptogens
|
1. echinacea
2. goldenseal 3. ginseng 4. eleutherococcus |
|
|
which echinacea plant (latin name) is the most common?
|
echinacea purpurea
|
|
|
which part of the echinacea purpurea plant is used medicinally?
|
aerial parts and roots
|
|
|
which major group of compound is absent in echinacea pallida?
|
isobutylamides
|
|
|
which echinacea plants have the most isobutylamides?
|
1. E. purpurea
2. E. angustifolia |
|
|
what is the MOA of the isobutylamides in echinacea?
|
1. stimulate phagocytosis
2. COX-2 inhibitor |
|
|
which compound in echinacea contributes to it's immunomodulating effects?
|
isobutylamides
|
|
|
there are caffeic acid derivatives in echinacea as well. Which caffeic acid is NOT found in E. purpurea?
|
echinaoside
|
|
|
there are caffeic acid derivatives in echinacea as well. Which caffeic acid is found in significant amounts in E. purpurea ONLY?
|
cichoric acid
|
|
|
Has echinacea shown more efficacy for prevention or treatment of the common cold?
|
treatment
|
|
|
patients with which type of dysfunction should not use echinacea?
|
those with problems with their immune system
|
|
|
What is the optimal dosage of echinacea?
|
there is none
|
|
|
when should a pharmacist recommend echinacea be taken?
|
as soon as signs and symptoms of a cold begins
|
|
|
what is the maximum amount of time that echinacea should be used for treatment of the common cold?
|
8 days
|
|
|
what is the maximum amount of time that echinacea should be used for prevention of colds?
|
8 weeks
|
|
|
what is the consequence of using echinacea for an excecssive amount of time?
|
decreased resistance to cold viruses
|
|
|
does echinacea stimulate or depress the immune system?
|
stimulates
|
|
|
hydrastis canadensis = ?
|
goldenseal
|
|
|
what is goldenseal used for?
|
immunostimulant
|
|
|
which parts of the goldenseal plant is used medicinally?
|
dried root and rhizome
|
|
|
what are the key compounds in goldenseal?
|
isoquinoline alkaloids
1. hydrastine 2. berberine |
|
|
there is primary evidence that goldenseal may stimulate which immunoglobulin antibody production?
|
IgM
|
|
|
what is the typical dosage of goldenseal?
|
none
|
|
|
why should goldenseal not be used in pregnancy?
|
the compound berberine has been shown to cause uterine contractions
|
|
|
what is an adaptogen?
|
something that fights stress
|
|
|
what are the 2 important adaptogen herbs?
|
1. ginseng
2. eleuthercoccus |
|
|
what are the 2 types of ginseng?
|
1. asian ginseng
2. north american ginseng |
|
|
panax ginseng = ?
|
asian ginseng
|
|
|
panax quinquefolius = ?
|
north american ginseng
|
|
|
what is the medicinal part of the ginseng plant used?
|
root
|
|
|
what are the key compounds in ginseng? (generally)
|
ginsenosides
|
|
|
is ginseng a stimulant or a depressant?
|
stimulant
|
|
|
ginseng extracts are not recommended for continuous use beyond ___ months without discontinuing for ___ month
|
3 months, 1 month
|
|
|
with which dosage is ginseng abuse syndrome seen?
|
>15 g
|
|
|
what is the normal dose of ginseng?
|
200-600mg of ginseng extract standardized to >0.5% ginsenosides
|
|
|
eleutherococcus senticosus = ?
|
eleutherococcus
|
|
|
which part of the eleutherococcus plant is used?
|
root
|
|
|
what is the main compound in eleutherococcus?
|
eleutherosides
|
|
|
eleutherococcus is also known as ____ ginseng
|
siberian
|
|
|
Which antioxidant was once used as an abortificant and should not be used in pregnant women?
|
Noni
|
|
|
What are some uses of mangosteen?
|
antioxidant - intestinal health, UTI, TB
|
|
|
What is the interaction between mangosteen and SSRIs?
|
increase in SSRI effects due to serotonin blockade
|
|
|
How is mangosteen commonly used?
|
as a juice in fruit or jams
|
|
|
What is a nootropic drug?
|
One that may improve dementia
|
|
|
What is an example of a nootropic herb?
|
gingko biloba - help to treat dementia
|
|
|
Which severities of dementia should gingko biloba be used in?
|
all forms: severe, mild and moderate
|
|
|
Which herbal supplement antagonizes platelet-activating factor?
|
gingko biloba
|
