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365 Cards in this Set
- Front
- Back
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According to the articles on regulatory issues, all of the following except one are good arguments in favor of stricter regulation of botanical medicines? Which one is not a good argument? |
CORRECT: Excessive prices for commercial herbal products INCORRECT:
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*List examples of expectorant herbs and describe their function. |
Increase ciliary activity, reduce mucus viscosity; liquefy pulmonary secretions EX: Eucalyptus, thyme |
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* List examples of mucilaginous herbs and describe their function. |
Form protective coating EX: Mullein, Marshmallow, Plantain |
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* What condition(s) are the tannin-containing herbs helpful in addressing? |
Acute diarrhea |
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* What herbs were formerly FDA-approved over-the-counter laxatives, but have since been disapproved due to modern efficacy and safety research? |
Cascara & Aloe |
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* What constituent of licorice can raise BP, so is removed in some preparations? |
Glycyrrhizin |
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* What does a carminative do in the digestive system? |
Carminative: relieve bloating and fullness |
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* What does a cholagogue do in the digestive system? |
Cholagogue: promote bile production |
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* What does a bitter do in the digestive system? |
Bitter: stimulate gastric secretions |
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* Which botanicals have caffeine as a significant constituent? |
Guarana, mate, black and green tea |
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* What are the pharmaceutical medications with which St. John’s wort is most likely to interact in a significant way? |
SSRIs, protease and reverse transcriptase inhibitors, anticoagulants, immunosuppressants |
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* What is the relationship between alliin, alliinase, and allicin in the pharmacokinetics of garlic? |
Allianase acts on alliin to produce allicin |
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* What does it mean for an herbal to “potentiate” a pharmaceutical medication? What precautions need to be taken in cases like this? What herbals are most known for potentiating anticoagulant medications? |
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* Discuss the history and evolution of the German Commission E and the development of its monographs on botanical therapeutics |
The commission E was appointed by a government agency to review phytotherapeutic agents for efficacy and safety |
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* What is a “declared content” on a botanical label and why is it important with potentially toxic herbals? |
Name of each ingredient and what it contains |
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* Describe current supplement labeling regulations regarding health claims and structure/function properties of herbs. |
In the U.S., the label can describe an effect on the structure or function of the body if supported by a reasonable amount of scientific evidence Therapeutic claims cannot be made on the label or in the package insert |
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* What is an enteric coated capsule? In what ways can they be helpful and at what point should they be used in relation to a meal? |
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* What is standardization about and what are its main purposes? |
Standardization guarantees the content of one or more active constituents and marker compounds |
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Tincture |
common preparation using alcohol or alcohol+water to produce extracts of a wide variety of herbs and herb combinations |
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Syrups |
especially useful for giving botanical medicines to children |
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Medicinal Oils |
alcohol-free preparation that would be expected to contain only lipid-soluble components |
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Medicinal Spirits |
a solution of a volatile substance in alcohol of alcohol+water |
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Plant Juices |
made from fresh plant parts and contain water-soluble components |
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Infusion |
water poured boiling over herb and covered, steeped 10 minutes, then strain |
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Decoction |
covered with water, boiled, simmer 10 minutes, strained |
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Maceration |
covered with room temperature water, stands 6 hours, strained |
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* Know the major pharmaceuticals drugs derived from herbs as covered in class and what the originating herbal is. |
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* What are the key arguments AGAINST increasing regulation of botanical medicines in the United States? |
-difficult to reach the proof for medical efficacy |
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* What are the key arguments FOR increasing regulation of botanical medicines in the United States? |
-many herbal products contain undisclosed prescription or over-the-counter drugs and heavy metals -standardizing herbal preparations promotes batch-to-batch consistency -more responsibility on the manufacturers of dietary supplements (evidence of good manufacturing practices) -ensuring what’s on the label is what’s inside -lack of routine reporting of adverse events -interactions between herbs and drugs |
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According to the articles on regulatory issues, all of the following except one are good arguments in favor of stricter regulation of botanical medicines? Which one is not a good argument? |
CORRECT: Excessive prices for commercial herbal products INCORRECT: - Interactions between herbs and drugs - Adulteration of some preparations with drugs - Lack of routine reporting of adverse events Lack of standardization among herbal preparations |
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Which one of the following is not a difference between the US and European countries such as Germany regarding the status of herbal medicines? |
CORRECT: The U.S. has always led the way worldwide in the development and testing of botanical medicine products INCORRECT: - Herbal medicines are subjected to more regulation in European countries such as Germany. - Herbal products are regulated as dietary supplements in the US. - Herbal medicines have higher stature in medical education and clinical practice in European countries such as Germany. |
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Digoxin is isolated from... |
Foxglove leaf |
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Codeine is isolated from... |
Opium poppy |
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Aspirin is isolated from... |
Willow bark |
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Quinine is isolated from... |
Chinchona bark |
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A typical botanical extract can be expected to concentrate active substances from the dried herb by how much in terms of an herb-to-extract ratio? |
5:1 |
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What is the volatile oil content of typical herbs that contain such oils? |
1-2% |
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Which of the following, if any, is not one of the factors that can affect the content of active constituents of medicinal herbs. |
All of these factors affect the content of active constituents of medicinal herbs:
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True or False: Standardization of botanical preparations is simply a process of adjusting chemistry to produce the desired content. |
False |
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Choose the correct statement about the use of solvents for preparing botanical extracts. |
Correct Answer: Aqueous extracts are high in polar compounds while alcohol extracts are high in lipophilic constituents INCORRECT:
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T or F: Using marker compounds to adjust the quality of botanical extracts can always be expected to guarantee consistent therapeutic potency of the product |
False |
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Which of the following, if any, is not true regarding fingerprint chromatograms? |
ALL ARE TRUE:
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Which of the following, if any, is not an advantage of coated tablets over uncoated tablets? |
CORRECT: Reduces the cost of the product INCORRECT: - Masks any unpleasant tastes of active ingredients |
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When should enteric-coated tablets or capsules be taken? |
At least 1 hour before a meal |
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State TWO alternate terms for lozenges? |
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Botanical product labels in the US are allowed to describe the purpose of the product according to which one of the following rules? |
Can describe an effect on the structure or function of the body if supported by a reasonable amount of scientific evidence. |
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Indicate all of the correct statements below regarding the German Commission E. |
CORRECT: The Commission E was appointed by a government agency to review phytotherapeutic agents for efficacy and safety INCORRECT: - Commission E monographs only review single herbs and preparations made from them - The Commission E continues to gather and review monographs today - - The Commission E monographs are only available in German language editions |
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The European Union relies on which agency to update critical information about phytomedicines? |
European Scientific Cooperative on Phytotherapy |
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T or F: The authors of our text present data showing that the placebo effect does not account for much of the therapeutic effect of treating disorders such as widespread pain, insomnia, gastric symptoms, and depression. |
False |
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When a study reports only the change in outcome within each group, this is called a __________ comparison, and is a common error that may fail to detect a __________. |
When a study reports only the change in outcome within each group, this is called a before & after comparison, and is a common error that may fail to detect a large placebo effect. |
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According to the Natural Standard Evidence-Based Validated Grading Rationale described in the file Important Terms in Botanical Medicine Research, what evidence grade would be given if any one of these criteria were met: 1) Evidence of benefit only from 1 small randomized controlled trial (RCT) of inadequate size and quality of design, or 2) Conflicting evidence of benefit from multiple RCTs with no clear benefit from the better designed trials, or 3) Evidence of benefit only from observational studies and non-randomized trials with no basic science supporting evidence, or 4) Support only from basic science evidence or theory. |
C (Unclear or conflicting scientific evidence) |
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What is the latin binomial for garlic? |
Allium sativa |
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What is the latin binomial for Indian guar? |
Cyamopsis tetragonolobus |
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What is the latin binomial for red yeast? |
Monascus purpureus |
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What is the latin binomial for onion? |
Allium cepa |
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What specific part of Allium saliva is used in botanical medicine? |
bulb |
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What specific part of Avena sativa is used in botanical medicine? |
seed coat (bran) |
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What specific part of Allium cepa is used in botanical medicine? |
bulb
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What specific part of Ginkgo biloba is used in botanical medicine? |
leaf |
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Which two botanicals have been shown to increase walking distance in subjects with peripheral arterial disease? |
Allium sativa Ginkgo biloba |
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Which of the following is true about the relationship of alliin, alliinase, and allicin? |
Allianase acts on alliin to produce allicin |
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Match the garlic preparation with the correct description: garlic powder |
used in most clinical trials |
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Match the garlic preparation with the correct description: garlic oil |
steam distillation product subject to enzymatic & thermal breakdown of active constituents
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Match the garlic preparation with the correct description: aged garlic |
fermentation product subject to degradation of active constituents |
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Which of the following, if any, is NOT a therapeutic effect of garlic demonstrated in at least some clinical studies? |
All of the following are therapeutic effects demonstrated in some studies:
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T or F: According to human research, garlic can reduce platelet aggregation after a few days of treatment. |
False |
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What is the daily intake of alliin associated with successful lipid-lowering in most clinical studies using garlic powder? |
About 6 -10 mg |
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Which two adverse effects should be monitored in patients taking garlic? |
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What is the most likely mechanism for the effects of guar gum on blood cholesterol? |
Inhibition of cholesterol uptake from the gut |
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What is the most likely mechanism for the effects of red yeast rice on blood cholesterol? |
Inhibition of cholesterol synthesis |
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What is the most likely mechanism for the effects of garlic on blood cholesterol? |
Inhibition of cholesterol synthesis |
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Which of the following is the family of active constituents associated with red yeast rice? |
Monacolins |
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Which two adverse effects should be monitored in patients taking red yeast rice? |
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According to the National Institutes of Health article, garlic has been found to interfere with the effectiveness of what type of drug? |
an HIV drug |
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Which of the following is the most accurate list of possible side effects of ginkgo biloba? |
Correct: headache, nausea, gastrointestinal upset, diarrhea, dizziness, or allergic skin reactions INCORRECT:
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Large amounts of a dangerous toxin are found in which ginkgo preparation? |
roasted seeds |
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What is the latin binomial for witch hazel? |
Hamamelis virginiana |
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What is the latin binomial for German chamomile? |
Matricaria recutita |
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What is the latin binomial for evening primrose? |
Oenotherae biennis |
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What is the latin binomial for pineapple (bromelain)? |
Ananas comosus |
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What is the latin binomial for comfrey? |
Symphytum officinale |
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What is the latin binomial for tea tree oil? |
Melaleuca alternifolia |
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Which specific part is used in botanical medicine? Calendulas |
flower |
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Which specific part is used in botanical medicine? Arnica |
flower |
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Which specific part is used in botanical medicine? Camomile |
flower
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Which specific part is used in botanical medicine? Evening primrose |
seed oil
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Which specific part is used in botanical medicine? Witch hazel |
leaves, twigs, & bark
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Which specific part is used in botanical medicine? Comfrey |
leaves & root
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Name the active constituent: Evening primrose oil |
gamma-linolenic acid |
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Name the active constituent: Witch hazel |
tannins
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Name the active constituent: Camomile |
apigenin |
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Name the active constituent: Tea tree oil |
(+)-terpinen-4-ol |
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Name the active constituent: Camomile |
alpha-bisabolol |
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Name the active constituent: Arnica |
helenalin |
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The health condition for which it has promising or good evidence as a therapeutic intervention: Bromelain |
post-operative or post-traumatic swelling, especially of the nose & paranasal sinuses |
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The health condition for which it has promising or good evidence as a therapeutic intervention: Aloe vera |
Psoriasis & genital herpes
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The health condition for which it has promising or good evidence as a therapeutic intervention: Tea tree oil |
cutaneous fungal infections
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The health condition for which it has promising or good evidence as a therapeutic intervention: Witch hazel |
hemorrhoidal disease
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The health condition for which it has promising or good evidence as a therapeutic intervention: Evening primrose oil |
atopic eczema |
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Comfrey products should have declared content of what potentially-toxic constituent? |
unsaturated pyrrolizidine alkaloids |
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Which botanical medicine may potentiate the effects of anticoagulant and platelet-inhibiting medications? |
Bromelain |
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A German product containing which herb has shown positive results in the treatment of several types of skin disorders, including decubitus ulcers? |
Chamomile |
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Which preparation of aloe vera is suitable for topical treatment of skin conditions? |
gel |
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An anti-inflammatory product called Phlogenzym (marketed in North America as Wobenzym PS) contains several ingredients, one of which is ___________. |
bromelain |
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Which botanical is used both topically as an extract in tinctures, ointments, and oils as well as orally in homeopathic dilutions? |
arnica |
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Which botanical agent may increase the potency of certain antibiotics? |
bromelain |
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What is the latin binomial name? Devil's claw |
Harpagophytum procumbens |
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What is the latin binomial name? Frankincense |
Boswellia serrata |
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What is the latin binomial name? Feverfew |
Tanacetum perthenium
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What is the latin binomial name? Butterbur |
Petasites hybridus
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What is the specific part used for pain in botanical medicine? Devil's claw |
tuber
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What is the specific part used for pain in botanical medicine? Boswellin |
gum resin
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What is the specific part used for pain in botanical medicine? Willow |
bark
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What is the specific part used for pain in botanical medicine? Peppermint |
essential oil from leaf
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What is the specific part used for pain in botanical medicine? Feverfew |
leaf
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What is the specific part used for pain in botanical medicine? Butterbur |
rhizome |
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What is the proposed active constituent or licensed standardized extract? Feverfew |
parthenolide |
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What is the proposed active constituent or licensed standardized extract? Cayenne |
capsaicinoids |
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What is the proposed active constituent or licensed standardized extract? Willow bark |
salacin |
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What is the proposed active constituent or licensed standardized extract? Devil's claw |
iridoid glycosides |
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What is the proposed active constituent or licensed standardized extract? Butterbur |
Petadolex |
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In clinical trials using Harpagophytum extracts with standardized active principle content, what is the minimum amount of harpagoside prescribed per day? |
50 mg
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T or F: Given the pharmacokinetics of harpagoside, both of the following statements are true: 1) a single morning dose could be expected to reduce symptoms within half an hour, and 2) relief should persist for the entire day. |
False |
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Persons allergic to members of the daisy family should be cautious consuming which TWO herbs? |
Feverfew & Butterbur |
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Persons sensitive to aspirin should not use which herb? |
Willow bark |
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Which TWO botanicals have been shown effective against some types of pain when used topically? |
Capsaicin & Peppermint |
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Which botanical has been shown clinically effective specifically against tension headache? |
Peppermint |
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For which TWO painful conditions have Devil's claw preparations been studied in controlled trials? |
Osteoarthritis & Chronic back pain |
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Capsaicin preparations have been studied in controlled trials for treating all of the following painful conditions except one. Which one has NOT been studied? |
Migraine headache |
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Which botanical has been found more effective as the whole dried herb than as an ethanolic extract? |
Feverfew |
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For which botanical extract is it important to have a guarantee that it is free of pyrrolizidine alkaloids? |
Butterbur |
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Interrupting which herb after taking it for a long time may result in difficulty sleeping, headaches, joint pain, nervousness, and stiff muscles? |
Feverfew |
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T or F: The traditional use of ginkgo biloba is based on medicinal use in Asia, not in Europe. |
True |
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Which part of the plant is used? Ginkgo biloba |
leaf only |
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Which part of the plant is used? St. John's wort |
leaf & flowers |
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Clinically-proven preparations are 4-7:1 concentrates: St. John's wort, Gingko biloba, or BOTH |
St. John's wort |
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Clinically-proven preparations are 35-67:1 concentrates St. John's wort, Gingko biloba, or BOTH |
Gingko biloba |
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Clinically-proven preparations are acetone-water extracts: St. John's wort, Gingko biloba, or BOTH |
Gingko biloba |
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Clinically-proven preparations are alcohol-water extracts: St. John's wort, Gingko biloba, or BOTH |
St. John's wort |
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Extracts contain phytochemicals from the flavonoid family: St. John's wort, Gingko biloba, or BOTH |
BOTH |
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Which constituent of ginkgo must be remove because it has been shown to incite allergic responses and other toxic reactions? |
ginkgolic acids |
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On which two families of constituents are medicinal ginkgo extracts standardized? |
flavonoid glycosides & terpene lactones |
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T or F: Since no pharmacokinetic studies of ginkgo extracts have been done, the amount absorbed and bioavailable is unknown. |
False |
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Inhibits synaptic reuptake of neurotransmitters: Hypericum perforatum or Gingko biloba |
Hypericum perforatum |
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Upregulates 5-hydroxytryptamine receptors: Hypericum perforatum or Gingko biloba |
Hypericum perforatum |
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Increases tolerance of brain tissue to hypoxia: Hypericum perforatum or Gingko biloba |
Gingko biloba |
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Inhibits platelet activation factor (PAF): Hypericum perforatum or Gingko biloba |
Gingko biloba |
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Reduces "behavioral despair" in animal models: Hypericum perforatum or Gingko biloba |
Hypericum perforatum |
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Increases skin reponse to the effects of UV radiation: Hypericum perforatum or Gingko biloba |
Hypericum perforatum |
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Inhibits age-related decline of choline and alpha-adrenergic receptors: Hypericum perforatum or Gingko biloba |
Gingko biloba |
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Affects brain waves evaluated by computer-analyzed EEG: Hypericum perforatum or Gingko biloba |
Gingko biloba |
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T or F: While ginkgo has been demonstrated to have value in the treatment of dementia, it has never been found helpful for improving cognitive function in non-demented subjects. |
False |
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According to the German Committee for Proprietary Medicinal Products, modern research on the efficacy of gingko biloba should assess all but one of the following categories of outcomes in patients with dementia. Which category is not a required outcome to assess? |
Subjective self-assessment of patient's mood state |
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The German Commission E determined that ginkgo extracts were indicated for all of the following except _____________. |
prevention of stroke |
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T or F: Only St. John's wort extracts with moderate to high hyperforin content have been found effective in clinical trials |
False |
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When assessing the response to antidepressant therapies using instruments such as the Hamiliton Depression Rating Scale, what percentage score improvement is considered good evidence of a meaningful response? |
50% |
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T or F: The placebo effect probaby accounts for at least 50% of the beneficial effects of St. John's wort on depression |
True |
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T orF: Lower cost and fewer adverse effects are two distinct advantages of either ginkgo or hypericum extracts over pharmaceutical medicines typically prescribed for dementia or depression, respectively. |
True |
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T orF: Marked improvement in depressive symptoms can be expected to occur withing one to two weeks of therapy with hypericum extracts. |
False |
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St. John's wort may interact significantly with which of the following types of drugs? (choose all of the correct answers) |
Anticoagulants |
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What is the Latin binomial name of Kava? |
Piper methysticum |
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What is the Latin binomial name of Hops? |
Humulus lupulus
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What is the Latin binomial name of Lemon balm? |
Melissa officianlis
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What is the plant part primarily used in Kava? |
rhizome |
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What is the plant part primarily used in Valerian? |
root
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What is the plant part primarily used in Lavender? |
flowers only, any gender |
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What is the plant part primarily used in Hops? |
stobiles (female flowers)
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What is the plant part primarily used in Lemon balm? |
leaf
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What is the plant part primarily used in Passion flower? |
aerial parts, including fruits
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What is the active constituent of Valerian? |
sesquiterpenes |
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What is the active constituent of Lavender? |
linalyl acetate and cineol |
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What is the active constituent of Kava? |
pyrones |
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What is the active constituent of Hops? |
humulone and lupulone |
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What is the active constituent of Lemon balm? |
geranial, ceral, and rosmarinic acid |
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Which medicinal herb has been studied primarily as aromatherapy? |
Lavender
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Human clinical studies of kava have tested extracts with varying amounts of active constituents; what is the highest percentage content of actives tested? |
70%
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Which potential adverse reaction to kava has led to a product recall in Europe and a public warning issued by the US FDA? |
Liver damage
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T orF: Aqueous and ethanol extracts of valerian root are equivalent in the quality of their actions. |
False |
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Which subspecies of Valerian is recommended for use in valerian preparations? |
officinalis |
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Valerian products with a high content of which constituent should not be used due to potential toxicity? |
Valepotriates |
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Upon which neurotransmitter does valerian appear to exert its pharmacological effects? |
Gamma-aminobutyric acid (GABA) |
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T or F: Kuhlmann (1999) demonstrated that valerian extract had no adverse effects on the reaction time, alertness, or concentration |
True |
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T or F: Patients with sleep disturbances can expect to achieve improvement after only a few days of valerian use. |
False |
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According to our text, which two additional herbal calmatives have been tested in combination with valerian in clinical studies? |
Hops & Lemon balm |
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All of the following measures except one were affected in human studies of the effects of lavender. Which measure was not assessed? |
NOT ASSESSED: Reductions in blood markers of the stress response ASSESSED:
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What are the reported side effects of Kava? |
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What is the reported side effect of Lavender (oral use)? |
Headache, appetite changes, constipation |
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What is the reported side effect of Lavender (topical use)? |
Breast growth in young boys |
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What is the Latin binomial name of Foxglove? |
Digitalis purpurea |
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What is the Latin binomial name of Hawthorne? |
Crataegus monogyna
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What is the Latin binomial name of Horse chestnuts? |
Aesculus hippocastanum
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What is the Latin binomial name of Guarana? |
Paullinia cupana |
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Which plant part is used with the herb Hawthorne? |
leaves & flowers |
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Which plant part is used with the herb Rosemary? |
leaves only
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Which plant part is used with the herb Horse chestnut? |
seed
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Which plant part is used with the herb Butcher's broom? |
rhizome
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Which plant part is used with the herb Mate'? |
leaves only |
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What is the active constituent of Hawthorne? |
flavonoids or oligomeric procyanidins |
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What is the active constituent of Coffee & black tea? |
Methylxanthines
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What is the active constituent of Indian snakeroot? |
reserpine |
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What is the active constituent of Hoser chestnut? |
aescin |
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A combination of hawthorne extract and what essential oil was found effective for raising blood pressure in subjects with orthostatic hypotension? |
camphor oil |
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T or F: A single dose of hawthorn extract has discernible effects on subjective complaints related to cardiac insufficiency |
False |
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Indicate all of the pharmacological effects of hawthorn extracts demonstrated in preclinical research in vitro or in animal models. |
ALL:
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How does hawthorne extract differ pharmacologically from cardiac glycosides such as digitalis? |
Hawthorne is positively inotropic yet antiarrhythmic |
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All but one of the following herbs is a source of digitaloids that are not recommended for phytotherapeutic use due to their pharmacokinetic and other shortcomings. Which one? |
Foxglove |
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What is the correct description of the extraction method used to produce WS 1442, the hawthorne extract used in many clinical studies of heart failure? |
Water and alcohol extraction |
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Which medicinal herb has been studied primarily as aromatherapy for circulatory disorders? |
Rosemary |
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Which two botanicals owe their circulatory effects to the presence of caffeine and related substances? |
Guarana & Mate' |
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According to our text, what outcomes have been demonstrated in human studies of horse chestnut extract? Choose all answers that are correct. |
ALL: - Significantly reduced foot and ankle edema after a long distance airplane flight - Significantly reduced symptomatic complaints in patients with chronic venous insufficiency - Equivalence between horse chestnut extract and compression stocking therapy for reducing edema in patients with chronic venous insufficiency - Significantly reduced leg volume in patients with chronic venous insufficiency |
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Extracts of which herb were recommended in a Commission E monograph for "nervous heart conditions?" |
Motherwort |
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Esculin is a toxin that must be processed out of ___________, and is one reason why the raw or unprocessed herb should not be used. |
Horse chestnut |
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What is the Latin binomial for Wormwood? |
Artemisia absinthium |
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What is the Latin binomial forBitter orange?
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Citrus aurantium |
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What is the Latin binomial forArtichoke? |
Cynarum scolymus |
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What is the Latin binomial forTurmeric? |
Curcuma longa |
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What is the Latin binomial forDandelion? |
Taraxacum officinalis
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What is the Latin binomial for Caraway? |
Carum carvi
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What is the Latin binomial forWild candytuft? |
Iberis amara |
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What is the Latin binomial for Licorice?
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Glycyrrhyza glabra |
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Which plant part is used for Wormwood? |
Aerial parts (leaves & flowering tops) |
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Which plant part is used forGentian? |
Root & rhizome
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Which plant part is used for Artichoke? |
Leaves only |
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Which plant part is used for Ginger? |
Rhizome only
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Which plant part is used for Caraway? |
Fruit
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Which plant part is used for Chamomile? |
Flowers |
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What is the active constituent of Peppermint? |
Menthol
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What is the active constituent of Turmeric? |
Curcumin |
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What is the active constituent of Artichoke? |
Cynarin
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What is the active constituent of Wormwood? |
Sesquiterpene lactones |
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Which mechanism of action is associated with this in the treatment of digestive tract dysfunction? Bitter
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Stimulate gastric secretionsd |
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Which mechanism of action is associated with this in the treatment of digestive tract dysfunction? Cholegogue |
Promote bile production & emptying of the gallbladder |
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Which mechanism of action is associated with this in the treatment of digestive tract dysfunction? Carminative
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Relieve bloating & fullness by facilitating gas expulsion |
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Match the herb with the digestive condition best proven to respond to its use: Artichoke
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Complaints in the upper abdomen aggravated by fat intake |
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Match the herb with the digestive condition best proven to respond to its use: Peppermint oil
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Irritable bowel syndrome
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Match the herb with the digestive condition best proven to respond to its use: Licorice
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Peptic ulcer |
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Which TWO alcoholic beverages use wormwood as an ingredient?
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Vermouth & absinthe |
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A combination of peppermint oil and which other essential oil has been shown effective for treating functional dyspepsia?
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Caraway |
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As treatment or prevention of nausea and vomiting, the effectiveness of ginger is least convincing when which of the following is the cause?
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LEAST: Postoperative
OTHER CHOICES:
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T or F: In the treatment of gastrointestinal disorders, peppermint oil given in delayed-release (enteric-coated) formulations has more clinical evidence than conventional formulations, and may be less likely to cause side effects of nausea, heartburn, and abdominal discomfort. |
False |
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Which component of licorice has mineralocorticoid-like action, and is removed in some formulations to prevent side effects of blood pressure elevation and potassium loss?
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Glycyrrhizin |
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Which herb is recommended NOT to be used in large amounts during pregnancy, based on research suggesting increased risk of preterm labor? |
Licorice |
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What is the Latin binomial for Black tea?
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Camellia sinensis |
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What is the Latin binomial for Bilberry? |
Vaccinium myrtillus |
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What is the Latin binomial for Carob? |
Ceratonia siliqua
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What is the Latin binomial for Flax? |
Linum usitatissimum
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What is the Latin binomial for Wheat? |
Triticum aestivum
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What is the Latin binomial forPsyllium? |
Plantago species
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What is the Latin binomial for Cascara? |
Rhamnus purshianus
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What is the Latin binomial for Castor? |
Ricinus communis |
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What is the Latin binomial forMilk thistle? |
Silybum marianum |
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What is the mechanism of action: Saccharomyces boulardii |
Antagonize pathogens & stimulate enteric immune system |
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What is the mechanism of action: Psyllium husk |
Bulk forming laxative |
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What is the mechanism of action: Sorbitol |
Osmotic laxative |
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What is the mechanism of action: Senna pods and leaves |
Anthranoid stimulation of intestinal mucosa |
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What is the mechanism of action: Buckthorn bark |
Anthranoid stimulation of intestinal mucosa |
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What is the mechanism of action: Aloe latex |
Anthranoid stimulation of intestinal mucosa
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Tannin-containing herbs can play an important role in the control of which health condition? |
Acute diarrhea |
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T or F: Consumption of 2 liters per day of tea by healthy subjects for four days resulted in prolonged intestinal transit time. |
True |
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The ability of apples, bananas, and carrots to help control diarrhea can be attributed to which common constituent? |
Pectins |
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According to our text, Saccharomyces boulardii has been effective for controlling or preventing diarrhea resulting from all but one of the following causes. Which one?
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Infectious diarrhea EFFECTIVE FOR:
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Which botanical is a potential source of hydrogen cyanide, but was shown not to raise blood cyanide levels in healthy subjects consuming moderate amounts over a 4-week period? |
Flaxseed |
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T or F: Wheat bran having coarse particles will be less effective for shortening intestinal transit time than wheat bran having smaller particles. |
False |
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Which type of botanical remedy for constipation is most likely to produce adverse effects of loose stools and colicky abdominal pain. |
Anthranoid-containing herbs |
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Which of the following is an FDA-approved non-prescription drug? |
Senna |
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Which TWO laxative herbs are no longer FDA-approved for use in over-the-counter medications due to lack of modern clinical and safety data? |
Cascara & aloe |
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Which botanical laxative is contraindicated in cases of biliary obstruction and other biliary disorders? |
Castor oil |
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Senna may be contraindicated in people taking either diuretics, horsetail, or licorice, due to concerns about altered blood levels of ___________. |
Potassium |
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T or F: While human trials of patients with cirrhosis of the liver have found silymarin treatment provides supportive benefits, improved survival rates have never been demonstrated. |
False |
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What part of the milk thistle plant is the typical source from which silymarin is extracted? |
Seed |
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The 2008 Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) study found that hepatitis C patients who used silymarin had which TWO of the following positive results? |
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Allergic reactions to milk thistle are more common among people allergic to all of the following except one. Which one? |
Wheat |
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What is the Latin binomial for Saw palmetto? |
Serenoa repens
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What is the Latin binomial forNettle? |
Urtica dioica
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What is the Latin binomial forPumpkin? |
Curcurbita pepo
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What is the Latin binomial for Rye? |
Secale cereale
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What is the Latin binomial forPygeum? |
Prunus africana
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What is the Latin binomial forChasteberry? |
Vitex agnus-castus |
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What is the Latin binomial forBlack cohosh? |
Cimicifuga racemosa
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Which plant part is used in Saw palmetto? |
Fruit
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Which plant part is used in Chasteberry? |
Fruit
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Which plant part is used in Nettle? |
Root and/or rhizome
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Which plant part is used in Black cohosh? |
Root and/or rhizome |
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Which plant part is used in Rye? |
Pollen |
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Which plant part is used in Pumpkin? |
Seed
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Which plant part is used in Pygeum? |
Bark |
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What are the active constituents of Uva Ursi? |
Arbutin & hydroquinone |
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What are the active constituents of Saw palmetto? |
Fatty acids & sterols |
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What are the active constituents of Pygeum? |
Phytosterols, pentacyclic terpenes, & ferulic acid esters |
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What are the active constituents of Black cohosh? |
Triterpene glycosides |
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What is the extraction features of clinically-studied preparations of Saw palmetto? |
Fat soluble extract prepared with hexane or liquid carbon dioxide
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What is the extraction features of clinically-studied preparations of Nettle? |
10:1 herb to extract ratio prepared with methanol-water solvent
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What is the extraction features of clinically-studied preparations of Pumpkin? |
20:1 herb to extract ratio prepared with ethanol |
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What is the extraction features of clinically-studied preparations of Rye? |
2.5:1 herb to extract ratio prepared with water-acetone solvent
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Which herb is recommended for bacterial inflammatory diseases of the urinary tract? |
Uva ursi
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Which herb has been best demonstrated for effectiveness against benign prostatic hypertrophy, based on the largest number of total subjects enrolled in randomized controlled trials, and comparisons with both placebo and established medical therapies? |
Saw palmetto |
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All of the following mechanisms, except one, have been demonstrated for saw palmetto extracts. Which one has NOT been demonstrated for saw palmetto extracts?
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Inhibit prostatic aromatase
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All of the following mechanisms, except one, have been identified for nettle extracts. Which one is NOT a mechanism for nettle extracts?
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Reduce blood prolactin levels
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Two of the following mechanisms have been demonstrated for pygeum extracts, one has not. Which one has NOT been demonstrated for pygeum extracts? |
Correct: Interactions with sex-hormone-binding globulin (SHBG)
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The clinical effects of chasteberry probably depend on modifying the activity of which hormone?
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Prolactin |
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A case of necrotizing hepatitis has been associated with use of which herb? |
Black cohosh |
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Which of the following is TRUE?
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Correct: People taking dopamine-related medications, such as certain antipsychotic drugs and Parkinson's disease medications, should avoid using chasteberry.
INCORRECT:
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Which of the following best describes the assumption regarding the anti-stress function of herbs such as the ginsengs?
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Correct: Expands the adaptation phase while delaying or preventing the exhaustion phase of the stress response.
OTHER CHOICES:
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What is the Latin binomial forSiberian ginseng? |
Eleutherococcus senticosus
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What is the Latin binomial forAmerican ginseng ? |
Panax quinquefolius
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What is the Latin binomial forAshwagandha? |
Withnia somnifera |
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What is the Latin binomial forCat's claw? |
Unicaria tomentosa or guianensis
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What is the Latin binomial forGotu kola? |
Centella asiatica
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What is the Latin binomial forGoldenseal? |
Hydrastis canadensis |
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Which plant part is used inGinseng and Eleuthero? |
Root
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Which plant part is used inAshwagandha, Rhodiola, and Astragalus? |
Root |
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Which plant part is used inCat's claw? |
Bark
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Which plant part is used inGotu kola? |
Leaf |
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What are the active constituents inAsian ginseng? |
Glycosidal saponins
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What are the active constituents inEleuthero? |
Lignan glycosides
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What are the active constituents inRhodiola? |
Rosavins
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What are the active constituents inGrape seed? |
Procyanidins
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What are the active constituents inEuropean mistletoe? |
Lectins
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What are the active constituents in Goldenseal? |
Berberine |
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Which two herbs were initially researched in the former Soviet Union?
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Eleuthero & Rhodiola
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Which herb originated in the Ayurvedic herbal tradition?
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Ashwagandha |
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Clinical studies of Asian ginseng before 1990, while not always meeting current standards of research methodology, suggested most of the following effects in humans. Which one of the following was NOT suggested by early clinical studies? |
CORRECT: Improved resistance to infection
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According to our text, what is the likely reason that western ginseng trials have not produced results as promising as Asian tradition and research has suggested? |
Western trials used dosages that were too low |
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According to the German Commission E monograph, all of the following uses for ginseng except one are recommended. Which one is not recommended in the monograph? |
To improve mood |
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What type of Cat's claw preparation was shown to be effective for osteoarthritis? |
Water-based extract |
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Which adaptogenic herb was specifically found to have beneficial effects when used by students during a long examination period? |
Rhodiola |
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Which of the following is not a source of "polyphenolic oligomers of the flavonoid type"? |
CORRECT: Cordyseps OTHER CHOICES:
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Which herb has been extensively studied in humans as a treatment for cancer? |
European mistletoe |
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T or F: Goldenseal is most appropriate for antimicrobial treatment of intestinal infections, not systemic infections, due to poor absorption of its active constituents. |
True |
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Which two preparations of Echinacea were approved by German Commission E? |
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Which constituent is apparently not present in expressed juice echinacea products? |
cicoric acid |
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T or F: Studies such as Dorn (1989), showing that echinacea can shorten the duration of a cold, typically give larger amounts of the preparation when symptoms first appear, followed by a smaller dosage for the remainder of treatment. |
True |
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According to our text, why may liquid echinacea preparations be more effective than solid forms that are swallowed? |
Liquid preparations may act locally on lymphoid tissues in the oropharynx |
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All of the following side effects have been reported for ginseng. According to NCCAM, which group may have been due to another herb or drug in the ginseng product? |
CORRECT: Breast tenderness, menstrual irregularities, and high blood pressure OTHER CHOICES:
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People are more likely to experience allergic reactions to echinacea if they are allergic to which of the following groups of plants? |
Ragweed, chrysanthemums, marigolds, and daisies |
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In an English study that randomized subjects with respiratory infections to treatment with antibiotics or no treatment, what determining factor predicted which patients recovered faster? |
Whether they were satisfied with their interaction with the doctor |
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What is the physiological action of a Diaphoretic ? |
Induces perspiration |
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What is the physiological action of anExpectorant? |
Increase ciliary activity, reduce mucus viscosity, liquefy pulmonary secretions |
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What is the physiological action of an Anti-tussive? |
Reduce irritability & stimulation of cough receptors above & below the pharynx |
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What is the physiological action of a Mucilaginous? |
Form protective coating over pharyngeal mucosa |
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What is the Latin binomial of Elder? |
Sambucus nigra
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What is the Latin binomial of Linden? |
Tilia platyphyllos/cordata
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What is the Latin binomial of Marshmallow? |
Althaea officinalis
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What is the Latin binomial of Mullein? |
Verbascum densiflorum/phlomoides
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What is the Latin binomial of Ivy? |
Hedera helix
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What is the Latin binomial of Butterbur? |
Petasides hybridus
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Which plant part is used in Ivy? |
Leaf |
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Which plant part is used inLinden, elder, or meadowsweet? |
Flower
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Which plant part is used inEucalyptus? |
Leaf |
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Which plant part is used inPelargonium? |
Root and/or rhizome
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What is the active constituent ofMeadowsweet? |
Flavonol glycosides
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What is the active constituent of Eucalyptus ? |
Cineol |
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What is the active constituent of Ivy? |
Saponins
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What is the active constituent ofEphedra? |
Alkaloids
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Which one of the following herbs has NOT been traditionally used to induce diaphoresis? |
Correct: Ivy
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T or F: Research on the pain-relieving efficacy of willow bark proves that virtually all of the effect is due to the salicylate content of the herb. |
False |
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Which one of the following herbs is NOT used as a source of essential oils in cough remedies and expectorants? |
Correct: Butterbur
OTHER CHOICES:
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T or F: According to our text, strong preparations of essential oils are contraindicated for use in the facial region of infants and children under 2 years of age |
True |
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Prospan is the brand name of the herbal product containing which botanical species? |
Hedera helix |
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Which plant part(s) of petasides hybridus was first used for an extract called Ze 339, developed to treat allergic rhinitis? |
leaf |
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Which herb has potential adverse effects including palpitations, elevated blood pressure, and sleeplessness? |
Ephedra |
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Which one of the following has NOT been traditionally used as a mucilaginous herb? |
Correct: Ivy OTHER CHOICES:
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Indicate which one of the clinical conditions listed that has NOT responded to treatment with ivy extract in controlled trials, according to our text. |
Correct: Respiratory infections in children INCORRECT:
***The respiratory infection study was observational, so there was no control group |
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Which two of the following botanicals can contain potentially toxic pyrrolizidines?
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Coltsfoot & Butterbur
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People are more likely to experience allergic reactions to butturbur if they are allergic to which of the following groups of plants?
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Ragweed, chrysanthemums, marigolds, and daisies
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