Quick & Dirty Herbal & OTC Agents

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  1. T/F: Herbal & OTC Agents are regulated by the FDA.
    False. Globally unregulated. German Commission E reviews herb use/safety, but the studies were small and do not meet FDA standards.
  2. T/F: Herbal and OTC Agents are considered drugs.
    False. They are considered FOOD, not drugs.
  3. T/F: Herbs are presumed hazardous until proven safe.
    • Nope-the opposite.
    • DESHA (Dietary Supplement Health and Education Act of 1994 says they are assumed safe until proven otherwise).
  4. What are the drug-drug interactions of St. John's Wort?
    • Holy St. Moly! It doubles P450 activity. (leading to faster elimination) = decreased plasma levels
    • *CCB
    • *Coumadin
    • *Digoxin
    • *Oral contraceptives
    • *Glucocorticoids

    • Serotonin Syndrome is possible with...
    • *MAOI, SSRI, TCA, nifedimine
  5. T/F: It is safe to continue St. John's Wort pre-op.
    Fasle. Stop it 5-7 days pre-op.
  6. Is black cohosh safe in pregnancy?
    • Co-to-the-NO. Contraindicated:
    • *pregnancy
    • *lactation
    • *children
  7. is echinacea safe during pregnancy?
    Who knows...
  8. Are garlic supplements safe during pregnancy?
    • No–might stimulate labor (not proven)
    • *might cause colic

    Normal/average dietary intake is ok
  9. Is ginger (for pregnancy-associated nausea) safe?
    No. Use with extreme caution; high does could theoretically stimulate the uterus and cause abortion–not adequately researched

    "there's nothing ginger about abortion"
  10. Is ginkgo safe in pregnancy?
    ginkgNO. Contraindicated:*pregnancy*lactation*children
  11. Is panax ginseng safe during pregnancy?
    Who knows (panax what??)
  12. Is glucosamine safe during pregnancy?
    • glucosaNO. Contraindicated for:
    • *pregnancy
    • *lactation
    • *shellfish allergy
  13. Is chondroitin safe during pregnancy?
    • CHONdroitin is CONtraindicated:
    • *pregnancy
    • *lactation
  14. Is melatonin safe during pregnancy?
    Who knows. Just avoid it. You're not going to be able to sleep anyway cause you'll have to get up and pee!
  15. Is St. John's Wort safe during pregnancy?
    • NO. Contraindicated for:
    • *pregnancy
    • *depression
    • *serotonin-enhancing drugs
    • *oral contraceptives
  16. Is saw palmetto safe during pregnancy?
    No. It has antiandrogenic effects.
  17. Should Echinacea be taken regularly for flu/cold prophylaxis?
    NO! It decreases immunity if taken long term, and decreases effectiveness of other meds (especially Cancer, HIV, TB drugs)
  18. What can you take to help relieve nausea and vomiting?
    Ginger root–as long as it is not r/t opioids, and as long as you are not pregnant (uterus stimulation/abortion)

    • Then what CAN I take it for?
    • post op N/V, motion sickness, cancer N/V
  19. I have BPH. Is there an herbal/OTC that can help?
    • Yes. Saw Palmetto is a mild diuretic that cuts down on frequency and pain.
    • Hmmm....how to remember this...
    • Image UploadImage Upload
  20. Is Saw Palmetto well-tolerated?
    Yep. Recommended by urologists even.
  21. I want to prevent osteoarthritis. What herbal/OTC can help?
    Glucosamine/chondroitin sulfate increases cartilage formation, increases elasticity, and might be anti-inflammatory. 

    It is well-tolerated also.
  22. I am on Coumadin. Any special info I need to know about OTC/Herbal agents?
    4G's...garlic, ginkgo, ginseng, ginger
Card Set:
Quick & Dirty Herbal & OTC Agents
2013-05-03 22:01:24
NU 420 Pharmacology Boston College

Pharm Exam 3.
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