Mild sedative effects

beware rxn to ragweed

contains coumarin, incr. warfarin effects

inhibits 3A4

From the purple cone flower

Immune system booster

use > 8 weeks causes liver damage when used with MTX, amio, ketoconazole, anabolic steroids, and APAP

May counter effects of immune suppressants (steroids, calcineurin inhibs, anti-prolifs) so don't use

used for migraines and muscle aches

inhibits platelet agg, PGs, TXA, Leukotrienes (by phospholipase A2)

beware ragweed/chamomile allergies

CI in pregnancy

use caution with warfarin, heparins, and anti-platelets

Antispasmodic, antiseptic, poass antiviral, decr. BP, and decr. cholesterol

contalins alliin that must be activated by crushing/chopping

usually in oil filled capsules but unstable in oil so little effectiveness

antiplatelet, can incr. warfarin effects

nausea/stomach upset

shogaol and gingerol stim gastric secretions and peristalsis

antiplatelet, incr. effects of warfarin so avoid

memory enhancer

flavoglycosides are free radicals and incr. cerebral blood flow

antiplatelet so caution with warfarin, heparins, and anti-platelets

inhibitor of 2C9, and lesser 1A2, 2E1, and 3A4

mood elevator, energy enhancer

ginsenosides similar to steroid hormones

AE's include stevens-johnson, vaginal bleeding, breast tenderness, hypotension, prolong QTc, hyperglycemia

incr./decr. effects of warfarin (3A4), incr. bleeding with NSAIDs, ASA, and antiplatelets,

incr. tremors/nervousness with Nardil/Parnate

OA relief

glucosamine:

modified sugar molecule

stim. cell growth and inhibits inflammation

derived from shells of crab/lobster/shrimp

(beware tropomyosin allergy)

caution with diabetics (loss of glycemic control)

chondroitin:

proteoglycan structure

elasticity/resilience in cartilage

extracted from cartilage of shark/cattle trachea

structure similar to heparin, caution with anticoags

anxiety/depression/sleep disorders

similar to Elavil

3A4 inducer so many interxns:

cyclosporine/tacrolimus/sirolimus levels decr. so some acute rejection

protease inhibitors (indinavir/nelfinavir/amprenavir/saquinavir) conc. decr. by 50% leading to tx failure

breakthrough bleeding with OC's and induces metabolism leading to tx failure

pgp inducer with dig and can decr. conc. by 25%

5-HT syndrome with MAOIs, TCAs, and SSRIs, also the triptans and ergot alkaloids

photosensitive, incr. risk of burn when taken with tetra, NSAIDs, diuretics, and amio

sleep aids

incr. risk for CNS depression when used with alcohol and barbs

kava kava can cause hepatotoxicity

CNS stimulants

cardiac stimulant (incr. BP/HR)

stim. uterine contractions

peripheral vasculature constriction

many AEs:

cardiac include tachyarrhythmias, HTN, cardiac arrest, MI, and sudden death

CNS include TIA, stroke, and seizure

liver protectant

silymarin/silybin active ingreds

inhibits 3A4 (0.1 mM up to 50%, 0.25 mM up to 100%)

antiarrhythmic at high doses

tx of menopausal sx

contain small amount of salicylic acid so beware ASA allergy

CI if estrogen-dep tumor or endometrial cancer

antiplatelet

anti-inflammatory

salicin converted to salicylic acid in GIT so beware ASA allergy

angina, HTN, HF

vasodilator and cardiotonic (inotropic)

caution with CV agents

incr. risk for orthostatic hypotension in elderly