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Herbal Drugs
IL- Dr. Chen Block 5
22
Pharmacology
Professional
02/18/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
how are herbal medications marketed in the US?
Definition

They are marketed without FDA or other governmental premarketing review of efficacy or safety

 

There is also little governmental oversight of purity, variations in potency, or adverse effects

Term
alternative medicine
Definition
treatments that are not recognized by the medical community as standard or conventional medical approaches
Term
controlled clinical trial
Definition
a clinical trial that compares a group of subjects who are receiving a treatment with a closely matched group of individuals who are not receiving a treatment
Term
herbal medication
Definition
plants or plant extracts that people use to improve their health
Term
nutritional supplement
Definition
a substance that is added to the diet to improve health and which usually containes dietary ingredients such as vitamins, minerals, amino acids, and enzymes
Term
placebo
Definition
an inactive medication made to resemble the investigational formulation as much as possible
Term
echinacea
Definition

use:decrease duration and intensity of cold symptoms

 

nature: leaves and roots - contains flavonoids, polyacetylenes, and caffeoyl conjugates

 

Pharmacology: has cytokine activation and anti-inflammatory properties

 

Tox.: unpleasant taste and GI effects

- some dizziness or headache

- no drug interactions reported

Term
ephedra (ma huang)
Definition

use: treatment of respiratory ailments such as bronchitis and asthma, and as a CNS stimulant

 

nature:  major chemical constituents = ephedrine (which is Rx drug) and pseudoephedrine (which is OTC decongestants); The FDA has banned marketing of dietary supplements containing ephedrine alkaloids (they pose cardiovascular risk); The ban not applied to Chinese herbal remedies

 

Pharmacology: indirect-acting sympathomimetics that release norepinephrine from sympathetic nerve endings

- ephedrine is a pressor agent

- commonly used for treatment of respiratory dysfunction, including bronchitis and asthma, and a s mild CNS stimulants

- In Chinese medicine, used for cold and flu sx, diuresis, and bone or joint pain

- ephedirine alkaloids = weight loss and enhancement of althletic performance

 

Toxicity: dizziness, insomina, anorexia, flushing, palpitations, tachycardia, and urinary retention

- in high doses = ↑ BP, cardiac arrhythmias, and toxic psychosis

 

Term
garlic
Definition

use: cholesterol lowering and atherosclerosis


Nature: contains organic thiosulfinates that can form allicin (this is the ODOR)

 

Pharmacology: - allicin inhibits hepatic hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase and angotensin-converting enzyme (ACE), blocks plately aggregation, increases nitric oxide (NO), in fibrinolytic, has antimicrobial activity, and reduces carinogen activation

- some evidence that it is more effective at lowering total cholestrol

 

toxicity: nausea, hypotension, and allergic reactions may occur

- antiplatelet action - so watch patients on anticoags or anti antiplatelets

Term
ginkgo
Definition

use: treatment of intermittent claudication, and cerebral insufficiency and dementia

 

nature: leaves = flavone glycosides and terpenoids

 

pharmacology: -anti-oxidant and radical scavenging effects and increases nitric oxide formation

- animal studies: blood viscosity and changes in CNS neurotransmitters

- may reduce markers of oxidative stress associated with coronary artery bypass surgery

 

toxicity: GI effects, anxiety, insomina, and headache occur

- possible antiplatelet action, so monitor pts on anticoags or antiplatelet druggs

- maybe epileptogenic - don't give to those with seizure hx

Term
ginseng
Definition

use: improvement of physical and mental performance

 

nature: plants = triterpenoid saponin glycosides (except the Siberian or Brazilian plants)


pharm.: - COLD prevention and lowering postprandial glucose

 

toxicity: estrogenic effects = mastalgia and vaginal bleeding

- insomina, nervousness, hypertension

- use with CAUTION in pts receiving anticoags, antihypertensives, hypoglycemic meds, and psych meds

Term
milk thistle
Definition

use: limitation of hepatic injury and as an antidote to Amanita mushroom poisoning

 

nature: fruit and seeds = contain flavonolignans such as silymarin

 

pharm.: in vitro studies = reduces lipid peroxidation, scavenges free radicals, enhances superoxide dismutase, inhibits formation of leukotrienes, and icnreases heptocyte RNA polymease activity

 

Tox: loose stools

Term
St. John's Wort
Definition

use: treatment of mild to moderate depression

 

Nature: dried flowers = hypericin and hyperforin

 

Pharm. Hyperforin = decreased activity of serotonergic reuptake systems

- downregulation of adrenoceptors and upregulations of 5-HT receptors

- hypericin, when photoactivated, may have antiviral and anticancer effects

 

Tox.: mild GI effects and photosensization

- avoid in pts taking selective serotonin reuptake inhibitors or MAO inhibitors and those with history of bipolar or psychotic disorder

- formation of P450 isoforms and P-glycoprotein drug transporters

- it decreases the effectiveness of:

* birth control pills

* cyclosporine

*digoxin

*HIV protease inhibitors

*warfarin

Term
Saw palmetto
Definition

use: improvement in sx of benign prostatic hyperplasia

 

nature: dervied from berries = contains phytosterols, aliphatic alcohols, polyprenes, and flavonoids

 

pharm: inhibition of 5alpha-reductase

 

tox: abdominal pain with GI distress, decreased libido, headache, and htn; no effect on PSA

Term
Coenzyme Q10
Definition

use: improvement of ischemic heart disease and for Parkinson's disease

 

nature: ubiquinone = benzoquinone; serves as cofactor in the mitochondrial electron transport chain --> reduced to ubiquinol (an important antioxidant)

 

pharm: small degree of efficacy in reducing systolic and diastolic blood pressure and in treating coronary artery disease and chronic stable angina

- may have some efficacy in reducing muscle pain in patients with statin-related myopathy

 

tox: GI distrubances; rare effects include rash, thrombocytopenia, irritability, dizziness, and headache

- structural similarity to vitamin K and decrease the effects of warfarin

Term
Glucosamine
Definition

use: reduction of pain associated with osteoarthritis

 

nature: amino sugar that serves as the precursor of nitrogen-containing sugars (major constituent of CT, including the carilage in joints)

 

pharm: trials = mixed results

 

toxicity: occasionally cause diarrhea and nausea but otherwise is well tolerated

- it is prepared from crustaceans, there is some concern about cross-allergenicity in people with shellfish allergy

Term
Melatonin
Definition

use: decrease jet lag symptoms and a sleep aid

 

nature: a serotonin derivative produced in pineal gland - regulates sleep wake cycles;

- other purported activities include contraception, prevention of aging, protection against oxidative stress, and the treatment of cancer, major depression, and HIV infection

 

pharm: FDA approved for insomnia

 

tox: sedation and next-day drowsiness and headache

- can suppress the midcycle susrge of luteinizing hormone (LH)

- DO NOT USE IN PREGNANCY or women attempting to conceive

- decrease prolactin levels = should not be used by nursing mothers

- can decrease sperm levels in healthy men

Term
which drug protects against hepatic dysfunction?
Definition
milk thistle
Term
which endogenous antioxidant reduces statin-induced myopathy?
Definition
Coenzyme Q10
Term
Treatment of BPH?
Definition
Saw palmetto
Term
Derivative of serotonin that may help in treating jet lag?
Definition
melatonin
Term
enhances immune function in vitro and used to treat sx of common cold?
Definition
Echinacea
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