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55 Cards in this Set

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St. Johns Wort: use
Depression
St. Johns Wort: SE
GI
dizziness
fatigue
dry mouth
restlessness
headache
phototoxicity may occur
St. Johns Wort: Drug Interactions
CYP3A: cyclosporin, indinavir, theophylline, digoxin
SSRIs
What happens when St. Johns Wort is given with SSRIs
Mental status changes
tremor
GI upset
restlessness
St. Johns Wort: metabolism
induces CYP3A and P-glycoprotein
Ephedra: Use
energy, stimulant, weight loss
Ephedra: preparation
Mormon tea
decoctions from stems
capsules from dried whole plant or plant extracts
Ephedra: contents
primary alkaloid = ephedrine
also contains pseudoephedrine, phenylpropanolamine
Ephedrine mechanism
a,b agonist --> NE release --> hypertension, cardiac arrhtymias, CNS stim
Ephedra: SE
Cardio
CNS
death
Ephedra: Drug Interactions
Caffeine --> inc cardio and CNS toxicity
MAOI
Echinacea: Use
Immune stimulant
early tx of URI in adults (no evidence of prevention)
Echinacea: mechanims
stimulates phagocytosis, inc leukocyte mobility, inc cellular respiration
Echinacea: SE
hypersensitivity rxns
Echinacea: Drug interactions
inhibits CYP3A
Gingko biloba: use
Improve blood flow to brain and peripheral circulation. Promoted as memory enhancer
Gingko biloba: active ingredients
flavonoids
terpene lactones
Gingko biloba: mechanism
1. antioxidant
2. blocks 5HT3 receptors
3. inc blood flow
4. inhibits PAF
Gingko biloba: SE
bleeding
toxicity with OD (loss of consciousness, tonic/clonic seizures, death)
Gingko biloba: Drug Interactions
drugs that affect platelet function or PTT:
NSAIDS
aspirin
warfarin
clopiodogrel
Panax Ginseng: Use
improve cognitive f(x) physical performance
lowered glucose & dec glycosylated hb levels in diabetics
Panax Ginseng: marketed uses
1. stimulate physically & mentally
2. incr resistance to stresses
3. aphrodisiac
4. tx for weakness
5. atherosclerosis
6. bleeding
7. colitis
8. cancer
Panax Ginseng: SE
HTN
euphoria
restless/nervous/insomnia
edema
diarrhea
vaginal bleeding
Panax Ginseng: Drug interactions
warfarin (subtherapeutic response)
phenelzine (manic)
Feverfew: use
migranes (evidence)
arthritis
fever
menstrual problems
dermatitis
asthma
Feverfew: mechanism
Inhibits PGI synthesis, platelet serotonin release, platelet aggregation
Feverfew: SE
gastric discomfort
oral mucosal ulceration
tachycardia
rebound myalgia
migrane
Feverfew: drug interactions
anticoags
antiplatelets
Feverfew: contraindications
pregnancy (causes uterine contraction)
Ginger: uses
nausea d/t motion sickness and morning sickness
Ginger: mechanism
In vitro suggests inhibits thromboxane, PGI production and ginger extract
Ginger: SE
minor heartburn
Ginger: drug interactions
anticoags
antiplatelet
Garlic: use
dec cholesterol (evidence)
lower BP
antiplatelet
antifungal
anti-inflammatory
Ginger: mechanism
inhibits platelet function (inhib thromboxane synthesis)
inhib HMG-CoA
Ginger: SE
heartburn
flatulence
sweating
lightheadedness
allergic rxns
menorrhagia
Saw Palmetto: use
BPH
Saw Palmetto: mechanism
antiandrogen effects
Saw Palmetto: SE
milder than finasteride
GI
Valerian: Use
insomnia (evidence suggests sedative effect)
Valerian: mechanism
GABA
Valerian: SE
headache
hangover
excitability
insomnia/uneasiness
ataxia
hypothermia
hallucinations
Valerian: Drug interactions
None, but may potentiate other CNS depressants
Melatonin: use
jet lag and problems falling asleep (conflicting evidence)
Melatonin: source
synthetic or
derived from bovine pineal gland
Melatonin: mechanism
produced and secreted by pineal during dark, secretion turned off by bright light.
free radical scavenger
Melatonin: SE
headache
psychosis
somnolence
GI
allergic rxns
cardio
CNS
Melatonin: drug interactions
enhanced by fluvoxamine
blocks anti-HTN effect of nifedipine
caution w/ CCB
what % of adults use natural products
25%
what's the #1 reason for use of natural products
therapy combined w/ conventional medical treatments would help
glucosamine/chondroitin: use
joint pain
glucosamine/chondroitin: mechanism
G stims GAG production
chondroitin sulfate inhibits GAG breakdown
glucosamine/chondroitin: SE
upset stomach
potential for cross-contamination w/ shellfish protein (caution for allergies)
hepatotoxic plants (4)
chaparral
germander
kava
life root
carcinogenic plants (6)
borage
coltsfoot
comfrey
life root
sasafras
calamus